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It is well-established that men in the Southern African region are less likely than women to access HIV, STI, TB and NCD testing and treatment within traditional clinic-based services, resulting in increased morbidity and mortality compared with women, and increased transmission of communicable diseases such as HIV, TB and STIs. Providing services in a way that is responsive to men’s health needs has the potential to substantially increase men’s access to treatment and preventative health services.

The consortium will conduct interrelated research studies to demonstrate how health systems in urbanised areas can be strengthened to deliver comprehensive health services including for HIV, STI, TB and NCD for men. We will do this by implementing and evaluating a co-developed community-based delivery of services to men, in a large, high-density urban community in Lusaka, Zambia. The intervention aims to achieve universal coverage of these services among men by complementing existing primary health service delivery through public facilities.

The implementation of the Yaba Guy Che intervention will be for 24 months during which the response to the intervention will be monitored and reviewed. The plausible impact of the intervention in reaching men with services will be evaluated through a before and after study design which will measure the difference in coverage before and after implementation using time-location sampling surveys and estimate costs of implementation.

Objectives

1. Co-develop an integrated, digitally supported care pathway (“Yaba Guy Che”) with men, community members, healthcare workers and policy-makers.
2. Deliver the Yaba Guy Che intervention and assess adoption, reach, fidelity, sustainability and scalability.
3. Create a men’s peer monitoring group to strengthen community health system accountability and document how men experience the Yaba Guy Che intervention.
4. Estimate the plausible impact of the Yaba Guy Che intervention on coverage of HIV and NCD services.
5. Measure the effect of the intervention across the six building blocks of the health system and assess the cost and economies of scope of implementing Yaba Guy Che to inform scalability and sustainability.