Yaba Guy Che (For the men): Implementation and evaluation of a co-developed multi-disease intervention for men to overcome health systems barriers

In Sub-Saharan countries such as Zambia men experience barriers to accessing health services including time and travel to health facilities, competing work commitments and in some cases social stigma around men seeking support. 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. This is important because men experience increased morbidity and mortality compared with women, and increased transmission of communicable diseases such as HIV, Sexually Transmitted Infections (STIs) and Tuberculosis (TB).

Over five years (2025-30) this consortium of medical, social science and community researchers will conduct interrelated studies to demonstrate how health systems in urbanised areas can be strengthened to deliver comprehensive health services for men, including for HIV/STI/TB and Non-Communicable Diseases (NCD). We will do this by implementing and evaluating co-developed, community-digital service called ‘Yaba Guy Che – For the Men’ in a large, high-density urban community in Lusaka, Zambia.

The intervention design includes co-developed hubs and outreach locations which will bring healthcare closer to men. The hubs will be developed and promoted via continuous community engagement including Community Advisory Board meetings, Peer Monitoring and a Peer Network of men’s discussion groups.

In the hubs men will benefit from point of care tests and supported self-testing and sampling. For HIV and STI self-testing and sampling they can also access test kits via digital vending machines located in the community. Mobile phones will be integrated into the care pathway, including both SMS, web application and smartphone services to support men who use phones to access results and health information. These community-digital services will join up with and complement existing primary health service delivery through public facilities.

The project aims to create new knowledge on how to improve access to health services for men and build local capability in community-digital service development focusing on sharing knowledge of the specific community, healthcare provider and digital capabilities that work in this context. The project will also work closely with the Ministry of Health in Zambia to ensure project deliverables align with and where possible, contribute to Zambia’s existing policy programmes in digital and public health.

The project builds on a range of previous research and specialism in community-based co-design and engagement led by our Zambian public health research partner Zambart and by University of Brighton, and research on HIV testing and treatment by London School of Hygiene and Tropical Medicine and Institute of Tropical Medicine, Antwerp. It also builds on prior successful digital innovation research into digital vending machines and digital care pathways conducted in the UK and Europe, led by University of Brighton, Brighton and Sussex Medical School and University Hospitals Sussex NHS Foundation Trust.