Research on adolescent sexual and reproductive health (SRH) in sub-Saharan Africa is heavily focused on preventing unintended pregnancies and preventing HIV infection. However, very little of this work focuses on, and actively targets, boys and young men. Gender-transformative approaches, or approaches that seek to shift gender norms and power relations, have been hailed as one way to disrupt underlying factors that can lead to poor health outcomes and drive HIV infection and adolescent pregnancy. Applying a gender-transformative approach in South Africa and Lesotho, across two low-resource settings with very high rates of both HIV and adolescent pregnancy, our research aims to meet an urgent need for localised solutions and do so in an innovative and inclusive way. The aim of this study is to address the evidence gap by adapting the If I Were Jack programme for use in South Africa and Lesotho, under the name If I Were Thabo. The original programme, developed in the UK, is a group-based intervention delivered to adolescents in educational settings, which includes a culturally sensitive interactive film about an adolescent who discovers that his girlfriend is unexpectedly pregnant, and a guided discussion about how participants would feel and react in his position. The programme is accompanied by educational materials and sessions for adolescents' caregivers, and has been shown to be acceptable and cost-effective in its current form. We propose to adapt the programme in two LMICs, South Africa and Lesotho, in partnership with adolescents, parents, teachers, community members and local experts. We will target adolescents aged 13-14, an age range where there is still potential to prevent sexual risk-taking before the majority of adolescents are sexually active, and before the increase in pregnancy and STIs reported in later adolescence. To develop and test the intervention, the proposed study will involve two phases. First, we will work with adolescents, their parents and caregivers, teachers, health professionals and other key community members to adapt and optimise the programme materials from the UK for use in South Africa and Lesotho. This will involve co-producing locally relevant and appropriate intervention materials in each site. Adolescents will work with researchers and filmmakers to write, cast and develop new films in each site, and advise on the acceptability of text-based material, and their caregivers will be consulted on caregiver-targeted information. Teachers, community group facilitators and healthcare professionals will provide feedback on materials designed for programme facilitators. In addition, we will ask adolescents and their caregivers to give feedback on some of the research tools that will be used in the next phase. Next, we will run a pilot of the programme within a feasibility cluster randomised trial to assess if the intervention implementation and evaluation design is feasible in both countries. As a part of this phase we will survey adolescents in schools and community groups, half of whom will be randomly chosen to receive the intervention and the other half of whom will continue with 'normal practice'. We will assess whether the questionnaires capture the necessary information on SRH outcomes for this group, including intentions relating to adolescent pregnancy, and HIV and STI infection. We will also evaluate whether the processes needed to implement the programme work well. After programme completion, we will interview adolescents and other stakeholders about their opinions of the programme and whether it is feasible to deliver in schools and community groups, and what will hinder or help the implementation in the two settings. Based on these results, we will decide if it will be feasible to do a larger trial of the intervention in both sites to see if the programme is effective in improving SRH for adolescents in these countries.

The project involves two interrelated approaches: a) organising networking events and other in-depth stakeholder engagements to build an active research consortium of academics and practitioners focused on combating violence against women; and b) facilitating the co-creation of problem-solving digital innovations to be implemented and studied in a further phase of the project (post-October 2020). a) The networking events and stakeholder engagements with 10 network partners (NGOs and tech companies) will explore 4 interrelated dimensions: - Understanding women's rights in a digital context: By means of inclusive stakeholder dialogues taking place at a Roundtable and a Public Forum, we will explore how women's rights are constructed in online spaces and collective movements in South Africa and elsewhere, in order to identify the tacit roots of discrimination and victimization, and to understand how these may be reproduced, but could also be addressed, in digital settings. - Access: Through focus groups, we will identify the primary local barriers to access that undermines the agency of women in realising their rights and protecting themselves against violence and intimidation. We aim to understand both practical impediments like access to electricity, affordable data and instruments, as well as the more tacit cultural, social and individual factors that could undermine active participation in digital spaces. - Participation: The potential of digital platforms to enable easier access to government services, especially around healthcare and justice, can play an important role in upholding women's rights, protecting them against violence and intimidation, and offering avenues for recourse and support. We will explore how the participation of women in relevant policy platforms could be strengthened and streamlined, as well as what government and corporate policy changes may be needed to protect women's rights and voices online. - Speak-out & Action: Studying the ways in which women communicate in digital spaces will allow us to identify the factors that make women feel safe, supported and empowered to speak out against violence and discrimination. The Affect Lab brings detailed expertise on participation in online chat forums, and one of their post-doctoral researchers will study engagements on a specific forum focused on violence against women that will be created within the Values Chat APP, a mobile tool which was designed and launched in a previous round of funding. b) Our engagements with our business and NGO partners will go beyond networking events towards the co-creation of potential digital innovations. The goal would be to understand these organisations' current business models, services and approaches to digitalization. This will ensure that we do not reinvent the wheel, but rather productively build on lessons learnt and leverage these insights to co-create specific pilot projects that could be funded in further phases of the DIDA grant-cycle. For instance, working with Wiconnect will allow us to understand the complex relationship between access to electricity, data and education and explore the potential impact of strengthening women's access to and productive use of digital innovations. By studying Saya-Setona's activities, women's current participation as digital citizens will be explored in order to identify specific factors that could enhance government communication and women's access to government services. We will also work with Praekelt.com, who delivers digital community projects through its sister organisation, Praekelt.org, as well as with OpenUp, which is a civic tech organisation in South Africa focused on open data for active citizenry. By studying their successful digital interventions, particularly those targeted at women, we hope to gain insight into how digital participation can be scaled and supported, and which future interventions would best address the problem of violence against women.