Overview

Gem Hub Initiative under the Gender Equality Fund model in Rivers State implements the HER360ACCESS Project. This is a comprehensive intervention designed to improve the health, wellbeing, and life outcomes of Adolescent Girls and Young Women (AGYW).

The project is aimed at equipping AGYW from underserved communities in Rivers State with leadership and advocacy skills as well as to ensure the quality delivery of integrated and youth friendly health services within the PHCs and general hospitals in the communities. It is currently being implemented in 3 LGAs in Rivers State; Degema-Usokun, Oyibo and Okrika, promoting awareness on Malaria, HIV, TB and the sexual reproductive health and rights of the AGYW in these communities.

The Approach

The project adequately mapped and engaged stakeholders, partnering with state MDAs, working with and through their systems for sustainability; training of AGYW to build their leadership and advocacy skills as well as their agency; facility assessments with the AGYW to identify gaps in access; advocacy strategies that targets decision and change makers at the state and local and community levels.

Stakeholder & Government Engagement

This is a key pillar of the project; an intentional collaboration with government structures to drive sustainability. Collaborating with Rivers State Ministry of Health, Rivers State Primary Health Care Management Board, Rivers State Contributory Health Protection Program(RivCHPP), and River State Agency for the Control of HIV/AIDS. This guaranteed

• Our active participation in Adolescent Health Technical Working Group (TWG) meetings and engagements with the AGYW on our program.
• Alignment with state priorities and national guidelines on adolescent health and Universal Health Coverage (UHC).
• A pool of trained health care workers who can confidently deliver youth friendly health care services through training the trainers approach. - Other facility staff acquired the knowledge through step down training.

Facility Assessment and AGYW Survey

Our team and AGYW adapted the TCI youth friendly facility assessment tool in conducting an assessment on the 4 facilities across the LGAs of focus to learn of their best practices and possible barriers to access. The team went further to conduct a survey amongst adolescent girls and young women the LGAs to understand their perception of the primary health care facilities. The result shows that some known barriers (for decades) are still persistent at the facilities. While some have best practices; some are still lagging behind. AGYW’s confidence in the use of government owned facilities is somewhat weak. Gaps identified were taken to clearly mapped out decisions and changemakers to ensure they fill up the gaps.

Community-Led Advocacy (WDC Engagements)

The project leverages the Ward Development Committees (WDCs) as grassroots structures for change. The team paid advocacy visits to the WDCs in 4 communities to 

• Inform them on the need for quality youth-friendly health services to be rendered at the facilities.
• Advocate for improved access to health care facilities; they should play key roles in removing barriers. For example, in one of the facilities, the road is very bad; WDC was urged to talk to the decision makers in their community or at the LGA or State to fix it.
• Take ownership of adolescent health issues, by promoting available, conducive, judgement-free, and quality adolescent-youth- friendly health services.

Direct Engagement with AGYW

HER360ACCESS places AGYW at the center through focused group meetings and interactive sessions. We create safe spaces for discussions on:

• HIV, TB, and Malaria - prevention, testing and treatment.
• Sexual and reproductive health (SRHR)
• Gender-based violence (GBV)
• Mental health and wellbeing

These engagements empower girls to:

• Ask questions freely
• Build confidence
• Make informed decisions about their health and future.

Community Ambassador Model

• The project identifServe as peer educators and mobilizers
• Drive awareness within their communities
• Act as a bridge between young people and available services.

Medical Outreach

HER360ACCESS translates the talk into action through well-thought-out medical outreaches that drive uptake of facility-based services by AGYW. This was done by ensuring the community is mobilized to assemble at the facility for the outreach interventions. The outreaches included:

• Provision of Malaria-HIV-TB testing, screening, treatment, and referrals to both AGYW and other members of the communities.
• Free medical consultation and counselling for about 200 AGYW; including STI screening and referral.
• Fostered relationship between AGYW  and the facility staff, thereby bridging gaps and making it easier for AGYW to go to the facilities.
• Distribution of essential commodities like sanitary pads, and educational materials.

Success recorded was as a result of collaboration with government agencies, medical doctors, development partners and CSOs.

Community Health Insurance Drive

Recognizing that cost is a major barrier for AGYW, the team took a step further to:

• Pay advocacy visit to RivCHPP to expand the vulnerability index to include AGYW or at least reduce the annual premium which was N15,000 in 2025 and now N25,000 in 2026.
• Support the enrollment of seven (7) selected adolescent girls into the health insurance scheme in the state .
• Involve RivCHPP at the medical outreaches in all the communities to drive uptake of insurance. RivCHPP recorded a good turnout, beyond the AGYW, other community members came out to enrol.

This intervention:

• Promotes sustained access to healthcare.
• Reduces out-of-pocket expenses.
• Introduces young people and other community members to formal health systems.

The Reach

• The project currently directly engages 50 AGYW across the 3 LGAs.
• Reached about 200 AGYW during the medical outreach with robust intervention. 
• Reached about 13,000 adolescents on social media platforms with information on SRH, HIV, TB and malaria.
• Reached about 50 community gatekeepers through advocacy.
• Reached 5 Government agencies with advocacy in improving adolescent health programming, funding and service delivery in the state.

The Outcome

The project is still ongoing, however we have started seeing some results. More AGYW are now:

• Accessing health information, and medical services at the facilities.
• Captured under the state health insurance coverage; ensuring continued access, including  other community members.
• Showing better understanding of SRHR 
• Showing increased confidence in seeking care.
• Serving as community ambassadors who are peer educators and influencers; driving conversations within their networks and in the communities - recording gradual behavioural change.

AGYW Policy and System Influence

Beyond the outcomes listed above, the team has also influenced Policy and Systems through participation of AGYW in TWGs and advocacies. This has led to: 

• Increased attention to the quest for  youth-friendly services being rendered not only at the primary health facilities  but at the General Hospitals as well.
• Strengthened dialogue on the need for affordability and accessibility of health care in the communities, especially for AGYW.
• Contribution to broader state-level adolescent health strategies. 

 Conclusion

The HER360ACCESS Project stands out as a holistic and systems-driven intervention that goes beyond traditional outreach models.

By combining:

• Government and Partners engagement
• Government and Community advocacy
• Youth empowerment
• Health insurance

Gem Hub is not only addressing immediate health needs but also building sustainable pathways for adolescent girls and young women to thrive.

HER360ACCESS is ultimately creating a model where health access, community ownership, and youth empowerment intersect to lay the foundation for long-term impact in Rivers State.