In the heart of an urban neighborhood in the Mwanza region of Tanzania, 25-year-old Mary Valeria was once intertwined with a gang that offered her a sense of belonging. Mary wanted to find a new path for her future, however, so she joined the DREAMS program, a comprehensive initiative focused on empowering young women to lead healthy and productive lives.
With support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC), ICAP in Tanzania provides adolescent girls and young women (AGYW) in the DREAMS program with economic strengthening and income-generating opportunities, mentorship, and coaching. The DREAMS program also facilitates training on behavior change communication, which focuses on safe sex practices, and the provision of HIV testing, condoms, family planning, and pre-exposure prophylaxis (PrEP).
DREAMS implementation in the Nyamagana district of Mwanza, where Mary lives, launched in February 2021. In just over a year, the program enrolled 15,714 AGYW. Around the same time, ICAP also implemented in the Nyamagana district the Families Matter! Program (FMP), a positive-parenting intervention that reaches parents and caregivers with children ages 15-19 through a seven-week curriculum focused on strengthening parent-child communication and creating safe spaces for children to discuss sexuality, gender-based violence, and sexual reproductive health, among other topics.
“The combined implementation of DREAMS and FMP has helped many young women like Mary and has increased access to HIV prevention education, HIV testing, peer support, biomedical services, skills-building, and economic opportunity,” said Haruka Maruyama, MPH, country director for ICAP in Tanzania. “These efforts have transformed their lives, helping young women attain their full potential while reducing risky practices that may increase acquisition of HIV.”
From April to June 2023, 1,534 adolescent girls and young women were tested for HIV and 240 initiated PrEP through the DREAMS program.
At a typical DREAMS meeting, members meet at a mutually selected safe space in the community, such as a church or a school, to receive mentoring from ICAP on sexual and reproductive health and economic strengthening practices. During the economic strengthening sessions, members receive education on financial literacy, savings and loans, business development, and entrepreneurship. Those interested in entrepreneurship propose business plans, and through these sessions, receive support in carrying out the plans with mentorship and coaching by ICAP. Many DREAMS members engage in what’s called WORTH+ packages, which provide opportunities for financial independence through savings and loans. From April to June 2023, adolescent girls and young women saved a total of $8,300 and received $5,000 in loans through the program.
Prior to joining the DREAMS program, Mary did not have access to a reliable source of income, which resulted in her engagement in transactional sex. Through DREAMS, Mary joined life skills workshops, where she learned about developing business plans, savings, market identification, job readiness, and entrepreneurship. Gaining new confidence, Mary started her own small business at a mini-shop selling a variety of food, soft drinks, and grains.
Mary was even inspired to tell her own story to other women going through similar challenges. After undergoing mentorship training, where she learned how to effectively communicate with, guide, and support other young women on their journeys, Mary became a DREAMS mentor. She began leading some of the very DREAMS meetings she once attended.
“I feel empowered,” said Mary, about her experience in the DREAMS program. “I hope to help other girls going through similar situations to take charge and control of their lives. I am confident, I can now contribute to my sibling’s education costs, and I support my family.”
As months turned into years, Mary’s influence began to ripple through her community. After receiving mentorship and coaching, the young women she mentored grew in confidence, pursued educational opportunities and vocational training, and started their own businesses. Some sewed their own products, like laptop bags and shopping bags, while others churned their own peanut butter, developed homemade soap, and began tailoring clothing, among other business activities.
Mary’s impact extended even beyond her mentees. With support from ICAP, she collaborated with local organizations and schools to raise awareness about the importance of providing opportunities for young women to break free from cycles of violence and poverty.
“Through the DREAMS program, we aim to address the underlying factors that increase adolescent girls’ and young women’s vulnerability to HIV by improving access to health services,” said Neema Gwido, assistant AIDS control coordinator and DREAMS focal person of the Nyamagana district, “equipping young girls with skills and knowledge to improve their lives. It has been a great success to see adolescent girls and young women start their own businesses; these income-generating activities have helped them support basic needs and support their families.”
“My life has turned for the better,” Mary said. “DREAMS has empowered me, and I want to change other girls’ life stories into success stories like mine.”
A major global health organization that has been improving public health in countries around the world for two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 40 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at icap.columbia.edu