Conducted at only intervention ADDOs, the mystery client visits were conducted six months following the intervention launch. Mystery client actors trained by the study team visited the shop and engaged in a guided interaction using a semi-structed script for seeking HIV self-test kits (HIVST) and contraceptive products. The actors visited the same shop with a maximum of two interactions per shop and four shops per ward. Based on previous studies to address provider biases and youth friendliness, we used two actor profiles: 1) AGYW, and 2) female >30 years. Using a survey on a tablet, actors answered questions administered by HPON staff immediately after the visit about:
- If Malkia Klabu was offered
- If so, how it was presented, including ‘rules,’ if HIVST was offered as a free, opt-out gift, and if the symbol card was explained
- If the request for contraception was honored and the girl received contraception following interaction
- If products were appropriately given for free
- If the product discount requested (for yeast infection cream or anthro) was granted as part of the pro sociality portion of interaction
- Overall ‘youth-friendliness’
The primary outcome of mystery client visits was to test the intervention fidelity of the AmbassADDOrs for Health Study, to see whether ADDO dispensers are introducing the program intervention, Malkia Klabu, to AGYW in the Shinyanga region (the Mwanza region to follow). The secondary outcome of the visits was testing the user-friendliness of the ADDO shops.
The results of the Shinyanga Mystery Client visits are forthcoming.