Including Males: Improving Sexual and Reproductive Health for Female Adolescents
AbstractDespite decades of public health interventions and research in sub-Saharan Africa, the prevalence of teenage pregnancy, early marriage, HIV and other sexually transmitted infections (STIs) in this population remain among the highest in the world. Moreover, 30 percent of ever-partnered adolescents aged 15 to 24 report intimate partner violence in the last 12 months (Stockl et al. 2014). Traditional family planning and sexual and reproductive health programs focus on married adults often leaving adolescents out. In addition, many of these programs target females even though males are an integral component of partner dynamics that lead to adverse female sexual and reproductive health outcomes.
We implement a randomized controlled trial (RCT) that targets adolescents in Tanzania to better understand which types of interventions best improve sexual and reproductive health (SRH) and intimate partner violence (IPV) outcomes for adolescent females. We also focus on including males in the intervention. We partner with BRAC, a large NGO in Tanzania, which runs a network of 150 adolescent girl clubs called Empowerment and Livelihoods of Adolescents (ELA). These clubs offer information on sexuality, menstruation, teenage pregnancy, negotiating relationships with the opposite sex, HIV/AIDS, etc. and fundamentally aim to empower adolescents to make better long-term decisions.
The control group will be ELA. We layer two additional treatment arms onto ELA and randomly assign the 150 clubs to each of the three arms.
(1) Demand side, ELA Continue operating business-as-usual which is ELA
(2) Supply side, ELA+MST: Continue ELA programming plus have bi-monthly visits from nurses who provided family planning contraceptives; and
(3) Male demand side, ELA+MST+GRS: Receive all programming previously described in (2) plus invite boys from the social networks of the girls to participate in SRH and life skills intervention that is delivered through weekly soccer clubs.