Digital Commons Network^™

Mentoring In Group-Based Adolescent Girl Programs In Low- And Middle-Income Countries: Evidence-Informed Approaches, Miriam Temin, Sarah Blake, Eva Roca

Adolescents and Young People

Adolescent girls face distinct challenges that require tailored and girl-centered responses. This brief draws on the knowledge of program implementers and researchers who work on community-based girl group (CBGG) programs (often called “safe spaces”) in various low- and middle-income settings and the US. It summarizes emerging lessons and insights on CBGGs, emphasizing the vital role that mentors play in this group-based model. The evidence emphasizes the importance of providing mentors with training, supervision, compensation, solidarity, and opportunities to build their own networks.

The Radical Power Of Education, Arindam Nandi, Nicole Haberland, Thoai Ngo

Gender, Education, Justice, and Equity (GEJE)

When education works, people thrive and societies flourish alongside economies. We have made real progress on primary enrollment on the global scale, with 90% of children enrolling in school. However, completion rates lag far behind—only 77% of children complete lower secondary school and 58% complete upper secondary. Those numbers decline sharply for those living in poverty, for girls, and for Indigenous communities, with 44% of adolescent girls in low- and middle-income countries (LMICs) either dropping out of primary school or never attending at all.

Low educational attainment and illiteracy exclude children from the freedoms that come with learning and also …

The Radical Power Of Education—Brief, Arindam Nandi, Nicole Haberland, Thoai Ngo

Gender, Education, Justice, and Equity (GEJE)

This research brief summarizes the findings of GEJE’s recent report on the impact of education across society.

Trends In Female Genital Mutilation In Kenya: Insights From Further Analysis Of The Kenya Demographic And Health Surveys, 2003–2022, Dennis Matanda, Francis Obare, Samuel Kimani, Stella Muthuri, Chi-Chi Undie

Sexual and Reproductive Health, Rights, and Choices

Highlights and recommendations:

• From 2003 to 2022, Kenya has experienced a commendable reduction in FGM prevalence among women aged 15–49 years at the national level. However, this progress is not uniform: regional disparities exist, with counties such as Mandera, Wajir, Samburu, and Isiolo consistently posting high FGM prevalence across the years.
• FGM prevalence has remained stubbornly high among women with no education, women in the poorest households, women of the Islamic faith and those from the Somali ethnic group.
• There is a concerning trend indicating a shift to younger ages at which FGM is performed, particularly with an observed increase …

Revitalizing And Expanding Commitment To Family Planning: Summary Of The Fp2030 Anglophone Africa Workshop, June 2023, Zoe Nakuya

Sexual and Reproductive Health, Rights, and Choices

In June 2023, Population Council, Kenya was a delegate at the first FP2030 Anglophone Africa Focal Point workshop in Kampala, Uganda, which was convened by the FP2030 East and Southern Africa Hub. The theme of the workshop was to call on partners and country family planning (FP) focal points to review and strengthen their country’s commitments toward achieving their FP2030 goals of expanding access and uptake of FP across the region. This brief summarizes the workshop and its outcomes.

How Climate Change Is Shaping Young People’S Livelihoods And Educational Opportunities, Population Council, Women Deliver

Adolescents and Young People

The climate crisis is threatening global access to education and the creation of livelihood and/or economic opportunities for adolescents and young people (AYP). Climate change prevents more than 12.5 million girls from completing their education each year, and this is projected to increase. The Population Council and Women Deliver conducted participatory, AYP co-led focus group discussions in three countries (Bangladesh, Guatemala, and Nigeria). In each country, a participant in the Women Deliver Young Leaders program teamed up with Council researchers to talk to AYP (ages 12–25 years) about how climate change is affecting their lives, from health to education to …

The Health Effects Of Climate Change: Experiences Of Young People In Bangladesh, Guatemala, And Nigeria, Population Council, Women Deliver

Adolescents and Young People

Climate change is affecting the health and well-being of adolescents and young people (AYP) worldwide. This happens through direct exposure pathways but mainly indirectly, by influencing economic and food insecurity, access to health services, and harmful gender norms and social inequalities. According to a recent meta-analysis of 130 studies, climate change disproportionately harms the health of women and girls, especially younger generations. There are intergenerational inequities in exposure to climate extremes. A child born in 2020 will face an up to sevenfold increase in extreme climate events compared to one born in 1960. These events will have cascading harms and …

Best Practices To Prevent And Respond To Sexual Violence: Evidence Review And Programme Considerations, Sycona

Sexual and Reproductive Health, Rights, and Choices

Presentation for AGYW & South-to-South Learning Network Champions to fill a knowledge gap about what strategies have been tested and found effective in low- and middle-income countries (LMICs) to prevent and respond to sexual violence experienced by adolescent girls and young women (AGYW). This topic was identified by East and Southern African Champions as a key impediment to their HIV prevention programming efforts. This review focused on evidence from all 15 South-to-South Learning Network (SSLN) countries to gather and synthesise contextually relevant information.

Patent: Combination Therapy Intravaginal Rings, Brid Devlin, Jonathon Holt, Andrew Brimer, Jeremy Nuttall, Karl Malcolm, Susan Fetherston, Peter Boyd

Formulation/Product Development

United States Patent 11,793,669 B2

Results From The Basmeh & Zeitooneh (B&Z) Intervention To Empower Adolescent Girls And Young Women At Risk Of Child Marriage And Poor Reproductive Health Among The Syrian Refugee Population In Lebanon, Rima Mourtada

Adolescents and Young People

This report presents results from the final evaluation of a social, health, and economic asset-building program implemented by the Lebanon-based non-governmental organization (NGO) Basmeh & Zeitooneh (B&Z) and aimed at reducing the social isolation of vulnerable adolescent girls and young women (AGYW) aged 10–21 years old living in the Shatila and Burj al Barajneh refugee camps in South Beirut. The program sought to help girls gain the skills and knowledge they need to avoid child marriage and adolescent pregnancy and to make a healthy transition to adulthood despite the numerous challenges they face. The program focused on two sub-populations of …

Research Snapshot: Impacts Of Cash-Plus Programs On Child Marriage, Elrha R2hc Programme

Adolescents and Young People

A cluster randomised controlled trial in Wajir County, Kenya demonstrates that multisectoral cash-plus interventions can significantly reduce the incidence of adolescent childbearing and marriage.

Exploring The Role Of Men In Child Marriage Decision-Making In Rural Upper Egypt, Salma Abou Hussein, Reham Abou El-Fadl, Sally Radwan, Nahla G. Abdel-Tawab

Adolescents and Young People

Egypt’s 2021 Family Health Survey indicated that nearly 18% of women aged 20–24 years had married or were engaged before turning 18. This brief explores the perspectives of adolescent girls, their families, and key stakeholders on the role of men in the decision-making process pertaining to child marriage. The study took place in Assiut and Sohag in Upper Egypt selected on the basis of the high prevalence of child marriage. Results confirm that, in line with the patriarchal norms that underlie most marriage decisions in rural Upper Egypt, fathers/male guardians are the primary decision-makers regarding when a girl gets married …

Menstruation And Adolescent Girls' Daily Lives In Rural Upper Egypt, Salma Abou Hussein, Nahla G. Abdel-Tawab

Adolescents and Young People

The Population Council conducted a qualitative study to understand the menstruation-related attitudes, practices, and perceptions that shape adolescent girls’ daily routines in rural upper Egypt communities, specifically Assiut and Sohag. The study relied on in-depth interviews with unmarried adolescent girls aged 13–16; focus group discussions with girls aged 13–16, mothers, fathers, and male siblings of adolescent girls; and key informant interviews with schoolteachers, doctors/nurses, pharmacists, and community leaders. “Period poverty” (lack of access to, or inability to afford period supplies) can be detected among adolescent girls in rural Assiut and Sohag. Lack of information and emotional and practical support before …

Guidance Document On The Use Of The Confidante Tool To Track New Or Recent Cases Of Female Genital Mutilation, Francis Obare Onyango, Dennis Matanda, Chi-Chi Undie

Sexual and Reproductive Health, Rights, and Choices

Female genital mutilation (FGM) is internationally recognised as a violation of human rights that is rooted in social norms including harmful gender norms. In countries where it is prevalent, FGM contributes to bottlenecks that curtail realisation of full potential by girls and women. In settings where FGM is illegal, practising communities may adopt strategies such as cutting girls at very young ages, performing supposedly less severe cuts, or conducting FGM in secret, and thus underreport the occurrence of the practice due to fear of legal consequences. This may hamper tracking and/or measuring the effectiveness and/or impact of interventions and actions …

Recap Report: Girls Deliver Pre-Conference On Adolescent Girls At The Women Deliver 2023 Conference, Girl Center

Adolescents and Young People

The Girls Deliver: Pre-Conference on Adolescent Girls was held on July 16, 2023 in Kigali Rwanda to kick off the Women Deliver 2023 Conference. Girls Deliver was led by the Population Council’s Girl Innovation, Research, and Learning Center (GIRL Center) and co-hosted by AFIDEP, Amplify Girls, Baobab Research Programme Consortium, Children’s Investment Fund Foundation, Coalition for Adolescent Girls, Exemplars in Global Health, FP2030, Girl Effect, Girls First Fund, Hilton Foundation, NDI, Plan International, PMNCH, Purposeful, Together for Girls, UNICEF, Women Deliver, and The World Bank Africa Gender Innovation Lab.

This recap report presents an overview of Girls Deliver, a summary …

Revitalizing Intermittent Preventive Treatment Of Malaria In Pregnancy In Kenya, Population Council-Kenya

Sexual and Reproductive Health, Rights, and Choices

Nearly a third of Kenya’s 51 million people live in malaria-endemic zones and pregnant women are especially susceptible to malaria infection. Intermittent preventive treatment of malaria in pregnancy (IPTp) using sulfadoxine-pyrimethamine (SP) helps prevent maternal malaria episodes, maternal and fetal anemia, placental parasitemia, low birth-weight, and neonatal mortality. WHO’s guidelines on IPTp recommend that pregnant women living in moderate to high malaria transmission areas in sub-Saharan Africa receive a dose of SP at each antenatal care visit, beginning in the second trimester. IPTp-SP is recommended alongside insecticide-treated nets and appropriate case management. Kenya adopted WHO’s recommendations in 1998, however IPTp-SP …

State Of The Evidence: A Reflection On The Gaps Identified In Breakthrough Research’S Research And Learning Agendas For Advancing Provider Behavior Change Programming And Advancing Integrated Social And Behavior Change Programming, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

No abstract provided.

A Structural And Provider Behavior Change Approach To Enhancing Respectful, Integrative, Responsive Care For Hospitalized Young Children (0–24 Months) In Kenya, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

This brief describes a co-creation process and a resulting provider behavior change intervention approach that can be adapted to similar low- and middle-income hospital contexts. It offers policy and program managers details around each intervention component, linking to an accompanying provider orientation PowerPoint and other training materials/job aids. Finally, it recommends a few lessons to guide those interested in engaging in a similar co-creation and implementation approach.

Findings From A Mixed Methods Evaluation Of An Integrated Social And Behavior Change Approach To Improve Health Outcomes In Niger, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

This brief summarizes findings from a mixed methods evaluation of an integrated social and behavior change (SBC) approach implemented in the Maradi and Zinder regions of Niger. It is intended to inform the Resilience in the Sahel Enhanced (RISE) II program implemented by the United States Agency for International Development (USAID) funded Resilience Food Security Activities (RFSA) to further improve reproductive, maternal, and child health outcomes. This brief provides an overview of the integrated SBC approach and evaluation methods and then guided by the program theory of change, describes the mechanisms through which the intervention contributed to change in health …

Evaluation Of Breakthrough Action-Nigeria’S Social And Behavior Change Public Sector Capacity Strengthening Approach, Adetayo Adetunji, Dele Abegunde, Augustine Ankomah, Nrupa Jani, Pooja Sripad, Bright Addo

Sexual and Reproductive Health, Rights, and Choices

No abstract provided.

Evaluation Of Biruh Tesfa (Bright Future) For All: A Program For Out-Of-School Girls, Migrants, And Domestic Workers In Low-Income Ethiopian Cities, Annabel Erulkar, Eyasu Hailu, Henock Markos, Getnet Demissie, Tsegahun Tessema, Hana Hailu

Adolescents and Young People

Biruh Tesfa (“Bright Future)” is the name of a program designed in the mid-2000s to address the disadvantage of out-of-school girls in urban Ethiopia. The program was originally designed to address social isolation by bringing girls together in safe spaces groups with adult female mentors and providing them with skills-building activities, including life skills, reproductive health, HIV education, nonformal education and referrals, and training. This evaluation examines various aspects of the Biruh Tesfa for All Program: characteristics of beneficiaries, including domestic workers; patterns of attendance, absenteeism, and dropout; indicators of mental health such as self-reported anxiety, sadness, and depression; and …

Does Size Matter? A Randomized Controlled Trial To Assess The Impact Of External Diameter On Adherence To 3 Different Intravaginal Rings Among 24 Us Couples, Irene Bruce, Marlena Gehret Plagianos, Jessica M. Sales, Jessica Atrio, Shakti Shetty, Caio Sant’Anna Marinho, Brady Zieman, Lisa Haddad, Barbara Friedland

Center for Biomedical Research (CBR)

Background: Intravaginal rings (IVRs) are being developed as multipurpose prevention technologies (MPTs) for simultaneous HIV and pregnancy prevention. However, no empirical data exists to support the current 54-58mm size as ideal. Understanding the impact of IVR size on adherence is critical for developing a product that can be used correctly and consistently. Methods: We conducted a randomized, open-label, 3-way crossover trial comparing adherence, preference, and acceptability of 3 non-medicated silicone IVRs of differing external diameters: 46mm, 56mm and 66mm. 24 couples in Atlanta, GA and Bronx, NY were randomized to the sequence of IVR use, used each continuously …

Role Of Stigma In Pre-Exposure Prophylaxis (Prep) Uptake And Continuation Among Adolescent Girls And Young Women (Agyw): Considerations For Programme Implementers, Waimar Tun, Lulama Lunika

Sexual and Reproductive Health, Rights, and Choices

A synopsis of a review of the role of PrEP-related stigma with practical considerations for programme implementers on strategies to reduce stigma.

Behavioral Sentinel Surveillance Survey In Nigeria: Endline Technical Report, Paul Hutchinson, Adolor Aisiri, Udochisom Anaba, Elizabeth Omoluabi, Akanni Akinyemi, U. C. Ifunanya Ozoadibe, Dele Abegunde

Sexual and Reproductive Health, Rights, and Choices

This technical report presents results from the Behavioral Sentinel Surveillance (BSS) endline survey undertaken by Breakthrough RESEARCH/Nigeria in Kebbi, Sokoto, and Zamfara states between October 1 and November 10, 2022. BSS surveys are intended to assess changes in indicators targeted by the integrated social and behavior change (SBC) activities of the USAID-funded Breakthrough ACTION/Nigeria project. The Breakthrough ACTION/Nigeria project, which began in 2019 and is slated to run until 2025, focuses on the health areas of malaria; family planning; and maternal, newborn, and child health plus nutrition (MNCH+N) in Kebbi and Sokoto states, as well as malaria-only SBC activities in …

Behavioral Sentinel Surveillance Survey In Nigeria: Endline Technical Report For Couples, Paul L. Hutchinson, Adolor Aisiri, Udochisom Anaba, Elizabeth Omoluabi, Akanni Akinyemi, U. C. Ifunanya Ozoadibe, Dominique Meekers, Dele Abegunde

Sexual and Reproductive Health, Rights, and Choices

This technical report presents information from married couples on health norms, attitudes, and beliefs as part of the Behavioral Sentinel Surveillance (BSS) endline survey undertaken by Breakthrough RESEARCH/Nigeria in Kebbi, Sokoto and Zamfara States between October 1 and November 10, 2022. BSS surveys assess changes in indicators targeted by the integrated social and behavior change (SBC) activities of the USAID-funded Breakthrough ACTION/Nigeria’s project. Breakthrough ACTION/Nigeria, which is slated to run from 2019 to 2025, utilizes SBC focused on the health areas of malaria; family planning (FP); and maternal, newborn, and child health plus nutrition (MNCH+N) in Kebbi and Sokoto states, …

Evidence From The Implementation Of A Social Accountability Approach To Improve Family Planning Services: Perspectives From Community Members And Health Workers In Togo, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

This brief summarizes findings from Breakthrough RESEARCH's formative qualitative evaluation of a social accountability approach implemented in and around the city of Lomé, Togo to strengthen family planning (FP) services. It is intended to inform FP programs implemented by the USAID-funded West Africa Breakthrough ACTION (WABA) and AmplifyPF projects to further improve FP related outcomes. This brief provides an overview of the social accountability approach and describes the enabling factors and challenges associated with implementation as well as perceived outcomes related to the effectiveness of the social accountability approach to improve FP service delivery at the community level, at the …

Cost-Effectiveness Analysis Comparing Integrated And Malaria-Only Social And Behavior Change Programming In Nigeria: Final Report, Avenir Health

Sexual and Reproductive Health, Rights, and Choices

In Nigeria, the Breakthrough ACTION project, funded by the United States Agency for International Development (USAID)/Nigeria, is working closely with the Nigerian government to improve the practice of priority health behaviors, with a focus on maternal, newborn and child health and nutrition, family planning and reproductive health, malaria, and tuberculosis. Within the broader program, Breakthrough ACTION uses different social and behavior change (SBC) approaches in different states. In northern Nigeria, Breakthrough RESEARCH compared the cost-effectiveness of the integrated SBC approach addressing multiple health areas in Kebbi and Sokoto states to a malaria-only approach in Zamfara. This cost-effectiveness study examined whether …

Cost-Effectiveness Analysis For Integrated Social And Behavior Change Programming By The Resilience In The Sahel Enhanced Ii Program In The Maradi And Zinder Regions Of Niger, Avenir Health

Sexual and Reproductive Health, Rights, and Choices

In March 2020, Breakthrough RESEARCH began applying their Guidelines for Costing Social and Behavior Change Health Interventions to the Resilience in the Sahel (RISE) II program in Niger for a cost-effectiveness analysis that will run until 2022. The purpose of this document is to share the findings of the application of the guidelines and provide an example and guidance for social and behavior change researchers and implementers on how these guidelines can be applied to other case study applications.

Costing For Family Planning Social And Behavior Change—Slide Deck, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

Slide deck for Breakthrough RESEARCH Legacy and Learning Event Series #4, held on 19 April 2023.

Evaluation Of Rise Ii Integrated Social And Behavior Change Activities In Niger: Family Planning; Maternal, Newborn, And Child Health; Immunization; Nutrition; Water, Sanitation, And Hygiene, Breakthrough Research

Sexual and Reproductive Health, Rights, and Choices

Breakthrough RESEARCH is conducting a mixed-methods study including baseline, midline, and endline surveys to assess differential changes over time in key health outcomes associated with the integrated social and behavior change (SBC) strategy and qualitative methods to explain how and why gender-related changes occurred or were associated with these changes. The goals of this study are to provide information to inform project implementation and to build the global evidence base related to multisectoral integrated SBC programming. These briefs present select baseline and midline findings among female and male respondents of reproductive age residing in three intervention sites—Hamzari (Maradi region) and …