Digital Commons Network^™

Introducing Oral Pre-Exposure Prophylaxis To Adolescent Girls And Young Women In Tanzania: Overview Of Findings From Implementation Science Research, Population Council

HIV and AIDS

The Population Council in collaboration with Tanzania’s National AIDS Control Program and CSK Research Solutions Limited conducted implementation science research in one urban district and one rural district in the country, to provide needed evidence for informing decisionmaking on whether and how to introduce oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW) in Tanzania. The aims of the research were to: assess the acceptability of PrEP among AGYW, their male partners, their parents/guardians, healthcare providers, and policymakers; determine the feasibility of and opportunities for providing PrEP to AGYW; and identify key facilitators and barriers to PrEP introduction …

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In South Africa, Population Council

HIV and AIDS

The Population Council is conducting implementation research in South Africa, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in Uganda, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in South Africa and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.

Policymakers' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

There is limited evidence from Tanzania to inform decisionmaking on whether and how to introduce oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW). To help fill this evidence gap, the Population Council in collaboration with the National AIDS Control Program and CSK Research Solutions Limited conducted implementation science research in one urban district (Dar es Salaam) and one rural district (Mbeya) in Tanzania to explore policymakers’ and key stakeholders’ perceptions and attitudes toward the introduction of PrEP to different groups, including AGYW, as well as to identify key issues that must be considered prior to its introduction. …

Rates Of Hiv And Hsv-2 Among Young People In Machinga, Malawi, Barbara Mensch, Erica Soler-Hampejsek

HIV and AIDS

To better understand the epidemiological context for the DREAMS programming, Project SOAR analyzed previously collected quantitative cohort data from the Population Council’s Malawi Schooling and Adolescent Study (MSAS) to identify the prevalence and incidence of HIV and the herpes simplex virus, commonly referred to as genital herpes. SOAR’s analysis provides a deeper understanding of the changing epidemiological and gendered context of the HIV epidemic in Machinga. The youth cohort data from the MSAS provide accurate estimates of HIV prevalence over time and HIV incidence, thereby filling important data gaps.

Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar

HIV and AIDS

Project SOAR is conducting implementation science research in Malawi to build needed evidence to inform decisionmaking about effective programming to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. Specifically, SOAR is: examining approaches to identify the most at-risk girls, particularly those out of school, and enroll and retain them in DREAMS programming; assessing HIV-risk and health-seeking behaviors before and after AGYW’s engagement in DREAMS interventions; exploring how to reach AGYW’s male sexual partners and increase their uptake of HIV services; and assessing facilitators and barriers to HIV service uptake by men living with HIV. …

Adolescent Girls Empowerment Program (Agep): Evaluation—Round 4 Update, Karen Austrian, Paul C. Hewett, Erica Soler-Hampejsek, Jean Digitale

Poverty, Gender, and Youth

To assess the impact of the Adolescent Girls Empowerment Program (AGEP) on mediating and longer-term demographic, reproductive, and health outcomes, Population Council researchers designed and implemented a longitudinal, cluster randomized controlled trial across all program areas. A baseline survey was conducted in 2013 prior to program implementation and data have been collected annually. A third round of data collection in 2015 produced the midline findings, measuring the program effect immediately at the end of AGEP. Details of the midterm results were published in a full technical report, executive summary, and brief. The focus of this brief is to provide an …

Executive Summary—Understanding The Lives Of Adolescents And Young Adults (Udaya) In Bihar, India [Hindi], K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Santosh Kumar Singh, Shilpi Rampal, A.J. Francis Zavier, Ashish Kumar Gupta

Poverty, Gender, and Youth

A program of research titled, “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh,” implemented by the Population Council, aimed to understand the factors that determine healthy transitions from childhood to adolescence and adulthood. The goal of UDAYA is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and assess factors that influence the quality of transitions they make. The specific objectives of UDAYA are: 1) to explore the situation of adolescents, with a focus on assessing the extent to which both younger and older adolescents have …

Adolescent Pregnancy In Zambia, Population Council

Reproductive Health

In 2015, the Population Council in conjunction with UNFPA conducted a study that drew on data from the 2013–14 Zambia Demographic and Health Survey and the 2010 Census of Population and Housing to identify where adolescent pregnancy is most likely to occur in Zambia. Using a literature review, key informant interviews among organizations working with adolescents, and in-depth interviews with adolescent girls, the study also identified key factors that lead to adolescent pregnancy. Study findings reaffirmed that adolescent pregnancies are high in Zambia, potentially undermining girls’ human rights and compromising their opportunity to fully realize their socioeconomic development potential. This …

Understanding Adolescent And Youth Sexual And Reproductive Health-Seeking Behaviors In Ethiopia: Implications For Youth Friendly Service Programming, Aparna Jain, Hussein Ismail, Elizabeth Tobey, Annabel Erulkar

Reproductive Health

To meet the unique sexual and reproductive health needs of its large adolescent and youth population, Ethiopia’s government has expanded and institutionalized youth-friendly services (YFS) at all levels of the health system. To help inform and improve these efforts, the Evidence Project, in collaboration with USAID/Ethiopia and the Ethiopian Federal Ministry of Health, conducted a study on adolescents’ and young people’s use of and opinions on YFS. Results showed that young people were satisfied overall with the health services they received, regardless of whether it was basic health services or YFS. Awareness and use of YFS was low, but many …

Herramientas Para La Formación Y El Acompañamiento A Mentoras Del Programa Abriendo Oportunidades®, Cecilia Garcés, Alejandra Munguia

Poverty, Gender, and Youth

Este compendio reúne herramientas de utilidad práctica para la implementación del programa Abriendo Oportunidades® del Population Council. Está dirigido a quienes facilitan el proceso de formación docente para mentoras comunitarias, así como a las mentoras monitoras. El mismo contiene dos tipos de herramientas: herramientas para la formación de mentoras comunitarias y herramientas para la implementación de sesiones. El Population Council pone este compendio de herramientas a disposición de quienes están implementando el programa Abriendo Oportunidades® en Guatemala y otros similares en la región, que se enfocan en las necesidades de las niñas y adolescentes.

---

This compendium collects practical tools …

Adolescent Girls Initiative-Kenya: Health And Life Skills Audio Training Script, Wajir, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative project-Kenya (AGI-K) helps young, vulnerable adolescent girls build their social, health, and economic assets. AGI-K tests combinations of interventions in health, violence prevention, wealth creation, and education to determine which package of interventions delivers the most impact and at what cost. The project was led by Population Council and implemented in two marginalized areas 1) Kiberain Nairobi and 2) Wajir County in Northeastern Kenya by Plan International and Save the Children, respectively. This scripted guide was designed to support the delivery of the health, life skills, and nutrition sessions in Wajir in response to challenges with …

More Than Brides Alliance (Mtba): Mariage N’Est Pas Un Jeu D’Enfat, Rapport De Référence Niger, Grace Saul, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Aissa Diarra, Chaibou Saadou

Poverty, Gender, and Youth

L’Alliance « Plus qu’une épouse » vise à améliorer la vie des adolescentes et propose des interventions dans plusieurs domaines (la santé reproductive, l’éducation, les normes de genre et les moyens de subsistance, entre autres). Dans le cadre d’une évaluation des interventions visant à retarder l’âge du mariage, le Population Council a mené des enquêtes de référence sur les adolescentes dans des zones sélectionnées dans deux régions au Niger (Tillabéry et Maradi). Les objectifs de l’étude de référence étaient les suivants : 1) fournir un point de référence permettant de mesurer les changements découlant de l’intervention à mi-parcours et à …

Understanding The Lives Of Adolescents And Young Adults (Udaya) In Bihar, India, K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Santosh Kumar Singh, Shilpi Rampal, A.J. Francis Zavier, Ashish Kumar Gupta

Poverty, Gender, and Youth

The goal of the “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” program is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and to assess factors that influence the quality of transitions they make. The study is designed to provide robust insights on how investments in adolescents influence their life course by the time they reach young adulthood; enable evidence-based decisions on the types of programs worthy of scale-up; and furnish important baseline indicators against which the long-term impact of programs can be measured. This …

Understanding The Lives Of Adolescents And Young Adults (Udaya) In Uttar Pradesh, India (2015–16), K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Ashish Kumar Gupta, Shilpi Rampal, Santosh Kumar Singh, A.J. Francis Zavier

Poverty, Gender, and Youth

The goal of the program of research titled “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and to assess factors that influence the quality of transitions they make. The study is designed to provide robust insights on how investments in adolescents influence their life course by the time they reach young adulthood; enable evidence-based decisions on the types of programs worthy of scale-up; and furnish important baseline indicators against which the long-term impact of programs can …

Adolescent Girls Empowerment Program (Agep): Adapting The Safe Spaces Model In Rural Settings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) was implemented with over 10,000 vulnerable adolescent girls aged 10–19 between 2013 and 2016 in five rural and five urban sites in Zambia. Safe Spaces was the core program element in AGEP, and was adapted based on prior programs implemented mainly in urban and peri-urban areas in East and Southern Africa. Given the key differences in the living environments and demographic data for adolescent girls in urban as compared to rural areas in Zambia, one key programmatic learning question for AGEP was if the Safe Spaces model could be adapted and successfully implemented in …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram (Rksk) In Uttar Pradesh, Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

Characteristics Of Married Adolescent Girls In Egypt [Arabic], Nahla G. Abdel-Tawab, May Gadallah, Doaa Oraby

Poverty, Gender, and Youth

Despite increases in the average age at marriage in Egypt, and laws mandating minimum marriage age, early marriage remains an issue, particularly in rural areas of the country where up to 33 percent of women marry before the age of 18. This brief describes characteristics of married adolescent girls, including health implications of early marriage on pregnancy and childbirth, risk of dangerous complications, and increased exposure to domestic violence.

Ensuring Adolescents In Uttar Pradesh Stay—And Learn—In School, Sapna Desai, Neelanjana Pandey

Poverty, Gender, and Youth

The Government of India has invested in improving education through two key programs for universal access to, and retention in, secondary education. In Uttar Pradesh, the Population Council found high levels of enrollment among younger adolescents, with limited gender disparity. Retention beyond elementary school, however, was low, and learning outcomes—literacy and numeracy—were poor. This policy brief focuses on two challenges to preparing Uttar Pradesh’s adolescents for the future: universal enrollment and retention in secondary school. The brief outlines recommendations that the government invest in secondary schooling, improve school facilities, support and evaluate quality teaching inputs and curriculum changes, remove economic …

Indigenous Adolescent Girls' Empowerment Network (Imagen), Kelly Hallman, Stephanie Martinez

Poverty, Gender, and Youth

The Population Council has developed and tested a cache of tools—which can be modified by and for Native communities—for organizations seeking to more intentionally serve girls. The tools allow programs to systematically gauge within their own communities the barriers and opportunities that exist for Native adolescent girls. This realization and opportunity sparked the creation of the Indigenous Adolescent Girls’ Empowerment Network (IMAGEN). The Network was conceived as a means of bringing together Native American–serving organizations that have the enthusiasm and capacity to adopt, document, and share evidence from programs that build on Native girls’ innate talents, while addressing the multiple …

More Than Brides Alliance: Baseline Report, India, Sharmistha Basu, Rajib Acharya, Andrea J. Melnikas, Sajeda Amin

Poverty, Gender, and Youth

The More Than Brides Alliance seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted surveys of adolescent girls and young women aged 12–19 in nine districts in four states in India to examine girls’ experiences, including education, marriage and relationships, literacy and numeracy, livelihoods, and gender-equitable attitudes. The study found that few girls were currently involved in any programs, despite demonstrated vulnerabilities (e.g., more than half of the sample was currently out of school) suggesting that there is a clear …

Adolescent Girls And Young Women’S Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

The Population Council, in collaboration with the National AIDS Control Programme and CSK Research Solutions Ltd., conducted implementation science research in Tanzania to identify key considerations for introducing pre-exposure prophylaxis (PrEP) antiretroviral medication to adolescent girls and young women (AGYW) at substantial risk of HIV infection. This brief presents results from qualitative in-depth interviews and focus group discussions with AGYWs. Based on the findings, the brief recommends including sensitization and education of communities, parents, and male partners of AGYWs in demand-creation activities; training providers to deliver adequate education about PrEP to avoid misperceptions about its intended use, side effects, and …

Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Zambia, Population Council

HIV and AIDS

The Population Council is conducting implementation research to build needed evidence to inform decisionmaking around effective implementation of community-based, girl-centered interventions and to assess their effectiveness in reducing HIV vulnerability among adolescent girls and young women (AGYW)—a population in which AIDS is the leading cause of death in the region. Learnings from this study in Zambia and similar ones in Kenya and Malawi will be valuable for informing each country and the region how to implement AGYW programming that goes beyond the health sector to reduce AGYW's vulnerability to HIV.

Characteristics Associated With Hiv And Hsv-2 Among Adolescents In Malawi, Barbara Mensch, Erica Soler-Hampejsek

HIV and AIDS

The DREAMS (Determined, Resilient, Empowered AIDS-free, Mentored, and Safe) partnership aims to significantly reduce new HIV infections in adolescent girls and young women (AGYW) in Malawi and other sub-Saharan African countries. To better understand the epidemiological context for the DREAMS programming, Project SOAR analyzed previously collected quantitative cohort data from the Population Council’s Malawi Schooling and Adolescent Study to identify the factors associated with the prevalence and incidence of HIV and the herpes simplex virus, commonly referred to as genital herpes. SOAR’s analysis provides a deeper understanding of the epidemiological and gendered context of the HIV epidemic in Malawi. This …

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Uganda, Population Council

HIV and AIDS

The Population Council is conducting implementation research in Uganda, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in South Africa, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in Uganda and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.

Parents' And Guardians' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

The Population Council, in collaboration with the National AIDS Control Programme (NACP) and CSK Research Solutions Ltd., conducted implementation science research in two research sites in Tanzania to identify key considerations for introducing oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW). The NACP and members of the study’s research utilization committee recognized the importance of learning about parents’ and guardians’ attitudes and perceptions of PrEP use by their adolescent and young adult daughters and peers to inform the PrEP implementation process in Tanzania. Moreover, existing research in Tanzania finds that parents communicate with their children about sexual …

Providers' Views On Prep For Adolescent Girls And Young Women In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

In collaboration with the Tanzania National AIDS Control Programme and CSK Research Solutions Ltd., the Population Council conducted an implementation science research study to identify key considerations among healthcare providers for oral pre-exposure prophylaxis (PrEP) introduction to adolescent girls and young women (AGYW) in an urban and a rural setting in Dar Es Salaam and Mbeya districts, respectively. This brief presents results from a survey and in-depth interviews conducted with healthcare providers in each setting, assessing their knowledge, attitudes, and perceptions about PrEP; willingness to prescribe PrEP to AGYW; and perceived barriers and facilitators to providing PrEP to AGYW. The …

Stakeholder Considerations For Prep Introduction To Adolescent Girls And Young Women: Laying The Groundwork For Research Utilization In Tanzania, Population Council

HIV and AIDS

In collaboration with the Tanzania National AIDS Control Programme and CSK Research Solutions Ltd., the Population Council is conducting an implementation science research study in that country to build needed evidence to inform decisionmaking around oral pre-exposure prophylaxis (PrEP) introduction to adolescent girls and young women (AGYW) aged 15–24. The study uses quantitative and qualitative methods to gather data from AGYW, policymakers and other stakeholders, health providers, and AGYW’s parents and male partners to: assess their knowledge and attitudes toward oral PrEP; determine opportunities and approaches for providing PrEP; and identify potential facilitators and barriers to PrEP introduction and use. …

Adolescent Friendly Health Corners (Afhcs) In Selected Government Health Facilities In Bangladesh: An Early Qualitative Assessment, Sigma Ainul, Iqbal Ehsan, Tasmiah Tanjeen, Laura Reichenbach

Reproductive Health

With high rates of early marriage, especially among girls, a significant proportion of adolescents in Bangladesh need sexual and reproductive health services (SRH), including contraceptive information. To address this gap and ensure that adolescents throughout the country, including unmarried adolescents, have access to SRH services through public health facilities, the Maternal and Child Health Services Unit of the Directorate General of Family Planning, with financial and technical assistance from development partners, has begun establishing Adolescent Friendly Health Corners (AFHCs) at selected government facilities at district and union levels. The Evidence Project/Population Council was asked to assess the implementation of the …

Married Young Women And Girls' Family Planning And Maternal Heath Preferences And Use In Ethiopia, Aparna Jain, Elizabeth Tobey, Hussein Ismail, Annabel Erulkar

Reproductive Health

Married young women and girls are the primary users of youth-centered sexual and reproductive health services in Ethiopia and, given the health risks associated with early and closely-spaced pregnancies, represent an especially important population to reach with sexual and reproductive health services. This brief looks specifically at the needs and preferences for family planning and reproductive health services among married young women and girls, with recommendations for how to more effectively ensure that they have access to those services.