Population Council Research that makes a difference

Although the HIV/AIDS epidemic in South Africa is showing some signs of slowing, it continues at an alarming rate in the province of KwaZulu-Natal (KZN), one of only two provinces in which prevalence rates are not declining. Everyone is not equally affected, however; in South Africa, disparities in HIV prevalence rates begin to emerge during adolescence, and those most affected by the pandemic are increasingly young, poor, and female.  Among 15–24-year-olds, four times as many females as males are living with HIV (16.9 percent vs. 4.4 percent), and the HIV incidence ratio among this age group is 8-to-1 female-to-male (Shisana et al. 2005). 

In collaboration with local partners and the Isihlangu Health and Development Agency, the Population Council is carrying out a program, "Siyakha Nentsha" (isiZulu for "building with young people"), to respond to the unmet needs of young people in KZN for strategies to manage their daily economic, social, and health challenges. This capabilities-enhancing program for adolescents integrates financial capabilities, HIV/AIDS and reproductive health education, and components aimed at strengthening social networks to help young people navigate the social and economic milieu that facilitates conditions for high-risk sexual behaviors.

Siyakha Nentsha was evaluated in a randomized controlled study of secondary school classes in periurban communities near Durban. The three-year study began in January 2008 and includes 18 months of intervention activities. Two versions of the program were tested—a basic version that focused on developing social and health capabilities and an enhanced version that also included developing financial capabilities. The highly participatory curriculum was developed out of a pilot intervention carried out by the study team from 2005 to 2007 in a similar area within KZN. The program is being delivered to female and male students in grades 10 and 11 by teams of trained young adult facilitators. The educational program developed for the intervention is accredited by the South African Qualifications Authority (the national government body that accredits education and training curriculums).

This research project measures young people's economic literacy, skills, aspirations, social capital (networks and support), and HIV/AIDS and reproductive health knowledge, skills and preventive behaviors. The program aims to reach young women and men residing in poor, HIV/AIDS-affected communities with a comprehensive package of skills that are geared to help offer protective strategies against HIV and mechanisms for coping with and mitigating the impact of AIDS. The work seeks to provide context-specific strategies for vulnerable adolescents to build their economic, social, and health assets, with the eventual goal of improving their lifelong functional capabilities and well-being.

More than 1,400 young people have participated in Siyakha Nentsha since 2008. Both versions of the program have led to important changes in young people's attitudes and behaviors. Some notable changes are that all participants (both male and female participants and in both versions of the program) were more likely than those in the control group to know where to get condoms, had improved budgeting and planning skills, were more likely to have tried to open a bank account, and knew much more about social grant requirements (critical in low-resource or AIDS-affected households). Boys in the program were more likely to have remained sexually abstinent between survey rounds, and those who did have sex reported having fewer partners than boys in the control group. Boys in the enhanced program were more likely to have completed an income-generating activity. Girls in the enhanced program were more likely to have a birth certificate—a critical document that must be acquired before other documents necessary for full citizenship and engagement—and also felt greater social inclusion in their communities.

More results can be found in a recently published brief (PDF) about the program and an upcoming program report.

Offsite links

• Isihlangu Health and Development Agency's Slideshare site
• Isihlangu Health and Development Agency's blog