The Population Council is implementing and evaluating a program for vulnerable adolescent girls in Zambia to help them avoid early marriage; sexually transmitted infections, including HIV; and unwanted pregnancy.
Social isolation, economic vulnerability, and lack of access to health care prevent healthy transitions from girlhood to womanhood, especially for vulnerable adolescent girls in developing countries. In Zambia, poor girls often are at high risk of gender-based violence, unintended pregnancy, and HIV. Many drop out of school, are unable to find employment, lack the ability to make independent decisions, and are not being reached by existing programs for young people.
To improve these outcomes, the Council is implementing and rigorously evaluating the Adolescent Girls’ Empowerment Program, which is designed to find the best way to improve girls’ social, health, and economic resources so that they can stay in school longer; avoid early marriage; delay sexual activity; and prevent unintended pregnancy, HIV, and other STIs.
The program is providing 10,000 girls in rural and urban Zambia with combinations of:
- health and financial education and life skills during weekly girls group meetings led by young women from the community;
- vouchers entitling girls to health services provided by facilities in the community; and
- girl-friendly individual savings accounts developed in partnership with a Zambian financial institution.
As part of the data collection for the study, participants are provided voluntary counseling and testing services for HIV and genital herpes, where appropriate and with their consent and that of their parents, to determine whether the program can help girls avoid infection.
To determine the effectiveness of these program elements, participating community areas will be randomly assigned to one of four study arms. Randomized designs such as this are widely considered a gold standard for attributing cause and effect between program treatment and outcomes. The study arms of the Adolescent Girls’ Empowerment Program are:
- Group 1: Girls will attend mentor-led, girl-only meetings.
- Group 2: Girls will attend mentor-led, girl-only meetings and receive health vouchers.
- Group 3: Girls will attend mentor-led, girl-only meetings, receive health vouchers, and gain access to savings accounts.
- Group 4: Girls will receive no program services.
The control group is essential and will allow the Council to determine whether any of the program combinations are effective, and to what extent.
Program and research findings will be presented to policymakers and program managers from the public, private, and NGO sectors. The program is working with government partners in Zambia, for-profit entities (i.e., banks and private clinics), and NGO partners, as well as in consultation with a wide range of stakeholders, so that best practices from the program can be shared as widely as possible. The goal is to make comprehensive, asset-building programs available to all vulnerable girls in Zambia and more widely in the region.