Kelly Hallman, Kasthuri Govender, Eva Roca, Emmanuel Mbatha,Kelly Hallman, Kasthuri Govender, Eva Roca, Emmanuel Mbatha,
M...
SettingSetting
• Semi-rural KwaZulu NatalSemi-rural KwaZulu Natal
– Poverty and income inequalityPoverty and income inequa...
Formative research:Formative research:
Structural factors associated withStructural factors associated with
adolescent HIV...
Poorer more likely to sexuallyPoorer more likely to sexually
debut earlierdebut earlier
Ever had sex: 14-16 year-olds
0
10...
Those with less social capitalThose with less social capital
more likely to experience forced sexmore likely to experience...
Orphans have moreOrphans have more
economically-motivated sexual encounterseconomically-motivated sexual encounters
Ever t...
Durban Program ScDurban Program Scan
• Few adolescent SRH or HIV programs
address social, economic, and cultural
underpinn...
PurposePurpose
Improve functional capabilities and well-being ofImprove functional capabilities and well-being of
adolesce...
Theory of changeTheory of change
• Participation builds skills
• Visible local role models and aspirations
• Leadership on...
Research MethodsResearch Methods
• Longitudinal survey w
gr 10 & 11 students
• FGs & IDIs w
students (F, M),
guardians, te...
Research design -Research design -
RandomizationRandomization
HIV
education,
social support
+ financial
literacy
HIV
educa...
Rationale
•Secondary schools
•Least selective sample in this context
•Scalable – DOE is base
•Bundled accredited package
•...
Programming principlesProgramming principles
• Maximal use of existing infrastructure
– Tapping & building local human cap...
Project teamProject team
Program FeaturesProgram Features
InterventionIntervention
• Evidence-basedEvidence-based
• PilotedPiloted
• Multi-sectoral...
CurriculumCurriculum
Government-accredited multi-session intervention
• Knowledge and skills for pregnancy and HIV
prevent...
FacilitatorsFacilitators
• Young adult graduates of local
program schools
• Aged 19-23; female & male
• Shared the same so...
“It’s different, in school we learn
mathematics and biology but here we
learn things that we can use in the future.”
- fem...
Participant attitudes on HIV and AIDS
“….. I didn’t understand about HIV and AIDS before
but now I do. I didn’t learn that...
More participant quotes about program
• It is good for young people like me because it teaches about things that happen in...
Research underway
• Outcomes
– Sexual behaviors
– Gender attitudes
– Aspirations; future planning
– Financial behaviors
– ...
Scaling up and outScaling up and out
• In dialog with DOE about scale up
• School-based program that retains
facilitators,...
Selected resources
• Hallman, K. 2010, in press. “Social exclusion: The gendering of
adolescent HIV risks in KwaZulu-Natal...
Thank you!Thank you!
Our funders: ESRC/Hewlett Joint SchemeOur funders: ESRC/Hewlett Joint Scheme
& DFID via the ABBA RPC&...
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Building health, social and economic capabilities among adolescents threatened by HIV and AIDS - The Siyakha Nentsha (Building with Young People) program in KwaZulu-Natal

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  • Orphan girls also less socially connected
    By safe spaces I mean:
    Ability to meet with friends
    Ability to cultivate and maintain social networks
    Ability to have a protective community environment
  • FET?
  • Aspirations failure from poverty trap literature. Low aspirations correlated with more sexual risk taking (Barnett)
  • I am presenting the baseline of the survey now
  • Building health, social and economic capabilities among adolescents threatened by HIV and AIDS - The Siyakha Nentsha (Building with Young People) program in KwaZulu-Natal

    1. 1. Kelly Hallman, Kasthuri Govender, Eva Roca, Emmanuel Mbatha,Kelly Hallman, Kasthuri Govender, Eva Roca, Emmanuel Mbatha, Mike Rogan, Rob Pattman, Deevia Bhana and Hannah TaboadaMike Rogan, Rob Pattman, Deevia Bhana and Hannah Taboada Linkages between Gender, AIDS and Development:Linkages between Gender, AIDS and Development: Implications for US PolicyImplications for US Policy Center for Strategic and International StudiesCenter for Strategic and International Studies Washington, DC, 10 June 2010Washington, DC, 10 June 2010 Building health, social and economicBuilding health, social and economic capabilities among adolescentscapabilities among adolescents threatened by HIV and AIDSthreatened by HIV and AIDS TheThe Siyakha NentshaSiyakha Nentsha (Building with Young People)(Building with Young People) program in KwaZulu-Natalprogram in KwaZulu-Natal
    2. 2. SettingSetting • Semi-rural KwaZulu NatalSemi-rural KwaZulu Natal – Poverty and income inequalityPoverty and income inequality – UnemploymentUnemployment – Early pregnancyEarly pregnancy – Early school leavingEarly school leaving – HIVHIV
    3. 3. Formative research:Formative research: Structural factors associated withStructural factors associated with adolescent HIV risk behaviorsadolescent HIV risk behaviors • Residing in relative povertyResiding in relative poverty • Fewer social connectionsFewer social connections • Non-cohesive communityNon-cohesive community • OrphanhoodOrphanhood
    4. 4. Poorer more likely to sexuallyPoorer more likely to sexually debut earlierdebut earlier Ever had sex: 14-16 year-olds 0 10 20 30 40 Low Mid High percent Wealth Male Female Poor Non-poor Source: Hallman 2005, 2008a
    5. 5. Those with less social capitalThose with less social capital more likely to experience forced sexmore likely to experience forced sex Ever forced sex:14-16 year-old females 0 2 4 6 8 Low Mid High percent Social Connectedness Source: Hallman 2008a, 2008b
    6. 6. Orphans have moreOrphans have more economically-motivated sexual encounterseconomically-motivated sexual encounters Ever traded sex: sexually debuted 14-16-year-olds 0 5 10 15 20 Orphan Non-orphan percent Orphan Status Male Female Source: Hallman 2008a, 2008c
    7. 7. Durban Program ScDurban Program Scan • Few adolescent SRH or HIV programs address social, economic, and cultural underpinnings of risk behaviors • Few livelihood programs make conceptual link to health risk behaviors – Not context-, age-, culture- or gender- specific – Design not evidenced based – Delivery weak – Little monitoring or evaluation
    8. 8. PurposePurpose Improve functional capabilities and well-being ofImprove functional capabilities and well-being of adolescents at high risk for:adolescents at high risk for: HIV and STIsHIV and STIs teenage pregnancyteenage pregnancy parenthoodparenthood school dropoutschool dropout loss of one or both parentsloss of one or both parents lack of knowledge of further employment and training opportunitieslack of knowledge of further employment and training opportunities
    9. 9. Theory of changeTheory of change • Participation builds skills • Visible local role models and aspirations • Leadership on HIV and standing in community • Standing in community and agency • Self-identity as capable economic/social decision maker and agency • Agency and sexual decision making
    10. 10. Research MethodsResearch Methods • Longitudinal survey w gr 10 & 11 students • FGs & IDIs w students (F, M), guardians, teachers, school principals and program facilitators to assess experience with intervention
    11. 11. Research design -Research design - RandomizationRandomization HIV education, social support + financial literacy HIV education and social support Delayed intervention
    12. 12. Rationale •Secondary schools •Least selective sample in this context •Scalable – DOE is base •Bundled accredited package •Females and males •Resounding community feedback •Male attitude, assets and behaviors •Work both sides of gender equation
    13. 13. Programming principlesProgramming principles • Maximal use of existing infrastructure – Tapping & building local human capacity • Make consistent w local reality – National government accreditation of program → cache and door opener for grads – Fin educ geared to local opportunity structures – Facilitator pay rate; local residence & non-absence • Designed w an eye toward scale-up – DOE decision-making from Day 1
    14. 14. Project teamProject team
    15. 15. Program FeaturesProgram Features InterventionIntervention • Evidence-basedEvidence-based • PilotedPiloted • Multi-sectoralMulti-sectoral • Participatory -Participatory - facilitatorsfacilitators • Intensive - multi-sessionIntensive - multi-session • Government accreditedGovernment accredited
    16. 16. CurriculumCurriculum Government-accredited multi-session intervention • Knowledge and skills for pregnancy and HIV prevention and AIDS mitigation; accessing preventive, treatment and care services • Skills to manage personal and familial resources; access existing social benefits, education and training opportunities; planning and aspiring for future; build savings/assets over time • Build and strengthen social networks and support
    17. 17. FacilitatorsFacilitators • Young adult graduates of local program schools • Aged 19-23; female & male • Shared the same socio-economic background, have the same struggles and difficulties understand local resource, social & cultural barriers • Paired in classroom during school hours • Facilitators were seen as successful older brothers/sisters or role models – Official weekly meetings in downtown Durban
    18. 18. “It’s different, in school we learn mathematics and biology but here we learn things that we can use in the future.” - female age 16 Participant views of program
    19. 19. Participant attitudes on HIV and AIDS “….. I didn’t understand about HIV and AIDS before but now I do. I didn’t learn that in school before.” –female age 20 years “It changed my attitude, because I know how to use a condom and I know how to trust my partner and I know how to advise my partner, when we are sitting together and talking about, how to have sexual intercourse and I know even to advise the community as a whole about HIV/AIDS…” –male age 22 years
    20. 20. More participant quotes about program • It is good for young people like me because it teaches about things that happen in real life. • I can express my ideas to others. • I can plan for my future. • Taking steps necessary to pursue my goals. • To make a plan and stick to it. • Made me realize I had a bright future. • What happens now determines my future. • I failed this grade but didn’t give up. • It builds my self-esteem. • I am confident. • How important it is to plan for everything you intend to do. • I have now decided to study and finish school first, rather than planning for family although I have one baby already. • To be prepared for any challenges or circumstances that may ever come. • In order to have a brighter future it starts now and plan what you are going to do with your life. • Knowing everything made me become more assertive. • I am planning high and also work hard to achieve my goals.
    21. 21. Research underway • Outcomes – Sexual behaviors – Gender attitudes – Aspirations; future planning – Financial behaviors – Empowerment and agency • Round 3……and 4 and 5? • Biomarkers…….?
    22. 22. Scaling up and outScaling up and out • In dialog with DOE about scale up • School-based program that retains facilitators, mentors and role models • Involve guardians (primary care givers) of students in the program • Challenge: fundingChallenge: funding
    23. 23. Selected resources • Hallman, K. 2010, in press. “Social exclusion: The gendering of adolescent HIV risks in KwaZulu-Natal, South Africa,” in J. Klot and V. Nguyen eds., The Fourth Wave: An Assault on Women - Gender, Culture and HIV in the 21st Century. Social Science Research Council and UNESCO. • Hallman, K. 2008.“Researching the determinants of vulnerability to HIV amongst adolescents,” IDS Bulletin, 39(5), November 2008. • Bruce, J. and Hallman, K. 2008. “Reaching the girls left behind,” Gender & Development, 16(2): 227-245. • Hallman, K and Roca, E. 2007. “Reducing the social exclusion of girls,” www.popcouncil.org/pdfs/TABriefs/PGY_Brief27_SocialExclusion.pdf • Hallman, K. 2007. “Nonconsensual sex, school enrollment and educational outcomes in South Africa,” Africa Insight (special issue on Youth in Africa), 37(3): 454-472. • Hallman, K. 2005. “Gendered socioeconomic conditions and HIV risk behaviours among young people in South Africa,” African Journal of AIDS Research 4(1): 37–50. Abstract: http://www.popcouncil.org/projects/abstracts/AJAR_4_1.html
    24. 24. Thank you!Thank you! Our funders: ESRC/Hewlett Joint SchemeOur funders: ESRC/Hewlett Joint Scheme & DFID via the ABBA RPC& DFID via the ABBA RPC
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