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    April 15th presentation April 15th presentation Presentation Transcript

    • “Building the Health, Social and Economic Assets of the Poorest Girls in the Developing World” Workshop” Judith Bruce, Senior Associate and Policy Analyst at the Population Council April 15th, 2010I would like to acknowledge Celia Gorman, Nicole Ippoliti, Virginia Kallianes and Marisela Morales who helped me prepare this presentation and mycolleagues at the Population Council with whom I am privileged to work.We have had over 20 active donors dedicated to this work over a span of 12 years from leadership engagement from DFID as a bilateral, to thesustaining moral and financial support from the Nike and NoVo Foundations to individuals giving in time, in kind and in cash.
    • OutlineI. Why Girls: Six Reasons on Which the World AgreesII. Which Girls: Finding the Highest Concentrations of the Poorest Girls Whose Destinies are Most Closely Linked to Health, Social and Economic OutcomesIII. When: Moving Upstream to Anchor Girls’ Rights and Assets at Critical MomentsIV. Current “youth” initiatives largely fail to reach the most disadvantaged and when they do it is not early enough.V. Strategic Program PrinciplesVI. Illustrative programs from the four developing regions
    • I. Why Girls: Six Reasons on Which the World Agrees • Building a strong economic base, reversing inter-generational poverty (Increased female control of income has far stronger returns to human capital and other investments than comparable income under male control) • Achieving universal primary education (the most deprived sector is rural girls) • Promoting gender equality (at the crucial moment of early adolescence as, gender- based abuses appear to be moving down the age spectrum) • Reducing maternal mortality and related infant mortality (selective of youngest and first time mothers) • Reversing the rising tide of HIV in young people (which is increasingly young, poor and female the ratio of female to male infection among those ages 10-24 reaches 8:1 in some parts of sub-Saharan Africa) • Reducing rapid population growth (eliminating child marriage could foster synergistic reduction in future population growth)
    • Intercept Poverty: Give Girls Assets and Preparationfor Decent Livelihoods and Give It To Them Young • $1 in female hands is worth $10 (and in some cases $20) in male hands • A rising and often majority proportion of children will rely exclusively or substantially on the economic and human resources of their mothers (and female relatives) • The vital roles females play in poor houses and the proportion of households supported exclusively by females is highest in the bottom two quintiles where cycles of poverty are entrenched The architecture of poverty for girls, the children they will eventually support, their communities, and, by extension, their nations, is set in late childhood/early adolescence, roughly between the ages of 10-14
    • Dramatic and Negative Transitions of Indigenous 10-14 Year-old Girls in Guatemala 80 70 In school 60 Paid work 50 Unpaid work% 40 30 Married 20 10 Has child 0 10 11 12 13 14 15 16 17 18 19 AgeSource: Hallman et al, 2005, ENCOVI 2000.
    • Girls and planners need to know that girls carry disproportionate and often soleresponsibility for the support of themselves and their children. If present trends continue*: •About one-third of the girls in Kenya •40% in Zimbabwe •50% in Malawi Will be on their own at some point before reaching their 50th birthday. More than 90% will also be economically responsible for one or more children under the age of 15. The risk of being a single mother from either widowhood or divorce, is greatest for girls who come from poor families and who are married under 20. The numbers are not small and the consequences are not insignificant. Failing to invest in these girls is, in effect, planned poverty.*Analysis by Shelley Clark, commissioned by the Population Council and Nike, who projected using suitable life event datafrom Malawi, Kenya, and Zimbabwe the proportion of women whose marriages will be disrupted by divorce or widowhood.This analysis excluded those who were never married, whether or not they had children, did not capture those in polygamousunion or women who were economically abandoned by their husbands-this data is probably the lower boundary of aproportion of women who carry this responsibility.
    • Investment in adolescent girls reduces population growth in four ways: •Delays marriage and child-bearing • Decreases the need for large families as security • Increases their ability to adopt health-seeking behaviors, including protection from HIV, contraception use, and safer maternity practices • Empowers vital intergenerational investment in children’s, especially girls’, educationSource: Tabulations by John Bongaarts, Population Council, estimates based on United Nations Projections
    • The Violence Epidemic: Increasingly Selective of Younger Girls Who are Neither Safe at Home, in School or Any Place in Between Zambia Case Study: Almost half of the girls had heard of a girl in the community who had been forced into sex with a relative in their own home, and over 1/3 with a teacher and 86% report girls are pressured to do things they don’t want for money. Girls’ perceptions of sexual violence at school, community, and home Yes n (percent) Have you ever heard of a girl in this community who has been forced to have sex with a relative from within (48%) her household? Have you ever heard of a schoolgirl in this community who has been forced to have sex with a classmate her (23%) own Have you ever heard of a schoolgirl in this community who has been forced to have sex with a teacher (36%) In any of these incidents, did the girl stop attending school? (61%) In any of these incidents, did the teacher stop teaching? (57%) Were any of these incidents (teacher, classmate, or relative) reported to the girls’ parents? (78%) Were any of these incidents (teacher, classmate, or relative) reported to the police or victim’s support unit? (59%) In any of these incidents (teacher, classmate, or relative), did the girl seek treatment from the local clinic or (62%) hospital? Are girls your age ever pressured to do things they don’t want to do for money? (86%)Source: Martha Brady, Joseph Simbaya, Alison Stone, Maya Vaughn-Smith. 2009. “Understanding Adolescents Girls’ Protection Strategies against HIV: An ExploratoryStudy in Zambia.” New York: Population Council.
    • The Violence Epidemic: Increasingly Selective of Younger Girls Who are Neither Safe at Home, in School or Any Place in Between Zambia Case Study: Almost half of the girls had heard of a girl in the community who had been forced into sex with a relative in their own home, and over 1/3 with a teacher and 86% report girls are pressured to do things they don’t want for money. Girls’ perceptions of sexual violence at school, community, and home Yes n (percent) Have you ever heard of a girl in this community who has been forced to have sex with a relative from within (48%) her household? Have you ever heard of a schoolgirl in this community who has been forced to have sex with a classmate her (23%) own Have you ever heard of a schoolgirl in this community who has been forced to have sex with a teacher (36%) In any of these incidents, did the girl stop attending school? (61%) In any of these incidents, did the teacher stop teaching? (57%) Were any of these incidents (teacher, classmate, or relative) reported to the girls’ parents? (78%) Were any of these incidents (teacher, classmate, or relative) reported to the police or victim’s support unit? (59%) In any of these incidents (teacher, classmate, or relative), did the girl seek treatment from the local clinic or (62%) hospital? Are girls your age ever pressured to do things they don’t want to do for money? (86%)Source: Martha Brady, Joseph Simbaya, Alison Stone, Maya Vaughn-Smith. 2009. “Understanding Adolescents Girls’ Protection Strategies against HIV: An ExploratoryStudy in Zambia.” New York: Population Council.
    • II. Which Girls: Finding the Highest Concentrations of the Poorest Girls Whose Destinies are Most Closely Linked to Health, Social and Economic OutcomesClassified by income: • Lower middle income economy (per capita GNP $761-$3,030) • Low income economy (per capita GNP $760 or less)Or classified by social factors such as: • Stage in the fertility transition • Maternal mortality and poor reproductive health • Prevalence of HIV and female : male infection ratios • Post-conflict and the persistence of sizable unsettled communities • Large populations of ethnic or culturally marginalized communities
    • Identify at the sub-national (or below) level high concentrations of vulnerable girls affected by conditions we want to “zero out.” Girls married under age 15: Ethiopia**of those currently ages 20-24 Prepared by Adam Weiner
    • Percent of girls who were married by 15 in Nigeria
    • Percent of 20-24 Year OldFemales Married by 15 in India
    • Percent of Girls 10-14 not in schooland not living with either parent in India (1,231,000)
    • Percent of Girls 10-14 not in school and not living with either parent in Rwanda (39,825 )
    • Percent of Girls 10-14 not in school and not living with either parent in Mozambique (137,768 )
    • Nigeria: Percent of females (10-14) not in school and not living with either parent with conflict zones superimposed (501,998)Source: U.S. State Department, Humanitarian Information Unit, 2009 Source: DHS 2003
    • Percent of 15-24 year-old Females who Experience JustifyDomestic Violence Under Certain Conditions in Kenya (by region)
    • Women in Zambia Experience High Rates of Physical Violence – mostly at the hands of partners• Over 40% of ever-married 15-24 year-old females have experienced physical violence• In general, gender-based violence is justified by cultural norms and often embedded in war-time behavior. Almost 60% of 15-24 year-olds in the Copperbelt region have experienced physical violence since the age of 15 Source: 2007 Zambia DHS, Tabulation by Marisela Morales
    • III. When: Moving Upstream to Anchor Girls’ Rights and Assets at Critical Moments
    • Adolescent policy is largely an empty cell-leaving adolescents, especially young female adolescents, without a supportive bridge from childhood into adulthood Immunization MCH/first birth (90% Any) (82% 4 + anti-natal visits) Entrance to primary school Legal age for National IDs Legal age for a savings account holder End of mandatory schooling Legal age of marriage ADOLESCENCE (65% of 10-14 year olds in school)Liberia Case Study
    • Emergent Issues by Age 12• Sexual maturation• Consolidation of gender norms, including regarding gender-based violence• Changes in the family (e.g., parents’ marital dissolution)• Disproportionate care and domestic work burden for girls• Withdraw and/or lack of safety from public space for girls• School leaving• School safety for girls• Loss of peers for girls• Migration for work (often informal and/or unsafe)• Subject to sexualizing and consumerist media• Rising need for independent and disposable income & assets• Pressure for marriage or liaisons as livelihoods strategies for girlsSource: Bruce, Judith. Joyce, Amy. 2006 The Girls Left Behind:The Failed Reach of Current Schooling, Child Health,Youth-serving, and Livelihoods Programs for Girls Living in the Path of HIV, Chapter 3
    • Dramatic and Negative Transitions of Indigenous 10-14 Year Old Girls in GuatemalaSource: Hallman et al. 2005, ENCOVI 2000
    • In Egypt, even when schooling levels of rural girls increased, girls’ school attendance dropped sharply near puberty.
    • School Enrollment among 10-17 Year Olds in India (Percent)
    • School Enrollment among 10-17 Year Olds in Pakistan (percent)
    • School Enrollment among 10-17 Year Olds in Rwanda (percent)
    • Schooling Status of Girls 10-14 Not in school In-school TOTAL Never been in school Some schooling 2-years behind On-time 12.9 87.1 RWANDA 4.9 8.0 49.0 38.1 100.0 26.2 73.8 GUATEMALA 9.9 16.3 13.5 60.3 100.0 17.2 82.8 NEPAL 11.4 5.8 39.2 43.6 100.0 71.0 29.0 BURKINA FASO 65.6 5.4 1.8 27.2 100.0 18.9 81.1 GHANA 15.0 3.9 29.4 51.7 100.0 10.6 89.4 KENYA 7.9 2.7 35.3 54.1 100.0 30.0 70.0 NIGERIA 26.5 3.5 27.7 42.3 100.0 23.7 76.3 ZAMBIA 14.7 9.0 14.1 62.2 100.0Derived From: Lloyd, Cythnia B. Young, Julia: New Lessons: The Power of Educating Adolescent Girls. Population Council. 2009
    • Child Marriage:The Second Catastrophic Transition Source: Judith Bruce
    • Social isolation of married girls Married adolescent girls are typified by: - Highly limited or even absent peer networks - Restricted social mobility/freedom of movement - Low educational attainment and virtually no schooling options - Very limited access to modern media (TV, radio, newspapers) and health messages - Very low participation in clubs or organizations - Almost entirely absent from current youth serving initiativesSource, N., Chong, E., and Bracken, H. “Married Adolescents: An Overview.” Paper prepared for the Technical Consultation on Married Adolescents, Source: Bruce, J. and Clark, S. “Including Married Adolescents in Adolescent Reproductive Health and HIV Policy,” Prepared for for the TechnicalWHO, Consultation on Married Adolescents, WHO, Geneva, December 9-12, 2003. Clark, S. “Early Marriage and HIV Risks in Sub-Saharan Africa,” Studies9-12, 2003 in Family Planning, 35(3), 2004; Clark, S., Bruce, J., and Dude, A. “Protecting Young Women from HIV/AIDS: The Case Against Child and Adolescent Marriage.” International Family Planning Perspectives,32(2), June 2006.
    • Child marriage and HIV Risk- without guidance • Older partners • Higher sexual frequency • Intense pressure for pregnancy • Greater social isolation • Difficulty benefiting from any of the conventional HIV protection messages: – Abstinence – Reduce sexual frequency – Reduce number of partners – Use condoms – Know one’s own and one’s partners HIV status, – Observe mutually monogamous relations with an uninfected partnerSources: Glynn, J.R., Caraël, M., Auvert, B., Kahindo, M., Chege, J., Musonda, R., Kaona, F., and Buvé, A., for the Study Group on Heterogeneity of HIV Epidemics in AfricanCities. “Why do young women have a much higher prevalence of HIV than young men?” A study in Kisumu, Kenya and Ndola, Zambia. AIDS 15(suppl 4), S51-60, 2001; Bruce,J. and Clark, S. “Including Married Adolescents in Adolescent Reproductive Health and HIV Policy,” Prepared for for the Technical Consultation on Married Adolescents, WHO,Geneva, December 9-12, 2003. Clark, S. “Early Marriage and HIV Risks in Sub-Saharan Africa,” Studies in Family Planning, 35(3), 2004; Clark, S., Bruce, J., and Dude, A.“Protecting Young Women from HIV/AIDS: The Case Against Child and Adolescent Marriage.” International Family Planning Perspectives,32(2), June 2006.
    • Emerging evidence of high rates of HIV infection in married girls Married Unmarried, sexually active Kisumu, Kenya 32.9% 22.3% Ndola, Zambia 27.3% 16.5%Sources: Glynn, J.R., Caraël, M., Auvert, B., Kahindo, M., Chege, J., Musonda, R., Kaona, F., and Buvé, A., for the Study Group on Heterogeneity of HIV Epidemics in AfricanCities. “Why do young women have a much higher prevalence of HIV than young men?” A study in Kisumu, Kenya and Ndola, Zambia. AIDS 15(suppl 4), S51-60, 2001;
    • IV. Current “youth” (and most alarmingly) HIV initiatives largely fail to reach the most disadvantaged and when they do it is not early enough.Photo Credit: Judith Bruce. South Sudan , 2009
    • Age and Gender Distribution of Participants in “Youth” Programs Demographic Characteristics Number of beneficiaries 10-14 15-19 Country served Males Females 20+ years years years (No. of contacts) 6216 Burkina Faso 56% 44% 7% 30% 63% (6860) 10866 Ethiopia 58% 42% 22% 45% 33% (10873) Guinea 7625 57% 43% 7% 37% 56% Bissau (8167) 5452 Mauritania 83% 17% 28% 42% 25% (8115) 12866 Guatemala 47% 53% 37% 54% 9% (N/A)For a list of authors and review see Transitions to Adulthood Brief No. 28: Accessing Equity of Access in Youth Programs prepared by Adam Weinerhttp://www.popcouncil.org/pdfs/TABriefs/PGY_Brief28_CoverageExercises.pdf
    • An Inversion of Care Those at lesser risk, with greater Those at greatest risk, with least social assets social assets (stable homes, (migrant, less stable families, lesser or no schooling) are receiving majority schooling, experiencing the most frequent share of youth serving resources unprotected sexual relations) are receiving a negligible share of youth serving resources –In school (older) boys –Out of school (younger) girls –Unmarried males –Married girls –Urban born, living in two parents house hold –Migrant, rural origin, living apart from parents –Older adolescents, youth 20+, even 24+ –Youngest adolescents, 10-14Source: Bruce, Judith. “Using Data to Count, Advocate for, and Invest in Adolescent Girls: An Ethiopian Case Study. Nov. 2008
    • While the HIV Epidemic isIncreasingly Young, Poor, and Female Prevalence of HIV/AIDS Average Female to Male ratio of the 15-24 year-old population with HIV/AIDS in Benin, Burkina Faso, Ethiopia, Malawi, Niger, Nigeria, Sierra Leone, Uganda and Zambia: 3 to 1 Source: www.data.un.org, UNICEF_SOWC_2009. Percentage in year 2007 9
    • HIV Prevalence by Gender Rate among 15 - 24 year old population by country and gender Country Female 15 - 24 Male 15 - 24 with Female to Male with HIV/AIDS HIV/AIDS Ratio (15 -24 with HIV/AIDS) Benin 0.9% 0.3% 3 to 1 Burkina Faso 0.9% 0.5% Almost 2 to 1 Ethiopia 1.5% 0.5% 3 to 1 Malawi 8.4% 2.4% 3.5 to 1 Niger 0.5% 0.9% Almost 1 to 2 Nigeria 2.3% 0.8% Almost 3 to 1 Rwanda 1.4% 0.5% Almost 3 to 1 Sierra Leone 1.3% 0.4% Over 3 to 1 Uganda 3.9% 1.3% 3 to 1 Zambia 12.7% 3.8% Over 3 to 1 Source: www.data.un.org , UNICEF_SOWC_2009. Percentage in year 20078
    • Prevention Efforts, HIV Programs are not Going to Young, Poor Girls • In a program scan in KwaZulu-Natal, South Africa, 23 community-based organizations were interviewed • Criteria for inclusion (at least one of the following as major program orientation): - Adolescent/youth issues - HIV/AIDS prevention, treatment, or care - Gender issues - Economic empowerment, income generating, or livelihood activities - Safety or violence prevention
    • Despite the Fact that Almost 17% of Girls 20-24 Living in This Area Were Living with HIV • Of the 14 programs with HIV/AIDS as a main theme, only 5 had gender as a major focus • Among all 23 organizations, only 3 (only 13%) had a significant engagement with or provision of significant social support to vulnerable adolescent girlsSources: Sishana, Olive, et al. (2002). Nelson Mandela, HSRC Study of HIV AIDS: South African National HIV prevalence, behavioural risksand mass media household survey 2002: executive summary. Pretoria: Human Sciences Research Council and Nelson Mandela FoundationSwan, Nick and Kelly Hallman. 2002. “Adolescent/Livelihoods Program Situation: Durban, South Africa,” Mimeo. Population Council.
    • HIV Funding and the Gender Equity Discussion has Prioritized Treatment over Prevention by Wide Margins Zambia Namibia Treatment Prevention Botswana 0 10 20 30 40 50 60 70 80Source: UNAIDS Resource Tracking by Country www.unaids.org/en/CountryResponses/Country
    • V. Strategic Program Principles•Combining data for targeting with structural analysis and grassrootsmobilization of girls•Segmenting-recognizing internal diversity of poor girls•Concentrating resources to reach a threshold proportion of vulnerable girls ineach segment•Developing “asset” building plans for each segment•Community “Contracts”•Girl-Only Platforms•Explicit Plans to Build and Sustain Girls Health, Social and Economic Assets (bysegment)•Recognizing the Close Relationship between Health, Social and EconomicAssets—Social Capital Being the Core
    • April 14, 2008 Judith Bruce, Population Council MAKING THE HANDS MEET Enabling Environment National Millennium Development Goals and Poverty-Reduction Strategies National commitment to CEDAW and the Convention on the Rights of the Child Female- and youth-friendly legal structure to allow access to entitlements, formal employment, savings, property Girl-friendly education – to get them to school on time and keep them there through adolescence Visibility & Advocacy Dedicated, strategically chosen platform: National Girls’ Agenda/Vital Voices/Gigren Public/private (and occasionally celebrity) advocacy and leadership networks Media support, informing about and validating rights, access to legal protections and entitlements, and identifying social and economic opportunities Dedicated Structures/Programs Currently or Potentially Increasing Access & Engagement of Girls &Young Women New progressive schemes/Child savings accounts/Conditional cash transfers Special entitlements to reach vulnerable, younger, excluded populations Women- and girl-led community foundations Self-help, participation, community-centered housing trusts Aereally development plans for conflict and post-conflict situations Aereal focused ‘business’ plans for girls & women in poverty zones (like the Bronx Redevelopment Corporation, for girls & women) Girls’ economic empowerment trusts (joining grassroots, private, public, & financial institutions) (a new idea) Community-based (tangible, viewable, huggable) Programs Demonstrating need, accessibility, feasibility, capacity building, among core beneficiaries, first-generation pilot, second- generation scaling out efforts with groups at the base Abriendo Oportunidades Program
    • Segmenting Develop categorical programs focused on key segments of adolescent girl populations No Currently Attending Attending Out of school schooling out of primary secondary Unmarried Married school school school or and/or higher with children Girls A B C D E F 10-14 Girls G H I J K L 15-19 Girls M N O P Q R 20-24Source: Bruce, Judith and Erica Chong. 2006. "The diverse universe of adolescents, and the girls and boys left behind: A noteon research, program and policy priorities." Background paper to the UN Millennium Project report Public Choices, PrivateDecisions: Sexual and Reproductive Health and the Millennium Development Goals.
    • Segments Case Study: West African Adolescent Girls Livelihoods InitiativeSegment: Challenge/Promise1. Girls 15-17 in secondary school at A potential leadership cadre, sometimes not rising even as high grade for age as 10% of girls. Without intervention, even these girls are at risk of no or unsafe work, sexual coercion, and early parenthood. “unfocused,” “shopping their bodies,” typically large populations2. 16-18, some schooling, literate?, of girls who have little effective demand, visibility, are seeking or less likely to have children (less get lost in “relationships” than 20%) “Ambitious survivors” seek livelihood opportunities and can be, with appropriate social support, childcare and the means to3. 19-24, of which often well over control earnings, prepared for financial capabilities skills, for 50% will already have children wage work in entrepreneurship Lost their childhood and adolescence in the conflict, desperate4. 25-30, have often two or more and deserving, not, however, providing any clear guidance on children, may have been victims of how to work with adolescent girls. extensive violence
    • Middle East, Upper EgyptPrioritizing within the segment: The goal is to reach at least 15% percent ofgirls 12-15 with no schooling or illiterate in villages of under 7,000 so thatthe concentration-the percentage of the eligible reached-is highest in thepriority category. Age No School Some Schooling, Not Literate 12-13 “1” “2” (85%) 14-15 “3” “4”
    • What is an Asset Building Approach? • NOT a specific program activity • It is a conceptual approach that underpins many adolescent programs • It is a framework to guide strategies for working with adolescent girls • What does a girl need to have to make a healthy transition into adulthood?Source: Jennefer Sebstad, Karen Austrian, Judith Bruce
    • Definition of Livelihoods“… The capabilities, assets (including both material and social resources) and activities required for a means of living.” (Carney 1998)Capabilities: the ability to do, to act, to beAssets: human, social, financial, physical assets 47
    • Examples of AssetsSocial assets Human assets• Social networks • Skills and knowledge• Group membership • Good health• Relationships of trust • Ability to work• Access to wider institutions • Self esteem of society • Bargaining power • Autonomy • Control over decisions
    • Examples of Assets (cont)Physical assets Financial assets• Personal assets (clothing, • Cash jewelry, household items) • Savings• Land • Entitlements• Housing• Transport• Tools, equipment and other productive assets
    • Role of assets for adolescent girls ASSETS  REDUCE VULNERABILITY ASSETS  EXPAND OPPORTUNITIES
    • Program Strategies that Build Girls’ AssetsSOCIAL ASSETS HUMAN ASSETSGroup formation Life skills trainingSocial support Health educationDevelopment of social Literacy programs networks Financial educationMentoring Rights education Employability training Vocational/skills training Business development training Business internships/attachments
    • Program Strategies that Build Girls’ Assets (cont)PHYSICAL ASSETS FINANCIAL ASSETSAccess to tools or equipment Savings for businesses CreditSafe physical space to meet Remittance servicesSafe place to work Other financial services
    • Name which asset(s) each program activity builds! A game
    • Name Which Asset(s) Each Program Activity Builds:• Girls meeting weekly in groups of 10-15 girls – social networks – group membership – relationships of trust – Friends• Rights awareness Training – self-esteem, autonomy, control over decision making
    • Name Which Asset(s) Each Program Activity Builds – Cont’d:• Providing Vouchers for Health Services – Good health group membership – Ability to work – Access to wider institutions of society• Savings opportunities – Access to wider institutions of society – Control over decisions – Personal assets, ID card – Savings• Tailoring Course that provides girls with their own sewing machine at completion: – Social networks – Skills, Ability to work, productive asset
    • Bringing it back to assets Asset Examples of Adolescent Program ActivitiesSocial Group formation, safe spaces and social support, networks, mentoringHuman Life skills training, health education, literacy programs, financial education, rights education, vocational training, business skills training, employability trainingFinancial Savings, credit, other financial servicesPhysical Safe physical space to meet;safe working space, access to transport, tools and equipment for businesses
    • What is a staged approach to adolescent programming?• Adolescents have an evolving sense of social and economic independence and responsibility• Adolescents have an evolving connection to the wider social and economic world• How can we accommodate the evolving capacities of adolescent girls in program strategies?
    • At An Early Age…• Group formation• Creation of venues to provide safe spaces for girls to meet• Social support• Mentoring• Life skills training• Introduction to different skills and topics
    • At An Older Age…• Vocational and/or business training• Internships or attachments• Business development• Credit/borrowing• Introduction to concepts of insurance
    • What do we hope to achieve?By the end of adolescence, we would like girls to be prepared for:• Meeting day to day needs• Dealing with life cycle events (births, marriage, educating children)• Coping with emergencies, crises, and unexpected events (risk management)• Taking advantage of opportunities when they present themselves
    • Planning Graphic by Segment: Mayan Highlands Lifecycle Stage Investment Girls, ages Adolescent Young Young Content Program Plan for each 8-12 girls, ages 13-17 womanhood, often young womanhood, often with Available Deliverers stage in the married, ages 12-21 children, ages 22-24 lifecycle stay in own a make hold past Goal school, proud self, informed assets to have have a goal choices, prepare for friends, be beyond initiate a safe supporting girls marriage, livelihood children as prepare for well as one’s decent self work HEALTH ASSETS •Knowledge •Skills •Access to Services SOCIAL ASSETS •Friendship Networks-places to meet friends weekly •Mentors •Safety Nets ECONOMIC ASSETS •Identification of self as an economic actor •Core financial capabilities(Abriendo Oportunidades, Guatemala)
    • Interventions for Rural Girls in Latin America
    • Recognize in program content and sequencing that health, social and economic assets are very closely linked. Females with more friends are: •Less likely to experience sexual coercion-across economic quintiles •More likely to have had an HIV test Ever been tested for HIV: 16-24-year-oldsSource: Hallman, Kelly. Population Council, Poverty, Gender and Youth Program. “Siyakha Nentsha”: Enhancing Economic, Health, andSocial Capabilities of Highly vulnerable Adolescents in South Africa”. December 2008.
    • Recognize the close relationship between economic assets and health assets. An extremely high proportion of the girls in South Africa are well informed about HIV, yet the ratio of female to male infection among those 15-24 has risen in some communities to 8:1Source: Hallman, Kelly. Population Council, Poverty, Gender and Youth Program. “Siyakha Nentsha”: Enhancing Economic, Health, and Social Capabilities ofHighly vulnerable Adolescents in South Africa”. December 2008.
    • Assess new interventions through the lens of segmentation and the interplay of health, social and economic assets: The case of cell-phones for banking. Which girls are likely to benefit? Grid through which to view the benefits, costs, operational considerations of using cell phone technology with respect to savings and assets for girls in different categories Six core elements of empowerment Types of assets conferred Type of Girl Five Place to Mentor Personal Finan- Personal Access to Access to support Airtime Fungible assets, Full service ability to friends meet, at to turn to documentation cially savings social network to minutes e.g. able to deposit and least literate account messaging support positive trade minutes withdraw money secure & tangible weekly and choices & for items linked (with transaction unique information behavior change to survival costs that are (food, clothing) reasonable & affordable)A) Girl 16-24,working for wagesB) School-aged girl,in schoolC) School-aged girl,working part-timeinformally (not inwaged work,typically), and inschoolD) School-aged girl,not working, not inschoolNorthern Nigeria
    • Remember the Shark RepellentThere is always someone who wants to take girls’ assets away.Identify the persons and the process and plan a response. •Counter intimates’ (parents’ and partner’s) attempts to prevent the acquisition of and/or appropriate girls’ assets. Males do not face this problem. •Preventative strategies to help girls/young women hold assets: capacity to make contracts, own and control property • Identify administrative procedures degree of ‘discretion’ that allow harassment and denial of benefits. •Develop explicit safety plans to address violence and threats of violence—at core, disinvestment in girls/women.
    • Community “Contracts”Policy change and community commitment can never be a secret.
    • Keep girls at the center while managing the threats and gatekeepers in her environmentSignificant Segments of Girls Her Special Key Personalities, Challenges Gatekeepers that need to be contactedThe in-school girl at or neargrade for ageThe deeply disadvantaged girl,abused, living apart fromparents, not in schoolThe married girlThe girl with a childThe girl who isn’t working andisn’t in school, “doing nothing”(ages 17-20, for example)The girl in domestic serviceThe wage-working girl
    • Engage communities in making explicit commitments. Forexample, the community could:• Support safe house-to-house surveys• Facilitate the recruitment process• Provide space and existing facilities for meetings, recruitment, training, follow up• Establish places where girls can meet• Create safety zones, put in street lights, developed specific security and protection procedures• Enforce protective laws more systematically• Organize service provisions/entitlements at times of days, seasons, and weeks which make them more accessible to girls
    • Delaying child marriage requires intervening in the current community contact and the community “marriage market.” Family level, and later community level, incentives may be necessary. Amhara girl with a goat her family received after she remained in school during the critical 13- 15 year old period Photo Credit: Fikreyesus GarredewSource: http://www.popcouncil.org/pdfs/Ethiopia_EvalBerhaneHewan.pdf
    • VI. Illustrative Programs
    • Core Strategy Girl-Only Spaces: An asset in themselves and a platform to build health, social, and economic assets Finding friends and Finding adult mentors Building community based female leadership Receiving health, especially reproductive health, information Developing skills that support community health Being knowledgeable and accessing health services Learning their rights Addressing negative gender norms Basic health, social support, safety assessment Provision of basic health information and services as appropriate, directly or on referral (vaccines, iron tablets, HPV vaccine, ARV treatment)For more information, see Bruce, Judith Reaching The Girls Left Behind: Targeting Adolescent Programming for Equity, Social Inclusion, Health, and Poverty Alleviation Prepared for:“Financing Gender Equality; a Commonwealth Perspective,” Commonwealth Women’s Affairs Ministers Meeting, Uganda, June 2007., Bruce, Judith. 2008. "The girls left behind: Usingpolicy research and evidence-based programs to’SEE’ the girls left behind," presentation at launch of UN Interagency Task Force on Adolescent Girls in Paris, France, 20 October., Bruce,Judith. 2008. “Investing in the poorest girls in the poorest communities: A critical development, reproductive health, and human rights strategy,” presentation at European ParliamentaryForum on Population and Development in Brussels, Belgium, 19 October. Chong, Erica, Kelly Hallman, and Martha Brady. 2006. "Investing when it counts: Generating the evidence base forpolicies and programs for very young adolescents--Guide and tool kit," New York: UNFPA and Population Council.
    • Girl-only spaces: An asset in themselves and a platform to build health, social, and economic assetsLearning basic financial literacy skills (principles of money management,building, retaining, and safeguarding assets)Obtaining vital documentation (ID cards, health certificates)Accessing health entitlements, including HIV-relatedPlanning for seasonal stressesDealing with prolonged illness, death, inheritance, succession planning,migration for work, rapeEstablishing safe and independent control over savingsBuilding capacity to access (when ready) more demanding opportunities:entrepreneurship training, participation in group lending, establishment ofbusiness
    • The platform is a bowl into which you can add manyelements. Without this bowl—or platform—very little of sustained value to girls is possible. Planning basic health entrepreneurship training information control over savings Building capacities
    • And Purposefully Build Solidarity Among Girls: Anchoring the Female Infrastructure
    • Abriendo Oportunidades:Keeping girls in school, delaying marriage and childbearing, and building a national rural girls’ movement in the Mayan Highlands of Guatemala. • Community clubs of girls ages 8-12 and 13-18 * • 80 young female mentors gain leadership and professional skills and experience • Girls clubs which meet weekly offer girls a 1-year age, gender and lifecycle-sensitive skill-building program, now adding community health skills and financial literacy • Mentors and participant girls are linked in a national network that provides an advocacy platform from the family to the international level Reaching 3,000 girls currently. Adding an additional 20 communities in 2010-2011.For more information, see Sandra Contreras Aprile Jennifer Catino, Kelly Hallman, Eva Roca, Marta Julia Ruiz, and Adam Weiner. "For Mayan girls, safe spaces lead tosocial gains," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 5. New York: Population Council. (updated September 2009)
    • Ishraq (“ Enlightenment” in Arabic) Offering second chance schooling, delaying marriage, creating female platforms in rural Upper Egypt. Girls participate 3-4 times a week for 2 years in a literacy, life skills, and sports program to empower 12 to 15-year-old out-of-school girls and facilitate their entry into formal schooling. It offers: • Safe, publicly acknowledged spaces for girls to gather, make friends, learn and play • To improve girls’ functional literacy and foster their continuing schooling, channeling girls to government schools • Information about girls’ rights regarding marriage, bodily integrity, nutrition, hygiene, and reproductive health •Physical education and sports for girls Reaching 2,000 girls in 30 villages of 7,000 or less in four Upper Egyptian governorates, and soon adding financial capabilities and savings.For more information, see Brady, Martha, Abeer Salem, and Nadia Zibani. "Bringing new opportunities to adolescent girls in socially conservative settings: The Ishraq program in rural UpperEgypt," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 12. New York: Population Council. (updated August 2007)http://www.popcouncil.org/pdfs/TABriefs/PGY_Brief12_Ishraq.pdf, Brady, Martha, Ragui Assaad, Barbara Ibrahim, Abeer Salem, Rania Salem, and Nadia Zibani. "Providing new opportunities toadolescent girls in socially conservative settings: The Ishraq program in rural Upper Egypt." New York: Population Council. http://www.popcouncil.org/pdfs/IshraqReport.pdf
    • Biruh Tesfa (Amharic for “Bright Future”) A program for migrant, destitute girls living in the heart of the urban Ethiopian HIV epidemic • Biruh Tesfa promotes single-sex and age-specific safe spaces for out-of-school girls aged 10–19 – many in-migrant girls working as domestic workers. • The program offers functional literacy, life skills, livelihood skills, and health and HIV education through girls’ clubs led by adult mentors • Meeting times accommodate the schedules of working girls, with groups meeting for two hours, three times a week. • The Biruh Tesfa project has its own identity card which includes the stamp of the kebele and the signature of its chairman, providing girls with a sense of inclusion and a degree of social protection. • Biruh Tesfa negotiated wellness checkups with local clinics for all girls in the program, collecting background information on the girls’ situation and including basic medical exams, laboratory tests, and treatment for simple ailments. Reaching 3,000 girls in Addis and Bahir Dar as both asset building and primary HIV prevention.For more information, see Erulkar, Annabel S., Tekle-Ab Mekbib, and Mesfin Tegegne. "Biruh Tesfa: Creating a Bright Future for migrant girls in urban areas of Ethiopia,"Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 21. New York: Population Council. (updated January 2008)
    • Berhane Hewan Delaying marriage and supporting married girls in Amhara, Ethiopia Girls’ groups & support to remain in school Three options for participation: •Support to remain in/return to school •Participation in unmarried girls groups led by mentors •Participation in married girls groups led by mentors Reaching 12,000 girlsErulkar, Annabel S. and Eunice Muthengi. "Evaluation of Berhane Hewan: A program to delay child marriage in rural Ethiopia," International Perspectives onSexual and Reproductive Health 35(1): 6–14.urce: Erulkar et al. 2009
    • Significant delays in marriage from early to later adolescence Percent of adolescent girls married at endline, by age & area of residence Control Experimental 100 80 Percent married 60 40 20 0 10 11 12 13 14 15 16 17 18 19 Age Reaching contraceptive use of 74% among married girlsErulkar, Annabel S. and Eunice Muthengi. "Evaluation of Berhane Hewan: A program to delay child marriage in rural Ethiopia," International Perspectiveson Sexual and Reproductive Health 35(1): 6–14.urce: Erulkar et al. 2009
    • Reaching the Youngest First-time Mothers in IndiaSafe space for married girls to meet, make friends,learn and take action, measurablly increased: – Married girls’ peer support – SRH knowlege and use of contraceptives (delay first birth) – Preparation for delivery – Post-partum service utilization – Immediate breast feeding (colostrum) – Spousal communication • Expressing own opinion to husbands when they disagree*Results more robust in Diamond Harbour where there was group social support intervention
    • Binti Pamoja Creating girl leadership and network of girls’ spaces for skill building in a poor, conflicted community •Girls mapped their constituencies to identify existing and potential safe spaces which revealed that less than 2% of girls in Kibera had access to girly only programming once a week • The Center provides intensive training in reproductive health/HIV, communication/leadership skills, and budgeting, savings and setting financial goals. • Utilizing a cascading leadership model, Binti girls start their own girls’ groups, which currently reach 500 girls.For more information, see Austrian, Karen. "Expanding safe spaces and developing skills for adolescent girls," Promoting Healthy, Safe, and ProductiveTransitions to Adulthood Brief no. 29. New York: Population Council 86
    • Kibera, Kenya: Number of Girl-Led Girl Groups by Constituencyce: Open Street Map
    • Now a savings product is offered by two banks in Uganda and Kenya, currently reaching 10,000 girls this year and scaling out (resources permitting) to another 30,000. Source: K-Rep Bank 2009. Marketing Materials for Go Girl Savings Account. This is supported by the Nike Foundation and the NoVo Foundation
    • Thank you!
    • SourcesAustrian, Karen. "Expanding safe spaces and developing skills for adolescent girls," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 29. New York: Population CouncilBrady, Martha, Abeer Salem, and Nadia Zibani. "Bringing new opportunities to adolescent girls in socially conservative settings: The Ishraq program in rural Upper Egypt," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 12. New York: Population Council. (updated August 2007) .Brady, Martha, Ragui Assaad, Barbara Ibrahim, Abeer Salem, Rania Salem, and Nadia Zibani. "Providing new opportunities to adolescent girls in socially conservative settings: The Ishraq program in rural Upper Egypt." New York: Population Council.Brady, Martha and Lydia Saloucou. "Addressing the needs of married adolescent girls in Burkina Faso," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 9. New York: Population Council. (updated July 2007) .Bruce, Judith and Erica Chong. 2006. "The diverse universe of adolescents, and the girls and boys left behind: A note on research, program and policy priorities." Background paper to the UN Millennium Project report Public Choices, Private Decisions: Sexual and Reproductive Health and the Millennium Development Goals.Bruce, Judith. 2007. "The girls left behind: Out of the box and out of reach," presentation at Gender Dimensions of HIV & Adolescent Programming in Ethiopia, Addis Ababa, 11 April.Bruce, Judith. Joyce, Amy. 2006 The Girls Left Behind:The Failed Reach of Current Schooling, Child Health,Youth-serving, and Livelihoods Programs for Girls Living in the Path of HIV, Chapter 3Bruce, Judith. 2008. "The girls left behind: Using policy research and evidence-based programs to ’SEE’ the girls left behind," presentation at launch of UN Interagency Task Force on Adolescent Girls in Paris, France, 20 October.
    • SourcesBruce, Judith. 2008. “Investing in the poorest girls in the poorest communities: A critical development, reproductive health, andhuman rights strategy,” presentation at European Parliamentary Forum on Population and Development in Brussels, Belgium, 19October.Bruce, J. and Clark, S. “Including Married Adolescents in Adolescent Reproductive Health and HIV Policy,” Prepared for the Technical Consultation on Married Adolescents, WHO, Geneva, December 9-12, 2003. Under review for publicationChong, Erica, Kelly Hallman, and Martha Brady. 2006. "Investing when it counts: Generating the evidence base for policies and programs for very young adolescents--Guide and tool kit," New York: UNFPA and Population Council.Clark, S. “Early Marriage and HIV Risks in Sub-Saharan Africa,” Studies in Family Planning, 35(3), 2004; Clark, S., Bruce, J., and Dude, A. “Protecting Young Women from HIV/AIDS: The Case Against Child and Adolescent Marriage.” International Family Planning Perspectives,32(2), June 2006.Erulkar, Annabel, Tekle-Ab Mekbib, Negussie Simie, and Tsehai Gulema. 2004. "The experience of adolescence in rural Amhara Region, Ethiopia," Accra, Ghana: Population Council.Erulkar, Annabel S., Tekle-Ab Mekbib, and Mesfin Tegegne. "Biruh Tesfa: Creating a Bright Future for migrant girls in urban areas of Ethiopia," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 21. New York: Population Council. (updated January 2008).Erulkar, Annabel S. and Eunice Muthengi. "Evaluation of Berhane Hewan: A program to delay child marriage in rural Ethiopia,"International Perspectives on Sexual and Reproductive Health 35(1): 6–14.urce: Erulkar et al. 2009Glynn, J.R., Caraël, M., Auvert, B., Kahindo, M., Chege, J., Musonda, R., Kaona, F., and Buvé, A., for the Study Group on Heterogeneity of HIV Epidemics in African Cities. “Why do young women have a much higher prevalence of HIV than young men?” A study in Kisumu, Kenya and Ndola, Zambia. AIDS 15(suppl 4), S51-60, 2001.Haberland, N., Chong, E., and Bracken, H. “Married Adolescents: An Overview.” Paper prepared for the Technical Consultation on Married Adolescents, WHO, Geneva, Dec 9-12, 2003.
    • SourcesHallman, Kelly, Eva Roca, Marta Julia Ruiz, Jennifer Catino, Alejandra Colom, and Sandra Contreras Aprile. "For Mayan girls, safe spaces lead to social gains," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 5. New York: Population Council. (updated September 2007).Hallman, Kelly. Population Council, Poverty, Gender and Youth Program. “Siyakha Nentsha”: Enhancing Economic, Health, and Social Capabilities of Highly vulnerable Adolescents in South Africa”. December 2008.Santhya, K.G. and Nicole Haberland. "Empowering young mothers in India: Results of the First-time Parents Project," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 8. New York: Population Council. (updated December 2007) .Weiner, Adam. 2007. “Assessing equity of access in youth programs,” Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 28. New York: Population Council.Weiner, Adam. “The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Ethiopia2009.” New York: Population Council, 2009. http://www.popcouncil.org/pdfs/PGY_AdolDataGuides/Ethiopia2005.pdfWeiner, Adam. “The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Ghana2009.” New York: Population Council, 2009. http://www.popcouncil.org/pdfs/PGY_AdolDataGuides/Ghana2003.pdfWeiner, Adam. “The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Kenya2009.” New York: Population Council, 2009. http://www.popcouncil.org/pdfs/PGY_AdolDataGuides/2003.pdf