Kelly Hallman, Kasthuri Govender, Eva Roca, Cecilia Calderon,
Emmanuel Mbatha, Mike Rogan, and Hannah Taboada
Population C...
Mixed methods at each stage
• Planning
• Program design
• Program implementation
• Measurement of outcomes
Strategic planning -
Mixed methods to learn
 Which adolescents vulnerable
- Identify highest concentrations of vulnerable...
Survey and quantitative analysis
Structural factors associated with
adolescent HIV risk behaviors
• Residing in relative p...
*of those currently ages 20-24
(2005 Ethiopia DHS)
Source: “The Adolescent Experience In-Depth:
Using Data to Identify and...
Pilot programme
– Via state-funded not-for-profit child welfare
organization
– Consultations with traditional leaders
– FG...
Extensive engagement
with stakeholders
• Traditional leaders
• Department of education
• Schools
• Guardians
Intervention purpose
Improve functional capabilities and well-being of
adolescents at high risk for:
HIV and STIs teenage ...
Intervention content
• Knowledge and skills for pregnancy and HIV prevention
and AIDS mitigation; accessing preventive, tr...
Intervention delivery - 1
• Incorporated into school day
• Least selective sample in this context
• Saturation of geograph...
Sound programming methodology
• Maximum use of existing infrastructure
– Tap & build local human and physical capacity
• M...
Randomized
intervention
HIV education,
social support
+ financial
literacy
HIV
education
and social
support Delayed
interv...
Research Methods
• Longitudinal survey w
participants
• Household-based interview
– Data quality
– Tracking (household GIS...
Implementation challenges
• Working within existing local program
– School or NGO
• Mandates, priorities
• Ownership (prog...
Advantages of mixed methods
• Ongoing partnership between researchers and
programme implementers
– Allows for iterative, d...
Advantages of mixed methods
Triangulation
• Sheds light on “confusing” results; reveals
complexities
• Research is more po...
Way forward
• Assessing differential impact of
two experimental arms
• DOE eager to scale programme
out
• Need to follow p...
Selected resources
• Hallman, K. 2010, in press. “Social exclusion: The gendering of adolescent HIV
risks in KwaZulu-Natal...
Thank you!
Our funders: ESRC/Hewlett Joint Scheme
& DFID via the ABBA RPC
photos by Ms.
Eva Roca
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Building Health, Social, and Economic Capabilities among Adolescents Threatened by HIV and AIDS (mixed-methods research)

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  • Ethiopia: Child Marriage rates in Amhara Province are nearly double that of the next most effective region (Tigray)
  • Aspirations failure from poverty trap literature. Low aspirations correlated with more sexual risk taking (Barnett)
  • Building Health, Social, and Economic Capabilities among Adolescents Threatened by HIV and AIDS (mixed-methods research)

    1. 1. Kelly Hallman, Kasthuri Govender, Eva Roca, Cecilia Calderon, Emmanuel Mbatha, Mike Rogan, and Hannah Taboada Population Council, Isihlangu HDA, University of KwaZulu-Natal Using mixed methods to study the relationship between reproductive health and poverty: Lessons from the field A methods workshop, PovPov Research Network November 4-5, 2010, London Building economic, health and social capabilities among adolescents threatened by HIV and AIDS The Siyakha Nentsha (“Building with Young People”) program in KwaZulu-Natal
    2. 2. Mixed methods at each stage • Planning • Program design • Program implementation • Measurement of outcomes
    3. 3. Strategic planning - Mixed methods to learn  Which adolescents vulnerable - Identify highest concentrations of vulnerable by gender, age & geography (quant w mapping)  Whether at-risk adolescents reached by “youth” initiatives (IDIs w programmes)  What components missing from existing programs (IDIs w programmes)  How to reach/target a programme
    4. 4. Survey and quantitative analysis Structural factors associated with adolescent HIV risk behaviors • Residing in relative poverty • Fewer social connections • Non-cohesive community • Orphanhood Source: Hallman 2004, 2005, 2007, 2008, 2010; Hallman & Roca 2007
    5. 5. *of those currently ages 20-24 (2005 Ethiopia DHS) Source: “The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Ethiopia 2005.” New York: Population Council, 2009. http://www.popcouncil.org/publications/serialsbriefs/ AdolExpInDepth.asp Highest rates (48%) in the Amhara region Girls married by age 15: Ethiopia*
    6. 6. Pilot programme – Via state-funded not-for-profit child welfare organization – Consultations with traditional leaders – FGDs with grandparents, parents, young men, young women – Local education expert and social workers developed the curriculum – Longitudinal survey
    7. 7. Extensive engagement with stakeholders • Traditional leaders • Department of education • Schools • Guardians
    8. 8. Intervention purpose Improve functional capabilities and well-being of adolescents at high risk for: HIV and STIs teenage pregnancy early unplanned parenthood school dropout loss of one or both parents lack of knowledge of further employment and training opportunities
    9. 9. Intervention content • Knowledge and skills for pregnancy and HIV prevention and AIDS mitigation; accessing preventive, treatment and care services • Skills for: – managing personal and familial resources – Accessing social benefits, education and training opportunities – planning and aspiring for the future – building savings/assets over time • Building and strengthening social networks and support
    10. 10. Intervention delivery - 1 • Incorporated into school day • Least selective sample in this context • Saturation of geographic area • Timing of “life orientation” as examinable • Females and males • Responding to local needs • Male attitudes, behaviors and future prospects • National accreditation of – Curriculum – Implementing organization as training providers
    11. 11. Sound programming methodology • Maximum use of existing infrastructure – Tap & build local human and physical capacity • Make consistent with local reality – Facilitator pay rate same as government auxiliary social worker – Local residence: no absences; know local realities – National accreditation of program → cache and door opener for graduates – Curriculum geared to local opportunity structures • Designed with an eye toward scale-up – DOE decision-making from Day 1
    12. 12. Randomized intervention HIV education, social support + financial literacy HIV education and social support Delayed intervention
    13. 13. Research Methods • Longitudinal survey w participants • Household-based interview – Data quality – Tracking (household GIS) • FGDs to assess experience with intervention: participants (by gender & grade) & guardians • IDIs with program facilitators • School quality assessments
    14. 14. Implementation challenges • Working within existing local program – School or NGO • Mandates, priorities • Ownership (programme; facilities; personnel) • Time and resource constraints • Managing local expectations of what programme will deliver • Explaining why programme is randomised • Rationale for control schools
    15. 15. Advantages of mixed methods • Ongoing partnership between researchers and programme implementers – Allows for iterative, dynamic process • “Course correction” during intervention • Improved research instruments • Ability to select qualitative study participants purposefully from survey, based on designated characteristics
    16. 16. Advantages of mixed methods Triangulation • Sheds light on “confusing” results; reveals complexities • Research is more policy relevant and responsive • New research issues emerge
    17. 17. Way forward • Assessing differential impact of two experimental arms • DOE eager to scale programme out • Need to follow participants to assess longer-term impact of intervention
    18. 18. 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
    19. 19. Thank you! Our funders: ESRC/Hewlett Joint Scheme & DFID via the ABBA RPC photos by Ms. Eva Roca

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