Stepping Stones and Creating FuturesGender and       Project Empower HEARD, UKZN          University ofHealth Unit, MRC   ...
Session ObjectivesThis session has three main objectives:   •   To enable participants to understand the importance of    ...
Outline of this session• Why tackle gender inequalities and poverty for  HIV prevention? Power Walk (30 minutes)• Stepping...
RationaleAssumption: Gender inequalities intersect with  livelihood insecurity to increase HIV risk behaviours  and gender...
Previous evaluations of similar    interventionsIntervention Approach            Setting          OutcomesIMAGE        Mic...
Informal settlements and HIVInformal settlements are a key HIV issue:  •   28% of people living with HIV/AIDS in southern ...
Stepping StonesUsed globally since 1995 – aims to achieve HIV  prevention through greater gender equalityTwo year evaluati...
Creating Futures: supporting young   people in building their livelihoods• Jointly created by the three partner  organisat...
Creating Futures• Builds on a livelihoods framework:  •   Human capital (education)  •   Social capital (networks, relatio...
Creating FuturesProcess to develop manual  1. Workshop with a broad set of stakeholders early in     2011 to explore the c...
Delivering Stepping Stones and Creating FuturesRecruited 233 young people (110 men, 123  women) with an average age of 21....
Design of study            2 weeks 0 Months                                                     12 Months                 ...
Implementing the interventionMay – August 2012• Retention/attendance:    •   Attended 1 session: 183 (13%        drop out)...
Outcomes: Warning!1. Not final results – April 20132. No significance tests done3. Instability of scales: reporting where ...
Improving livelihoods• Men and women increased mean income in past  month:  •   Men from R411 (US$45) to R713 ($77 a 73% i...
Improved thinking around livelihoodsImproved navigation of work settings:Young man: “Before I used to do things recklessly...
Critical thinking about gender relationships   INTERVIEWER: According to you, what makes a good woman?   NOMZAMO (Female):...
Greater focus on main partner   Interviewer: let’s talk about the experience you had with the   program like what made you...
Transactional sexMen’s participation in transactional sex in the past  three months from 24% to 18% (a 23% decline)Women’s...
Mental HealthSevere depression amongst men: 50% down to  37% (74% decline)Suicidal thoughts past 4 weeks: 28% decline  amo...
Substance use   Vusi (Male): You see we sit down [my girlfriend and I] and   discuss things together, like maybe let’s for...
Outcomes SummaryShort-term positive trends:  •   Strengthening livelihoods (more working, more      earnings, women ‘tryin...
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Building young people's capacity around gender equality and livelihoods: the Stepping Stones and Creating Futures intervention - HEARD

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Building young people's capacity around gender equality and livelihoods: the Stepping Stones and Creating Futures intervention

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Building young people's capacity around gender equality and livelihoods: the Stepping Stones and Creating Futures intervention - HEARD

  1. 1. Stepping Stones and Creating FuturesGender and Project Empower HEARD, UKZN University ofHealth Unit, MRC PretoriaRachel Jewkes Mpume Mbatha Andy Gibbs Milly MushingaNwabisa Jama- Laura Washington Alison MisselhornShaiYandisa Ntokozo Madlala Samantha WillanSikweyiya Funded by: SIDA, the Joint Gender Fund and the MRC (South Africa) Project Start Date: January 2011 Project End Date: August 2013
  2. 2. Session ObjectivesThis session has three main objectives: • To enable participants to understand the importance of tackling gender inequalities and poverty simultaneous • To share initial findings of the Stepping Stones/Creating Futures intervention • To provide participants with the experience of a livelihoods intervention
  3. 3. Outline of this session• Why tackle gender inequalities and poverty for HIV prevention? Power Walk (30 minutes)• Stepping Stones and Creating Futures - presentation (30 minutes)• Creating Futures - experience (30 minutes)
  4. 4. RationaleAssumption: Gender inequalities intersect with livelihood insecurity to increase HIV risk behaviours and gender-based violence: • Women – poverty linked to IPV, challenges negotiating condom use, transactional sex, inability to exit violent relationships (Hunter, 2010; Jewkes & Morrell, 2012) • Men – livelihood insecurity linked to perpetration of violence, HIV prevalence, MCPs, alcohol use (Hunter, 2010)Therefore: transform gender relationships and buildlivelihoods…
  5. 5. Previous evaluations of similar interventionsIntervention Approach Setting OutcomesIMAGE Microfinance and South Africa: Women’s experience of IPV gender Rural, av. age 41, reduced by 55% transformation womenSHAZ! Gender Zimbabwe: Increase in HIV-related transformation & urban, knowledge and relationship vocational skills adolescent, power, no significant change in women current sexual activity or condom use at last sexMicro- Microfinance, Kenya: urban, 45% reported leaving sex work.enterprise peer education female sexservices workers These results were highly agefor sex dependent with olderworkers women reporting better outcomesTRY Microfinance, Kenya: urban, Increased ability to insist on educational topics adolescent condom use
  6. 6. Informal settlements and HIVInformal settlements are a key HIV issue: • 28% of people living with HIV/AIDS in southern and eastern Africa live in 14; approximately 15% of the global epidemic (van Renterghem & Jackson, 2009) • In South Africa, 29.1% of the total estimated number of new HIV infections are found in urban informal settlements, even though only 8.7% of South Africans older than 2 years live in these areas (Rehle et al., 2007) • Few scientific evaluations of interventions in these communities (Gibbs et al., 2012)
  7. 7. Stepping StonesUsed globally since 1995 – aims to achieve HIV prevention through greater gender equalityTwo year evaluation (by MRC): • Reduced HSV2 new infections by 33% in men and women • Less risky drinking – men • Reduced IPV – men • Less transactional sex – women and men (Jewkes et al., 2008)10 session intervention
  8. 8. Creating Futures: supporting young people in building their livelihoods• Jointly created by the three partner organisations• It seeks to encourage reflection and action among young people on their livelihoods through participatory activities• Ten sessions
  9. 9. Creating Futures• Builds on a livelihoods framework: • Human capital (education) • Social capital (networks, relationships) • Physical capital (housing) • Financial capital (savings, work) • Natural capital (land, rivers)• Creating Futures encourages young people to reflect on their activities and decisions within this broad framework
  10. 10. Creating FuturesProcess to develop manual 1. Workshop with a broad set of stakeholders early in 2011 to explore the context 2. Partnered with an ‘implementing’, grass roots organisation 3. Literature scan- livelihoods and curriculum theory 4. Log-frame development 5. Expert review 6. Manual development 7. 2x pre-tests
  11. 11. Delivering Stepping Stones and Creating FuturesRecruited 233 young people (110 men, 123 women) with an average age of 21.7 yearsAll from informal settlements around Durban • Two-thirds of women had given birth to a child, compared to one third of men who had fathered a child • Only 45% of men and 24% of women had finished high school • Men and women reported rates of intimate partner violence (physical and sexual) in the past 12 months of 40%, compared to a national average of 13%
  12. 12. Design of study 2 weeks 0 Months 12 Months 6 Months Combined Stepping Stones & Creating Futures Intervention (20 sessions)Quantitative Quantitativesurvey (233), survey (221 – QuantitativeFGDs – in- 95% followed- surveydepth up)interviews In-depth In-depth interviews Quantitative survey (206) interviews
  13. 13. Implementing the interventionMay – August 2012• Retention/attendance: • Attended 1 session: 183 (13% drop out) • Attendance – 50% overall• Taxi strikes• Highly mobile population: CT, EC, Jo’burg, rural areas Sbu facilitates a discussion on• Boyfriends controlling a body map participants have girlfriends drawn
  14. 14. Outcomes: Warning!1. Not final results – April 20132. No significance tests done3. Instability of scales: reporting where we have ‘strong’ evidence of change/ correlate with Stepping Stones outcomes4. Small scale study with no control Casper facilitating a discussion on women’s expectations of men
  15. 15. Improving livelihoods• Men and women increased mean income in past month: • Men from R411 (US$45) to R713 ($77 a 73% increase) • Women R174 ($18) to R255 ($28 a 47% increase)• Job seeking only changed among women: • Looking for jobs in newspapers more in the past three months, from 45% to 66% • Sent off a job application in past 3 months – increased by 11%• Stealing in the last month because hungry: • 22% decline among men, 18% decline among women
  16. 16. Improved thinking around livelihoodsImproved navigation of work settings:Young man: “Before I used to do things recklessly, drink alcohol and come back home around 12am or 1am while I would be going to work that morning, and I would go to work and get warnings, but Project Empower showed me how to do things”Improvement in savingsMale participant – focus group: What I have learnt is to stick to my budget and also make a list and stick to those things that are in the list and not spend money on unimportant things.
  17. 17. Critical thinking about gender relationships INTERVIEWER: According to you, what makes a good woman? NOMZAMO (Female): Women who would be independent, they would not expect to be controlled by men, firstly. They would not allow a man to control them. They must know that they also have rights and have to fight for them. She must work for herself and not expect to be given thingsCritical thinking about relationships is a pre- condition for acting in new ways Male participants acting out a role play during Stepping Stones
  18. 18. Greater focus on main partner Interviewer: let’s talk about the experience you had with the program like what made you get involved with the project? Mandla (male): this programme has helped me a lot like workwise I’m holding on to it, and the person I am dating I have committed myself to her and other things are progressive and my child is growing wellPercentage men who reported that their last sexual act was with main partner: 50% at baseline to 62% at follow up, a 23% increase (potential decrease in overlapping/concurrent relationships)Percentage women reporting satisfactory sexual relationship with main partner increased (up 12%)
  19. 19. Transactional sexMen’s participation in transactional sex in the past three months from 24% to 18% (a 23% decline)Women’s participation in transactional sex in the past three months increased – same as Stepping Stones. But, there was a 23% reduction in women reporting that their last experience of transactional sex was conditional on the exchange
  20. 20. Mental HealthSevere depression amongst men: 50% down to 37% (74% decline)Suicidal thoughts past 4 weeks: 28% decline among menNo impact on mental health among women
  21. 21. Substance use Vusi (Male): You see we sit down [my girlfriend and I] and discuss things together, like maybe let’s for an example like when I used to drink… Interviewer: So have you stopped drinking? Vusi: Yes. Interviewer: Or you have taken a break? Vusi: No I have stopped, but they [friends] try to get me to drink again but they never are successful at it (laughing) no they fail!Arguing with a partner about alcohol use in the past three months also declined among men (35%) and women (27%)Women’s use of drugs: declined from 17% to 8%
  22. 22. Outcomes SummaryShort-term positive trends: • Strengthening livelihoods (more working, more earnings, women ‘trying’ more) • Gender relationships changing – parallel Stepping Stones (esp. focus on main partner) • Wider health benefits – parallel Stepping Stones (reduction in substance abuse, decrease mental health issues)Sustaining these into the future - critical

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