Adolescent Development
Conditions
Brief summary
This trial will serve as an outcome evaluation of 'Adolescent Transition in West Africa' (ATWA), a school-based program in Mali, Burkina Faso, and Niger for adolescents ages 10-19. The overall objectives of the project are as follows: Impact: Improved sexual and reproductive health and rights of 472,180 adolescents. Outcome 1: Improved sexual and reproductive health and rights and gender equality knowledge, intent, and behaviors among 472,180 adolescents. Outcome 2: 500 health facilities offer quality adolescent responsive SRH services that are used by adolescent girls and boys. To evaluate program impact, an external evaluation will be conducted. A pre/post cross-sectional evaluation design will be used across two evaluation years.
Interventions
BEHAVIORALATWA
The Adolescent Transition in West Africa (ATWA) program is an in-school (Niger, Mali, Burkina Faso) and out-of-school (Niger and Mali) educational intervention implemented by local staff members at Save the Children, local community members, and teachers. ATWA provides internationally-recognized life skills education (LSE) to adolescents ages 10-19 years, and seeks to improve adolescents' knowledge and behaviors regarding sexual and reproductive health and rights. Outcome indicators to assess knowledge, behavior and attitudes of adolescents will vary by adolescent demographics as well as by country context, as based on the final set of curriculum deemed appropriate by the respective Ministries of Education (MOE).
Sponsors
Save the Children Netherlands
GRADE Africa
University of California, San Diego
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
10 Years to 19 Years
Healthy volunteers
Yes
Inclusion criteria
* Enrolled in primary or secondary school * Participating in community group (Niger only) * Aged 10 to 19
Exclusion criteria
* Not enrolled in school (Mali and Burkina Faso) * Younger than age 10 * Older than age 19
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Impact Indicator 1. Decrease in adolescent birth rate | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | The average number of births to female respondents ages 15-19 |
| Impact 2. Decrease in proportion of adolescents who have ever been pregnant or caused a pregnancy | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | The percent of adolescent females who have ever been pregnant + the percent of adolescent males who have ever caused a pregnancy |
| Impact 3. Increase in need for family planning satisfied with modern contraception | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Indicator definition 3A: Percentage of \[sexually active\] adolescents age 15-19 years currently married or in union who have their need for family planning satisfied with modern contraceptive methods Indicator definition 3B: Percentage of female adolescents (15-19) who are sexually active and who have their need for contraception satisfied with modern methods |
| Impact 4. Increase in adolescent modern contraceptive prevalence rate | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | The percent of sexually active adolescents (15-19) who are currently using (or whose partner is using) a modern contraceptive method. Currently is defined as 'at last sex' |
| Impact 5. Decrease in proportion of adolescents married | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Indicator definition 5A: Percentage of women 10-19 years old living with spouse before age 18. Indicator definition 5B: Percentage of women 10-19 years old living with spouse before age 15. |
| Outcome 1.1. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of adolescents who respond yes to planning to use modern contraception in the future, disaggregated by method |
| Outcome 1.2. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of sexually active adolescents reporting using a condom at last sex |
| Outcome 1.3. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of sexually active unmarried adolescents who respond yes to having used a condom every time they had sex in the last 6 months |
| Outcome 1.4. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of adolescents with significant increase from baseline to end-line in average score on a 6-item gender equitable attitude scale |
| Outcome 1.5. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Average number of modern contraceptive methods known among women 10-14 and 15-19 years old |
| Outcome 1.6. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of adolescents with correct knowledge about body changes during puberty, the menstrual cycle, fertility and conception, pregnancy risk and prevention, as assessed via a 9-item composite indicator |
| Outcome 1.7. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of adolescents with correct knowledge about STI risk and prevention and treatment, assessed using a composite indicator of 4 questions on STI prevention and treatment |
| Outcome 1.8. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of adolescents with comprehensive knowledge of HIV prevention, assessed using a composite indicator of 6 questions on HIV prevention |
| Outcome 1.9. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of adolescents with knowledge of where to seek SRH services, including where to get tested for HIV, where to get condoms, and where to get contraceptives |
| Outcome 1.10. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of girls who report properly disposing of absorbent materials (sanitary napkins or menstrual cloth) (denominator = the total number of girls who use absorbent materials (sanitary napkins or menstrual cloth)) |
| Outcome 1.11. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of girls who report hygienically washing and drying reusable menstrual cloth (denominator = number of girls who washed and reused menstrual materials) |
| Output 1.2.1. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of girls and boys that can correctly answer a basic set of four yes/no questions about menstruation |
| Output 1.2.2. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of girls that can answer a set of five questions correctly about how to hygienically manage menses |
| Output 1.2.3. | Year 1 Evaluation: September 2021 - May 2022; Year 2 Evaluation: September 2022 - May 2023 | Proportion of girls and boys that answer a question correctly regarding that menstruation is a normal biological function of the female body |
Countries
Burkina Faso, Mali, Niger
Outcome results
None listed