Siyakha Nentsha. A randomized experiment in KwaZulu-Natal, South Africa to examine how HIV/AIDS education supplemented with financial education and social support impacts upon young women's and young men's economic, health and social capabilities

1. “Siyakha Nentsha”Enhancing the Economic, Health, and Social Capabilities of Highly Vulnerable Youth by Kelly Hallman, Kasthuri Govender, Eva Roca, Emmanuel Mbatha and Mike Rogan Population Council Isihlangu Health and Development Agency University of KwaZulu-Natal KwaZulu-Natal, Department of Education

2. Thank you Our funders The William and Flora Hewlett Foundation Economic and Social Research Council DFID via the ABBA RPC KwaZulu-Natal Department of Education MS. NOMALI MAGWAZA & STAFF (UMBUMBULU) MR. N. CELE, DISTRICT MANAGER (UMBUMBULU) Additional team members Nombango Anna Sibeko / ThabileShozi / Mboneni Genesis Thwala / Nduduzo Blessing Msomi Pretty ThandaniCele / Nontobeko Charlotte Cele / Sabelo Emmanuel Mkhize Banele Precious Ngcobo / Njabulo Freedom Ndlovu / Noxolo Peaceful Makhanya NokulungaDorahShange / Suprise Patience Mseleku /Sithembile Pretty Gumede Mbali Pretty Mseleku / Bongekile Carol Shozi / AyandaMthabela / Siphiwe Cyril Mbava

3. Purpose Improve functional capabilities and well-being adolescents at high risk for HIV and STIs teenage pregnancy school dropout non-receipt of social benefits actual or potential loss of one or both parents

4. Project team

5. Formative research: Adolescent HIV risk behaviors influenced by Relative wealth Social capital Being an orphan

6. Durban 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

7. Project content Longitudinal survey In learners households GPS coordinates Government-accredited multi-session intervention 10th & 11th graders during school hours Participatory reflective learning Role-plays/drama Workbooks/portfolios and diaries Community mapping Focus group with participants, parents, and mentors

8. Curriculum Government-accredited multi-session intervention Increase knowledge and skills for pregnancy and HIV prevention and AIDS mitigation; accessing preventive, treatment and care services Develop skills to manage personal and familial resources; access existing social benefits, education and training opportunities; plan and aspire for the future; build savings/assets over time Build and strengthen social networks and support

10. Least selective sample

11. Scalable

12. Bundled package

13. Females and males

14. Resounding community feedback

15. Male knowledge and behaviors

18. Research design Randomized to secondary school classrooms (grades 10-11) in seven schools Three study arms SRH/HIV, Social Support, Financial Education SRH/HIV, Social Support Delayed Intervention

19. Outcomes SRH and HIV/AIDS : knowledge, skills and behaviors, including adoption of safer sexual behaviors and service use Economic skills: ability to plan and manage personal and familial finances; identify and access available social benefits; articulate a plan for pursuing future livelihood-enhancing opportunities Social networks and support: access to friends, adult role models and individuals/groups who can assist with crisis management and provide links to opportunities

20. Sample

21. Sample

22. Sample

24. Participant views of financial education “We learnt about budgeting and saving and all those things, before we when we get money we spent it. This program was like an eye-opener to us, because, we know now when we get some money, we have to save something…” - male participant

25. “It’s different, in school we learn mathematics and biology but here we learn things that we can use in the future.” - female participant

26. Participant views of health education “….. I didn’t understand about HIV and AIDS before but now I do. I didn’t learn that in school.” –female participant “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 participant

27. Baseline associations Factors associated with protective behaviors Relative wealth Social support (friends, role models) Belonging to a community organization Having tried to start an income-generating activity Factors associated with higher-risk behaviors Having no hope for the future Orphanhood Personal luxury items

28. Communications Engage policymakers and programmers in dialogues to raise profile of issue Communicate the research process Utilize products in addition to policy briefs, reports, academic articles and website Facebook, Brochures, Postcards, Multimedia, Video Non-traditional public events Frontline Club, London

32. Multimedia Lindiwe’s Story (see pdf)

33. REFERENCES Hallman, K. “Social exclusion: The gendering of adolescent HIV risks in KwaZulu-Natal, South Africa,” in J. Klot and V. Nguyen eds., (in press), The Fourth Wave: An Assault on Women - Gender, Culture and HIV in the 21st Century. 2009. Social Science Research Council and UNESCO. Grant, M and Hallman, K. “Pregnancy-related School Dropout and Prior School Performance in South Africa,” Studies in Family Planning, 2008. 39(4): 369-382. Hallman, K. “Researching the determinants of vulnerability to HIV amongst adolescents,” IDS Bulletin, 2008. 39(5): 36-44. Bruce, J. and Hallman K. “Reaching the girls left behind,” Gender & Development,2008. 16(2): 227-245. Hallman, K. “Nonconsensual sex, school enrollment and educational outcomes in South Africa,” Africa Insight (special issue on Youth in Africa), 2008. 37(3): 454-472. "Orphanhood Type and Sexual Debut: A panel study from KwaZulu-Natal, South Africa," (under review). Kenworthy, N., Hallman, K. et al. “Geographies of Violence: Participatory Mapping with South African Adolescents to Understand Dimensions of Social Exclusion,” (under review).

34. POPULATION COUNCIL POLICY BRIEFS “Identifying sources of adolescent exclusion due to violence: Participatory mapping in South Africa,” Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 30. 2008. New York: Population Council. http://www.popcouncil.org/gfd/TA_Briefs_List.html "Enhancing financial literacy, HIV/AIDS skills, and safe social spaces among vulnerable South African youth," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 4. 2007. New York: Population Council. http://www.popcouncil.org/gfd/TA_Briefs_List.html "Reducing the social exclusion of girls," Promoting Healthy, Safe, and Productive Transitions to AdulthoodBrief no. 27. 2007. New York: Population Council. http://www.popcouncil.org/gfd/TA_Briefs_List.html

35. http://www.facebook.com/pages/ABBA-RPC-Addressing-the-Balance-of-Burden-in-AIDS/184906411290