A longitudinal qualitative evaluation of an economic and social empowerment intervention to reduce girls' vulnerability to HIV in rural Mozambique. (December 2019)

• Record Type: Journal Article
• Authors: Burke, Holly McClain; Packer, Catherine; González-Calvo, Lázaro; Ridgeway, Kathleen; Lenzi, Rachel; Green, Ann F.; Moon, Troy D.
• Is Part Of: Evaluation and program planning. Volume 77(2019)
• Publication Date: 2019-12
• Subjects: ASCAs Accumulated savings and credit associations -- FGD Focus group discussion -- GBV Gender-based violence -- HIV Human Immunodeficiency Virus -- IDI In-depth interview -- SEM Social ecological model -- SCIP Strengthening Communities through Integrated Programming -- USAID United States Agency for International Development; HIV prevention -- Economic strengthening -- Multi-Sector -- Integrated development -- Adolescents -- Girls -- Mozambique -- Gender-based violence -- School attendance -- Sexual behavior -- Qualitative; Health planning -- Periodicals; Medical care -- Evaluation -- Periodicals; 362.1068
• DOI: 10.1016/j.evalprogplan.2019.101682
• Languages: English
• ISSNs: 0149-7189

Abstract

Highlights: Longitudinal qualitative data revealed some promising effects of the intervention on outcomes. Findings illustrated potential pathways from intervention to reductions in HIV vulnerability. Programs serving vulnerable girls need to address potential harms of the intervention. We demonstrate the value of using mixed-methods for programmatic evaluations to better understand intervention effects. Abstract: Purpose: An intervention including business training and health education was implemented in Mozambique, where girls are at elevated risk for acquiring HIV. As part of a mixed-methods evaluation, we describe perceived effects of the intervention on girls' sexual behavior and school attendance. Methods: We conducted 49 in-depth interviews (IDIs) with girl intervention participants (ages 13–19), 24 IDIs with heads of girls' households, 36 IDIs with influential males identified by girls, and 12 focus group discussions with community members after the intervention ended and one year later. Results: Informants said the primary intervention benefit was realized when girls had money to stay in or return to school and/or to buy necessities for themselves and their households—reducing their need for transactional or intergenerational sex. However, some girls did not make a profit and some businesses were not sustainable. Sometimes the intervention appeared to be implemented in a way to reinforce inequitable gender norms resulting in some girls feeling shame when they reengaged in risky sex after their businesses failed. Conclusions: Earning money enabled girls to potentially reduce their vulnerability to HIV. We offer recommendations for future multi-sector interventions, including the need to address potential harms in programs serving vulnerable girls.