Abstract
Poor reproductive health among youth and adolescents threatens their future health and economic wellbeing in Zimbabwe amidst a high HIV/AIDS prevalence. This study evaluates the impact of a multi-pronged adolescent sexual and reproductive health (ASRH) strategy implemented by government of Zimbabwe between 2010 and 2015 to improve ASRH in terms of the uptake of condoms and HIV testing as well as outcomes in terms of sexually transmitted infection (STI) prevalence and HIV prevalence. We combine the difference in difference and propensity score matching methods to analyse repeated Zimbabwe demographic health survey cross-sectional datasets. Young people aged 15–19 years at baseline in 2010, who were exposed for the entire five-year strategy are designated as the treatment group and young adults aged 25–29 at baseline as the control. We find that the ASRH strategy increased HIV testing amongst youth by 36.6 percent, whilst treatment of STIs also increased by 30.4 percent. We also find that the HIV prevalence trajectory was reduced by 0.7 percent. We do not find evidence of impact on condom use and STI prevalence. The findings also suggest that although HIV testing increased for all socio-economic groups that were investigated, the effect was not the same. Lastly, we do not find evidence supporting that more resources translate to better ASRH outcomes. We recommend designing future ASRH strategies in a way that differentiates service delivery for youths in HIV hotspots, rural areas and out of school. We also recommend improving the strategy’s coordination and monitoring, as well as aligning and enforcing government policies that promote sexual and reproductive health rights.
Highlights
Young people, a collective group of adolescents aged 10–19 and youth aged 15–24, are faced with a myriad of reproductive health (RH) challenges globally [1]
The analysis revealed that the ASRH program increased HIV testing for both males and females significantly at the 1 percent level and that the rise was more marked in females
Whilst the literature reviewed arrived at mixed evidence with respect to ASRH strategies, this study indicated that the ASRH strategy was successful in combating the HIV epidemic through increasing testing, reducing prevalence trajectory and increasing treatment of sexually transmitted infection (STI)
Summary
A collective group of adolescents aged 10–19 and youth aged 15–24, are faced with a myriad of reproductive health (RH) challenges globally [1]. These challenges consist of risks of HIV and other sexually transmitted infections (STIs), unintended pregnancies and unsafe abortions [2]. Impact of the adolescent and youth sexual and reproductive health strategy in Zimbabwe. There is no fee charged to access these datasets. Permission for HIV datasets used in the study requires the applicant to accept a Terms of Use Statement and a consent form which should be signed electronically by entering the password for the user’s account
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