Economic Empowerment Intervention Research Articles

The effects of a cash transfer intervention on sexual partnerships and HIV in the HPTN 068 study in South Africa

Evidence on cash transfer interventions for HIV prevention in adolescent girls and young women is unclear and indicates that they may not work uniformly in all settings. Qualitative interviews were conducted with 22 girls and young women post-intervention to determine how a cash transfer study (HPTN 068) in South Africa was perceived to influence sexual behaviours and to explore mechanisms for these changes. Participants described how the intervention motivated them to increase condom use, have fewer partners, end risky relationships and access HIV testing services at local primary health clinics. Changes were attributed to receipt of the cash transfer, in addition to HIV testing and sexual health information. Processes of change included improved communication with partners and increased negotiation power in sexual decision-making. Economic empowerment interventions increase confidence in negotiating behaviours with sexual partners and are complementary to sexual health information and health services that provide young women with a foundation on which to make informed decisions about how to protect themselves.

A longitudinal qualitative evaluation of an economic and social empowerment intervention to reduce girls’ vulnerability to HIV in rural Mozambique

PurposeAn 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. MethodsWe 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. ResultsInformants 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. ConclusionsEarning 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.

Gender Matters in Economic Empowerment Interventions: A Research Review

AbstractEvidence shows that women face additional constraints because of their gender that affect their economic performance. A review of recent evaluation research demonstrates the types of gender-related constraints women face and the role that economic empowerment interventions can play in overcoming them, especially if they incorporate aspects of smart design, increasing their development impact. The evidence suggests that financial services and training programs are not gender-neutral and that specific design features can yield more positive economic outcomes for women by helping them overcome gender-related constraints. These features include savings and “Graduation” programs that increase women's economic independence, self-reliance and self-control, and the practice of repeated micro-borrowing that increases financial risk-taking and choice. “Smart” design also includes high-quality business management and jobs skills training, and stipends and other incentives in these training programs that address women's and young women's additional time burdens and childcare demands. Peer support may also help to increase financial risk-taking and confidence in business decisions. However, when social norms are too restrictive, and women are prevented from doing any paid work, no design will be smart enough. Subjective economic empowerment appears to be an important intermediate outcome for women that should be promoted and more reliably and accurately measured. Lastly, whenever possible, results should be sex-disaggregated and reported for individuals as well as households.

Gender Matters in Economic Empowerment Interventions: A Research Review

A review of the recent evaluation evidence on financial services and training interventions questions their gender neutrality and suggests that some design features in these interventions can yield more positive economic outcomes for women than for men. These include features in savings and ‘Graduation’ programs that increase women’s economic self-reliance and self-control, and the practice of repeated micro borrowing that increases financial risk-taking and choice. ‘Smart’ design also includes high quality business management and jobs skills training, and stipends and other incentives in these training programs that address women’s additional time burdens and childcare demands. Peer support may also help to increase financial risk taking and confidence in business decisions, and may augment an otherwise negligible impact of financial literacy training. These features help women overcome gender-related constraints. However, when social norms are too restrictive, and women are prevented from doing any paid work, no design will be smart enough. Subjective economic empowerment appears to be an important intermediate outcome for women that should be promoted and more reliably and accurately measured. More research is also needed on de-biasing service provision, which can be gender biased; lastly, whenever possible, results should be sex-disaggregated and reported for individuals as well as households.

Utilizing a family-based economic strengthening intervention to improve mental health wellbeing among female adolescent orphans in Uganda

BackgroundIt is estimated that almost 20% of the world’s adolescents have experienced or are experiencing a mental health problem. Several factors have been associated with the onset of adolescent mental health disorders, including poverty, child abuse and violence, particularly among adolescent girls. This paper examines the effect of participating in a family-based economic strengthening intervention on the mental health well-being of female adolescent orphans impacted by HIV/AIDS in rural Uganda.MethodsData utilized in this study was from the Bridges to the Future Study (2011–2016), an economic empowerment intervention aimed at improving health outcomes of orphaned children. Adolescents were randomly assigned to either the control condition receiving bolstered standard of care services for orphaned adolescents; or one of two treatment conditions receiving bolstered standard of care as well as an economic empowerment intervention comprising of a child development account, a mentorship program and workshops on financial management and microenterprise development. Data was collected at baseline, 12- and 24-months post intervention initiation. Multilinear regression analyses were conducted to examine the impact of an economic empowerment intervention on mental health functioning of female participants over time. Mental health functioning was measured by: (1) the Child Depression Inventory; (2) Beck Hopelessness Scale; and (3) Tennessee Self Concept Scale.ResultsAnalysis results show an improvement in mental health functioning over time among female participants receiving the intervention compared to their control counterparts. Specifically, compared to participants in the control condition, participants receiving the intervention reported a reduction in depressive symptoms from baseline to 12-months follow-up (b = − 1.262, 95% CI − 2.476, − 0.047), and an additional 0.645-point reduction between baseline and 24-months follow-up (b = − 1.907, 95% CI − 3.192, − 0.622). Participants receiving the intervention reported significant improvement in their reported self-concept from baseline to 24 months follow-up (b = 3.503 (95% CI 1.469, 5.538) compared to participants in the control condition.ConclusionsEmpowerment of young girls, either in the form of peer mentorship and/or economic strengthening seems to significantly improve the overall mental health functioning of adolescent girls impacted by HIV and AIDS in low-income settings.

The effect of a savings intervention on women\u2019s intimate partner violence victimization: heterogeneous findings from a randomized controlled trial in Colombia

BackgroundWomen’s economic empowerment has long been assumed to lead to their social empowerment, but systematic tests of this relationship have only recently begun to appear in the literature. Theory predicts that control over resources, as through a savings account, may increase women’s negotiating power and self-efficacy. In this way, “economic empowerment” may lead to “social empowerment,” and have related benefits such as helping to reduce risk of intimate partner violence (IPV). The current study tests effects of an economic empowerment intervention on women’s social empowerment, IPV victimization, and health.MethodsWe conducted an 18-month randomized controlled trial among 1800 urban poor women in Colombia between 2013 and 2015. The trial tested the impact of a savings account offer bundled with health services (vs. health services alone) on social empowerment outcomes, IPV victimization, and health.ResultsThe bundled savings treatment did not have average effects on most outcomes, although it produced a small significant increase in financial participation and decrease in symptoms of depression. Treatment effects on perceived norms, decision-making patterns, self-reported IPV victimization, and health depended on whether women’s partnerships were free of violence when they entered the trial; specifically, women in nonviolent partnerships at baseline showed more positive effects of the intervention.ConclusionsAlthough bundling economic empowerment interventions with support features has been shown to empower poor women, this trial found that a bundled treatment did not on average improve most social and health outcomes of poor women experiencing IPV.Trial registrationRegistered retrospectively, prior to realization of outcomes, 5/29/14: Evidence in Governance and Politics #20140529AA.

Non-adherence among women enrolled in a contraceptive vaginal ring use study in Kisumu, Kenya, 2014-2015.

Given future potential use of vaginal rings to prevent HIV infection, we examined the association of contraceptive vaginal ring (CVR) non-adherence with user dissatisfaction, tolerability, demographic, and behavioral factors. In an open-label single-group study, sexually active women aged 18-34 years using oral or injectable hormonal contraception, conveniently sampled from general population, were assigned to 6-month use of a commercial CVR currently not licensed for use in Kenya. Non-adherence in any CVR cycle completed was assessed from: (1) self-report (not used for at least 1 day), and (2) pharmacy record (failure to timely receive a new CVR or return a used one). Additionally, non-adherence was assessed in a subset of participants by residual progestin and estrogen levels measured in returned CVRs. Of 202 participants who underwent CVR insertion by a study clinician, 142 completed all 6 visits, 172 responded to questions about ring use, and 43 provided used CVRs from months 1, 3, and 6 for residual hormone analysis. Non-adherence was 14.0% (24/172) by self-report and 54.5% (110/202) by pharmacy record. Non-adherence by pharmacy record was significantly reduced among women with a salary-based income (prevalence ratio (PR) 0.71, 95% confidence interval (CI) (0.55-0.91)] compared to women with income not salary-based or no income. Participants dissatisfied with CVR on ≥4 aspects (ambiguity of instructions, inconvenience of use, sensation, sexual discomfort, etc.) were more likely to report non-adherence (PR 2.69, 95% CI=(1.31-5.52)] compared to those dissatisfied with ≤3 aspects. Non-adherence by residual hormone levels was identified in 46.5% (20/43) participants. Over time, this subset of participants showed increasing non-adherence (P=0.004). We found lack of agreement among the various measures of non-adherence. Economic empowerment interventions, especially those emphasizing partner-independent income options, and expanded education on CVR features may alleviate non-adherence. Addressing CVR dissatisfaction preemptively may also help mitigate non-adherence.

Exploring intersections of localised gender norms and unanticipated effects of a sexual and reproductive health intervention: implications of respect and being a “good girl” in Zambézia Province, Mozambique

Women First was a combined economic and social empowerment intervention implemented between 2010 and 2015 in Zambézia Province, Mozambique. The intervention was designed to reduce adolescent girls’ risk of HIV and gender-based violence, improve school attendance and empower girls. However, perceptions of girls’ improved respectfulness also emerged as an unanticipated effect during the programme evaluation. In this paper, we explore emic definitions of respect and girls’ good behaviour and perceptions of how the intervention caused improvements in behaviour from the perspective of intervention participants, their heads of household, influential men in their lives, and community members. In depth interviews and focus group discussions were conducted at two time points in 12 rural communities where the intervention was implemented. Respondents described “good girls” as deferential and obedient; productive and willing to serve their families and communities; and sexually chaste and modestly dressed. Respondents believed the intervention had reinforced or taught these behaviours, although they were generally aligned with gender norms that were not part of the formal intervention content and sometimes contrary to the intervention’s primary goals. Implications for future sexual and reproductive health programmes are discussed.

Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda

BackgroundAsset-based economic empowerment interventions, which take an integrated approach to building human, social, and economic capital, have shown promise in their ability to reduce HIV risk for young people, including adolescent girls, in sub-Saharan Africa. Similarly, community and family strengthening interventions have proven beneficial in addressing mental health and behavioral challenges of adolescents transitioning to adulthood. Yet, few programs aimed at addressing sexual risk have applied combination interventions to address economic stability and mental health within the traditional framework of health education and HIV counseling/testing. This paper describes a study protocol for a 5-year, NIMH-funded, cluster randomized-controlled trial to evaluate a combination intervention aimed at reducing HIV risk among adolescent girls in Uganda. The intervention, titled Suubi4Her, combines savings-led economic empowerment through youth development accounts (YDA) with an innovative family strengthening component delivered via Multiple Family Groups (MFG).MethodsSuubi4Her will be evaluated via a three-arm cluster randomized-controlled trial design (YDA only, YDA + MFG, Usual Care) in 42 secondary schools in the Central region of Uganda, targeting a total of 1260 girls (ages 15–17 at enrollment). Assessments will occur at baseline, 12, 24, and 36 months. This study addresses two primary outcomes: 1) change in HIV risk behavior and 2) change in mental health functioning. Secondary exploratory outcomes include HIV and STI incidence, pregnancy, educational attainment, financial savings behavior, gender attitudes, and self-esteem. For potential scale-up, cost effectiveness analysis will be employed to compare the relative costs and outcomes associated with each study arm.ConclusionsSuubi4Her will be one of the first prospective studies to examine the impact and cost of a combination intervention integrating economic and social components to reduce known HIV risk factors and improve mental health functioning among adolescent girls, while concurrently exploring mental health as a mediator in HIV risk reduction. The findings will illuminate the pathways that connect economic needs, mental health, family support, and HIV risk. If successful, the results will promote holistic HIV prevention strategies to reduce risk among adolescent girls in Uganda and potentially the broader sub-Saharan Africa region.Trial registrationClinical Trials NCT03307226 (Registered: 10/11/17).

Does Economic Strengthening Improve Viral Suppression Among Adolescents Living with HIV? Results From a Cluster Randomized Trial in Uganda.

To assess the effect of a savings-led economic empowerment intervention on viral suppression among adolescents living with HIV. Using data from Suubi + Adherence, a longitudinal, cluster randomized trial in southern Uganda (2012-2017), we examine the effect of the intervention on HIV RNA viral load, dichotomized between undetectable (< 40 copies/ml) and detectable (≥ 40 copies/ml). Cluster-adjusted comparisons of means and proportions were used to descriptively analyze changes in viral load between study arms while multi-level modelling was used to estimate treatment efficacy after adjusting for fixed and random effects. At 24-months post intervention initiation, the proportion of virally suppressed participants in the intervention cohort increased tenfold (ΔT2-T0 = + 10.0, p = 0.001) relative to the control group (ΔT2-T0 = + 1.1, p = 0.733). In adjusted mixed models, simple main effects tests identified significantly lower odds of intervention adolescents having a detectable viral load at both 12- and 24-months. Interventions addressing economic insecurity have the potential to bolster health outcomes, such as HIV viral suppression, by improving ART adherence among vulnerable adolescents living in low-resource environments. Further research and policy dialogue on the intersections of financial security and HIV treatment are warranted.

Microfinance for women at high risk for HIV in Kazakhstan: study protocol for a cluster-randomized controlled trial

BackgroundAmong women at high risk for HIV and other sexually transmitted diseases (STIs), gender and economic issues limit the impact of behavioral prevention strategies. Women in Kazakhstan with dual risks of sex trading and drug use face elevated risk for HIV and STIs and may benefit from an economic empowerment intervention which combines HIV-risk reduction (HIVRR) education with financial skills-building and asset-building to promote reduced reliance on sex trading for income.Methods/designThe study employs a two-arm, cluster-randomized controlled trial (c-RCT) design. We will use cluster randomization to assign 350 women in approximately 50 cohorts to a traditional four-session HIV-risk-reduction intervention combined with a six-session financial literacy intervention, enrollment in a 24-session vocational training program and receipt of matched savings (HIVRR+MF); or to the four-session HIV-risk-reduction intervention alone (HIVRR). Repeated behavioral and biological assessments will be conducted at baseline, then at 6, 9, and 15 months post randomization/session 1.DiscussionThis study responds to an identified need in the academic literature for rigorous testing of structural interventions, including combination microfinance and HIV-prevention interventions.Trial registrationClinicalTrials.gov, ID: NCT02406482. Registered on 30 March 2015.

Understanding how Afghan women utilise a gender transformative and economic empowerment intervention: A qualitative study

ABSTRACTThe processes through which women's economic empowerment interventions are envisaged to improve women's health are strongly embedded in notions of building women's agency and autonomy. Yet despite the ubiquity of such interventions, there remains incredibly little qualitative work exploring how women actually utilise interventions to reshape their lives and wellbeing. Drawing on 9 focus groups discussions among 52 women who participated in the Women for Women International intervention in Afghanistan, an economic strengthening and social empowerment intervention, we explore processes of change. Data showed women learnt new skills around numeracy and animal husbandry; they perceived themselves to have become more respected within the household setting; they invested cash they received for intervention attendance in businesses, primarily their husband's or family's, and saved cash. Women did not, however, report their relationships to have been radically restructured. Rather women described incremental changes in their relationships within their household and used what they gained from the intervention to secure and sustain this. This conceptualisation of agency and empowerment reflects approaches to understanding agency, which move away from ‘action-oriented’ understandings, to ones that recognise ‘distributed agency’ as pathways to change through interventions.

An individually randomized controlled trial to determine the effectiveness of the Women for Women International Programme in reducing intimate partner violence and strengthening livelihoods amongst women in Afghanistan: trial design, methods and baseline findings

BackgroundIntimate Partner Violence (IPV) is the most common form of violence in conflict and post-conflict settings, but there are few evaluations of interventions to prevent IPV in such settings.MethodsThe Women for Women International (WfWI) intervention is a year-long combined economic and social empowerment intervention for marginalized women survivors of conflict. Primarily, it seeks to support women to achieve four key outcomes: women earn and save money; women improve their health and well-being; women influence decisions in their homes and communities; women connect to networks for support. The organization recognizes Violence Against Women and Girls (VAWG) as a significant barrier to women’s empowerment and expects to see reduction in VAWG, and specifically IPV, as part of building women’s social and economic empowerment. This program is being quantitatively evaluated through an individually randomized control trial amongst women in Afghanistan, with a 24-month follow up. A comparison of baseline characteristics of participants is also included as well as a discussion of implementation of the baseline research.DiscussionThere is a high demand amongst Afghan women for such interventions, and this posed challenges in completing the randomization and baseline. In addition, the complex security situation in Afghanistan also posed challenges. However, despite these issues, recruitment was successfully achieved and the arms were balanced on socio-demographic measures. The evaluation will contribute to the limited evidence base on interventions to prevent IPV in conflict-affected settings.Trial registrationNCT03236948. Registered 28 July 2017, retrospectively registered.

Cost-Effectiveness of a Savings-Led Economic Empowerment Intervention for AIDS-Affected Adolescents in Uganda: Implications for Scale-up in Low-Resource Communities

PurposeNearly 12 million children and adolescents in sub-Saharan Africa have lost one or both parents to AIDS. Within sub-Saharan Africa, Uganda has been greatly impacted, with an estimated 1.2 million orphaned children, nearly half of which have experienced parental loss due to the epidemic. Cost-effective and scalable interventions are needed to improve developmental outcomes for these children, most of whom are growing up in poverty. This article examines the direct impacts and cost-effectiveness of a savings-led family economic empowerment intervention, Bridges to the Future, that employed varying matched savings incentives to encourage investment in Ugandan children orphaned by AIDS. MethodsUsing data from 48 primary schools in southwestern Uganda, we calculate per-person costs in each of the two treatment arms—Bridges (1:1 match savings) versus Bridges PLUS (1:2 match savings); estimate program effectiveness across outcomes of interest; and provide the ratios of per-person costs to their corresponding effectiveness. ResultsAt the 24-month postintervention initiation, children in the two treatment arms showed better results in health, mental health, and education when compared to the usual care condition; however, no statistically significant differences were found between treatment arms with the exception of school attendance rates which were higher for those in Bridges PLUS. Owing to the minimal cost difference between the Bridges and Bridges PLUS arms, we did not find substantial cost-effectiveness differences across the two treatment arms. ConclusionAfter 24 months, an economic intervention that incorporated matched savings yielded positive results on critical development outcomes for adolescents orphaned by AIDS in Uganda. The 1:1 and 1:2 match rates did not demonstrate variable levels of cost-effectiveness at 24-month follow-up, suggesting that governments intending to incorporate savings-led interventions within their social protection frameworks may not need to select a higher match rate to see positive developmental outcomes in the short term. Further research is required to understand intervention impacts and cost-effectiveness after a longer follow-up period.

Exploring factors associated with ART adherence and retention in care under Option B+ strategy in Malawi: A qualitative study

Although several studies have documented challenges related to inadequate adherence to antiretroviral therapy (ART) and high loss to follow-up (LTFU) among Option B+ women, there is limited understanding of why these challenges occur and how to address them. This qualitative study examines women’s experiences with ART adherence and retention in care. Between July and October 2015, in-depth interviews were conducted with 39 pregnant and lactating women who initiated ART at Bwaila Hospital in Lilongwe, Malawi. Study participants included 14 in care and 25 out of care women, according to facility records. Data were analyzed using an inductive, open-coding approach to thematic analysis. Ten of the respondents (7 out of care, 3 in-care) had stopped and re-started treatment before the interview date. One of the most important factors influencing adherence and retention was the strength of women’s support systems. In contrast to women in-care, most out-of-care women lacked emotional and financial support from male partners, received minimal counseling from providers at initiation, lacked designated guardians to assist with medication refills or clinic appointments, and were highly mobile. Mobility led to difficulties in accessing treatment in new settings. The most common reasons women re-started treatment following interruptions were due to providers’ counseling and encouragement and the mother’s desire to be healthy. Improved counseling at initiation, active follow-up counseling, women’s economic empowerment interventions, promotion of peer counseling schemes and meaningful engagement of male partners can help in addressing the identified barriers and promoting sustained retention of Option B+ women.

Reducing PTSD symptoms through a gender norms and economic empowerment intervention to reduce intimate partner violence: a randomized controlled pilot study in Côte D'Ivoire.

Women living in war-affected contexts face high levels of gender-based violence, including intimate partner violence (Stark & Ager, 2011). Despite well-documented negative consequences, including posttraumatic stress disorder (PTSD) (Garcia-Moreno et al. 2006; Steel et al. 2009), evidence remains thin regarding intervention effectiveness to mitigate consequences in these settings. This study used a two-armed parallel pilot randomized controlled trial to compare the impact of a group savings only (control) to gender dialogue groups added to group savings (treatment) on women's symptoms of PTSD in northwestern Côte d'Ivoire. Eligible Ivorian women (18+ years, no prior experience with group savings) were invited to participate and 1198 were randomized into treatment groups. In the ITT analyses, women in the treatment arm had significantly fewer PTSD symptoms relative to the control arm (β: -0.12; 95% CI: -0.20 to -0.03; p = 0.005). Partnered women in the treatment arm who had not experienced intimate partner violence (IPV) at baseline had significantly fewer PTSD symptoms than the control arm (β = -0.12; 95% CI: -0.21 to -0.03; p = 0.008), while those who had experienced IPV did not show significant differences between treatment and control arms (β = -0.09; 95% CI: -0.29 to 0.11; p = 0.40). Adding a couples gender discussion group to a women's savings group significantly reduced women's PTSD symptoms overall. Different patterns emerge for women who experienced IPV at baseline v. those who did not. More research is needed on interventions to improve mental health symptoms for women with and without IPV experiences in settings affected by conflict.

Peer-supported economic empowerment: A financial wellness intervention framework for people with psychiatric disabilities.

People with psychiatric disabilities experience substantial economic exclusion, which hinders their ability to achieve recovery and wellness. The purpose of this article is to describe a framework for a peer-supported economic empowerment intervention grounded in empirical literature and designed to enhance financial wellness. The authors followed a 3-step process, including (a) an environmental scan of scientific literature, (b) a critical review of relevant conceptual frameworks, and (c) the design of an intervention logic framework based on (a) and (b), the programmatic experience of the authors, and input from peer providers. We identified 6 peer provider functions to support individuals with psychiatric disabilities to overcome economic inclusion barriers, achieve financial wellness goals, and lessen the psychosocial impact of poverty and dependency. These include (a) engaging individuals in culturally meaningful conversations about life dreams and financial goals, (b) inspiring individuals to reframe self-defeating narratives by sharing personal stories, (c) facilitating a financial wellness action plan, (d) coaching to develop essential financial skills, (e) supporting navigation and utilization of financial and asset-building services, and (f) fostering mutual emotional and social support to achieve financial wellness goals. Financial wellness requires capabilities that depend on gaining access to financial and asset-building supports, and not merely developing financial skills. The proposed framework outlines new roles and competencies for peer providers to help individuals build essential financial capabilities, and address social determinants of mental health and disability. Research is currently underway to pilot-test and refine peer-supported economic empowerment strategies. (PsycINFO Database Record

Effect of savings-led economic empowerment on HIV preventive practices among orphaned adolescents in rural Uganda: results from the Suubi-Maka randomized experiment

ABSTRACTImproving economic resources of impoverished youth may alter intentions to engage in sexual risk behaviors by motivating positive future planning to avoid HIV risk and by altering economic contexts contributing to HIV risk. Yet, few studies have examined the effect of economic-strengthening on economic and sexual behaviors of orphaned youth, despite high poverty and high HIV infection in this population. Hierarchal longitudinal regressions were used to examine the effect of a savings-led economic empowerment intervention, the Suubi-Maka Project, on changes in orphaned adolescents’ cash savings and attitudes toward savings and HIV-preventive practices over time. We randomized 346 Ugandan adolescents, aged 10–17 years, to either the control group receiving usual orphan care plus mentoring (n = 167) or the intervention group receiving usual orphan care plus mentoring, financial education, and matched savings accounts (n = 179). Assessments were conducted at baseline, 12, and 24 months. Results indicated that intervention adolescents significantly increased their cash savings over time (b = $US12.32, ±1.12, p < .001) compared to adolescents in the control group. At 24 months post-baseline, 92% of intervention adolescents had accumulated savings compared to 43% in the control group (p < .001). The largest changes in savings goals were the proportion of intervention adolescents valuing saving for money to buy a home (ΔT1−T0 = +14.9, p < .001), pursue vocational training (ΔT1−T0 = +8.8, p < .01), and start a business (T1−T0 = +6.7, p < .01). Intervention adolescents also had a significant relative increase over time in HIV-preventive attitudinal scores (b = +0.19, ±0.09, p < .05), most commonly toward perceived risk of HIV (95.8%, n = 159), sexual abstinence or postponement (91.6%, n = 152), and consistent condom use (93.4%, n = 144). In addition, intervention adolescents had 2.017 significantly greater odds of a maximum HIV-prevention score (OR = 2.017, 95%CI: 1.43–2.84). To minimize HIV risk throughout the adolescent and young adult periods, long-term strategies are needed to integrate youth economic development, including savings and income generation, with age-appropriate combination prevention interventions.

Economic Empowerment of Women Working in Khadi Village Industries (KVI) in Aligarh

Empowerment is comprehensive and multi-dimensional. It has cognitive, economic, social, and political dimensions. Economic empowerment is to make women take economic decisions and act on them. Women are the nucleus of a family and responsible for change, transformation and mobilisation. Acknowledging this fact and also women's individuality, government make interventions for their economic empowerment. Khadi and Village Industries (KVI) is a similar intervention for economic empowerment of marginalised women and other groups. It is an amalgamation of Gandhian philosophy of self-reliance and sustainability. It is significant to study KVI intervention as it is the oldest movement of mass-mobilisation and recognition of marginalised women. It intends to acknowledge women's capacity of balance and contribution to their family economy.The purpose of this study was to analyse the role of KVI intervention in the economic empowerment of rural women. The objectives of the study were to explore the demographic profile of women working with KVI and to measure the economic empowerment of women through KVI interventions. The study locale was Aligarh. A sample of 120 participants was selected randomly. The data was collected through semistructured interview scheduled under the guidelines provided by the International Centre for Research on Women (Golla, Malhotra, Nanda, & Mehra, 2011) (ICRW, 2011). As per ICRW there are three key indicators of economic empowerment (Reach and Process Indicators; Economic Advancement Indicators; and Agency or Power Indicators). For the purpose of the study, power indicator was selected. Tabulation and representation of data were done through measures of central tendency. Data was analysed through a qualitative approach. Due to intervention there was less gender segregation of work, more equity of domestic loads and contribution of other members in household work. Hence, along with providing avenues for income generation KVI is also empowering marginalised rural women.

Stepping Stones and Creating Futures intervention: shortened interrupted time series evaluation of a behavioural and structural health promotion and violence prevention intervention for young people in informal settlements in Durban, South Africa.

BackgroundGender-based violence and HIV are highly prevalent in the harsh environment of informal settlements and reducing violence here is very challenging. The group intervention Stepping Stones has been shown to reduce men’s perpetration of violence in more rural areas, but violence experienced by women in the study was not affected. Economic empowerment interventions with gender training can protect older women from violence, but microloan interventions have proved challenging with young women. We investigated whether combining a broad economic empowerment intervention and Stepping Stones could impact on violence among young men and women. The intervention, Creating Futures, was developed as a new generation of economic empowerment intervention, which enabled livelihood strengthening though helping participants find work or set up a business, and did not give cash or make loans.MethodsWe piloted Stepping Stones with Creating Futures in two informal settlements of Durban with 232 out of school youth, mostly aged 18–30 and evaluated with a shortened interrupted time series of two baseline surveys and at 28 and 58 weeks post-baseline. 94/110 men and 111/122 women completed the last assessment, 85.5% and 90.2% respectively of those enrolled. To determine trend, we built random effects regression models with each individual as the cluster for each variable, and measured the slope of the line across the time points.ResultsMen’s mean earnings in the past month increased by 247% from R411 (~$40) to R1015 (~$102, and women’s by 278% R 174 (~$17) to R 484 (about $48) (trend test, p < 0.0001). There was a significant reduction in women’s experience of the combined measure of physical and/or sexual IPV in the prior three months from 30.3% to 18.9% (p = 0.037). This was not seen for men. However both men and women scored significantly better on gender attitudes and men significantly reduced their controlling practices in their relationship. The prevalence of moderate or severe depression symptomatology among men and suicidal thoughts decreased significantly (p < 0.0001 and p = 0.01).ConclusionsThese findings are very positive for an exploratory study and indicate that the Creating Futures/Stepping Stones intervention has potential for impact in these difficult areas with young men and women. Further evaluation is needed.