Impact Evaluation of the African Youth Alliance in Ghana, Tanzania, and Uganda: Implications for future youth programming

APHA Scientific Session and Event Listing

5070.0: Wednesday, November 07, 2007 - 8:45 AM

Abstract #159222

Jessica Posner, MPH¹, Timothy Williams, MA, MEM¹, Ali Karim, PhD¹, and Stephanie A. Mullen, DrPH². (1) John Snow, Inc., 1616 North Fort Myer Drive, 11th Floor, Arlington, VA 22209, 7035287474, jposner@jsi.com, (2) M&E Specialist, Measure Evaluation/JSI, 1616 N. Fort Myer Drive, 11th floor, Arlington, VA 22209

The Africa Youth Alliance (AYA), a Gates-funded partnership between PATH, Pathfinder, and UNFPA, worked in four African countries from 2000-05 to improve adolescent sexual and reproductive health (ASRH) through integrated, multi-sectoral, and scaled up programs. A multi-pronged approach was employed that used advocacy to create a supportive environment, developed behavior change communication strategies, integrated ASRH into livelihood skills development programs for youth, and expanded access to youth friendly services. The approach was unique in seeking to implement all components simultaneously, while building capacity and fostering coordination among established partners to encourage sustainability of ASRH services.

Population-based surveys with samples ranging from 1800 to 3400 respondents were conducted with youth (17-22) in Ghana, Tanzania, and Uganda to evaluate impact of the comprehensive intervention package. The post-test only research design determined program impact by comparing behavioral outcomes 1) between intervention sites and controls, and 2) between youth who were exposed to AYA and those who were not. A combination of propensity score matching and instrumental variable approaches were used to analyze results on key behavioral outcomes: condom and other contraceptive use, age of sexual debut, abstinence, and number of sexual partners.

This presentation will review findings from surveys in the three countries, focusing on AYA's impact on key behavioral outcomes. Major findings include a)more impact on condom use outcomes than on sexual debut and number of sexual partners, b)more impact on behavioral outcomes than antecedents and c)more impact on females than males.

Learning Objectives: Learning Objectives

Cite key results on ASRH knowledge, attitudes, and outcomes from studies in the three AYA countries
Describe how propensity score matching and instrumental variable analysis were used to enable impact measurement in a post-test only research design
Articulate how the study findings can be used by decision makers to improve youth program effectiveness and outcomes
List and discuss programmatic areas in ASRH programming in need of future research

Keywords: Youth,

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Adolescents: International Perspectives and Programs

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA