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

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.