Dataset Information

Imagining the future: Community perceptions of a family-based economic empowerment intervention for AIDS-orphaned adolescents in Uganda.

ABSTRACT: AIDS-orphaned children and adolescents in sub-Saharan Africa have inadequate access to basic services, including health and education. Using a qualitative approach, the study explores the meaning of education in rural Uganda, obstacles faced by AIDS-orphaned adolescents and their caregivers to access secondary education, and the potential of an economic empowerment intervention SEED in addressing the challenges of accessing educational opportunities for AIDS-orphaned adolescents. The findings come from 29 semi-structured interviews conducted with eleven adolescents study participants, four caregivers and fourteen community leaders involved in the pilot SEED intervention. Study participants and community members indicated that the savings accounts offer a unique opportunity for orphaned adolescents to stay in school and imagine the future with optimism.

SUBMITTER: Ismayilova L

PROVIDER: S-EPMC3611978 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Imagining the future: Community perceptions of a family-based economic empowerment intervention for AIDS-orphaned adolescents in Uganda.

Ismayilova Leyla L Ssewamala Fred F Mooers Elizabeth E Nabunya Proscovia P Sheshadri Srividya S

Children and youth services review 20120621 10

AIDS-orphaned children and adolescents in sub-Saharan Africa have inadequate access to basic services, including health and education. Using a qualitative approach, the study explores the meaning of education in rural Uganda, obstacles faced by AIDS-orphaned adolescents and their caregivers to access secondary education, and the potential of an economic empowerment intervention SEED in addressing the challenges of accessing educational opportunities for AIDS-orphaned adolescents. The findings co ...[more]

PMID: 23543861

Similar Datasets

Project description:Improving 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 (?T1-T0?=?+14.9, p?<?.001), pursue vocational training (?T1-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.

Project description:BackgroundChildren who have lost a parent to HIV/AIDS, known as AIDS orphans, face multiple stressors affecting their health and development. Family economic empowerment (FEE) interventions have the potential to improve these outcomes and mitigate the risks they face. We present efficacy and cost-effectiveness analyses of the Bridges study, a savings-led FEE intervention among AIDS-orphaned adolescents in Uganda at four-year follow-up.MethodsIntent-to-treat analyses using multilevel models compared the effects of two savings-led treatment arms: Bridges (1:1 matched incentive) and BridgesPLUS (2:1 matched incentive) to a usual care control group on the following outcomes: self-rated health, sexual health, and mental health functioning. Total per-participant costs for each arm were calculated using the treatment-on-the-treated sample. Intervention effects and per-participant costs were used to calculate incremental cost-effectiveness ratios (ICERs).FindingsAmong 1,383 participants, 55% were female, 20% were double orphans. Mean age was 12 years at baseline. At 48-months, BridgesPLUS significantly improved self-rated health, (0.25, 95% CI 0.06, 0.43), HIV knowledge (0.21, 95% CI 0.01, 0.41), self-concept (0.26, 95% CI 0.09, 0.44), and self-efficacy (0.26, 95% CI 0.09, 0.43) and lowered hopelessness (-0.28, 95% CI -0.43, -0.12); whereas Bridges improved self-rated health (0.26, 95% CI 0.08, 0.43) and HIV knowledge (0.22, 95% CI 0.05, 0.39). ICERs ranged from $224 for hopelessness to $298 for HIV knowledge per 0.2 standard deviation change.ConclusionsMost intervention effects were sustained in both treatment arms at two years post-intervention. Higher matching incentives yielded a significant and lasting effect on a greater number of outcomes among adolescents compared to lower matching incentives at a similar incremental cost per unit effect. These findings contribute to the evidence supporting the incorporation of FEE interventions within national social protection frameworks.

Project description:Some evidence points to the positive effects of asset accumulation programs on mental health of children living in low-resource contexts. However, no evidence exists as to why and how such impact occurs. Our study aims to understand whether child poverty, child work, and household wealth serve as pathways through which the economic strengthening intervention affects the mental health of AIDS-orphaned children. The study employed a cluster-randomized experimental design with a family-based economic strengthening intervention conducted among 1410 school-going AIDS-orphaned children ages 10 and 16 years old in 48 primary schools in South Western Uganda. To test the hypothesized relationships between the intervention, mediators (household wealth, child poverty, and child's work) and mental health, we ran structural equation models that adjust for clustering of individuals within schools and account for potential correlation among the mediators. We found significant unmediated effect of the intervention on children's mental health at 24 months (B = -0.59; 95% CI: 0.93, -0.25; p < 0.001; β = -0.33). Furthermore, the results suggest that participation in the intervention reduced child poverty at 12 months, which in turn improved latent mental health outcome at 24 months (B = -0.14; 95% CI: -0.29, -0.01; p < 0.06; β = -0.08). In addition, though not statistically significant at the 0.05 level, at 36 and 48 months, mental health of children in the treatment group improved by 0.13 and 0.16 standard deviation points correspondingly with no evidence of mediation. Our findings suggest that anti-poverty programs that aim solely to improve household income may be less advantageous to children's mental health as compared to those that are specifically targeted towards reducing the impact of poverty on children. Further studies using more comprehensive measures of child work and age-appropriate child mental health may shed more light on understanding the link between asset accumulation interventions, child labor and children's mental health.

Dataset Information

Imagining the future: Community perceptions of a family-based economic empowerment intervention for AIDS-orphaned adolescents in Uganda.

Publications

Imagining the future: Community perceptions of a family-based economic empowerment intervention for AIDS-orphaned adolescents in Uganda.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets