Background: Adolescent pregnancies pose a risk to the young mothers and their babies. In Zambia, 35% of young girls in rural areas have given birth by the age of 18 years. Pregnancy rates are particularly high among out-of-school girls. Poverty, low enrolment in secondary school, myths and community norms all contribute to early childbearing. This protocol describes a trial aiming to measure the effect on early childbearing rates in a rural Zambian context of (1) economic support to girls and their families, and (2) combining economic support with a community intervention to enhance knowledge about sexual and reproductive health and supportive community norms.
Methods/design: This cluster randomized controlled trial (CRCT) will have three arms. The clusters are rural schools with surrounding communities. Approximately 4900 girls in grade 7 in 2016 will be recruited from 157 schools in 12 districts. In one intervention arm, participating girls and their guardians will be offered cash transfers and payment of school fees. In the second intervention arm, there will be both economic support and a community intervention. The interventions will be implemented for approximately 2 years. The final survey will be 4.5 years after recruitment. The primary outcomes will be “incidence of births within 8 months of the end of the intervention period”, “incidence of births before girls’ 18th birthday” and “proportion of girls who sit for the grade 9 exam”. Final survey interviewers will be unaware of the intervention status of respondents. Analysis will be by intention-to-treat and adjusted for cluster design and confounders. Qualitative process evaluation will be conducted.
Discussion: This is the first CRCT to measure the effect of combining economic support with a community intervention to prevent adolescent childbearing in a low- or middle-income country. We have designed a programme that will be sustainable and feasible to scale up. The findings will be relevant for programmes for adolescent reproductive health in Zambia and similar contexts.
Shut out (of the field) and shut in (our homes) – navigating a PhD in times of pandemic
Survey participation effects in conflict research
Alexander De Juan, Carlo Koos
Journal of Peace Research
Human rights in Angola
Inge Amundsen (CMI), Cesaltina Abreu and Catarina Gomes (LAB)
Prevalence, risk factors and association with delivery outcome of curable sexually transmitted infections among pregnant women in Southern Ethiopia
Mengistu Hailemariam Zenebe, Zeleke Mekonnen, Eskindir Loha, Elizaveta Padalko
No city is the same: Livelihood opportunities among self-settled Syrian refugees in Beirut, Tripoli and Tyre
(ترتیبات الحكم المؤقتة في البیئات الھشة وبیئات ما بعد الصراع)
Considering kin and countrymen – challenges to social networks among Syrians in Tripoli, Lebanon
Information Sharing and Rationing in Credit Markets
Jon Einar Flåtnes
American Journal of Agricultural Economics