Economic Empowerment as a Health Care Intervention Among Orphaned Children in Rural Uganda

This study evaluated an economic empowerment intervention to reduce HIV risks among orphaned children in Uganda. Children (n=97) were randomly assigned to receive an economic intervention or to a control arm. Data obtained at baseline and 12-month follow-up revealed differences on HIV prevention attitudes, educational plans, and child-caregiver relationship for intervention arm children relative to control children. Findings lend support to use of economic empowerment interventions for HIV risk reduction among orphaned children

Predictors of Human Immunodeficiency Virus Knowledge among Jordanian Youths

Objectives: Understanding factors associated with the level of human immunodeficiency virus (HIV) knowledge acquisition is crucial to inform preventative programmes for young people. This study examines predictors of HIV knowledge among Jordanian youths. Methods: A cross-sectional survey was conducted among 8,129 youths aged between 14 and 25 years randomly selected from schools representing each of the 12 governorates of Jordan. A total of 50% of respondents were female and, on average, 17 years old. Participants completed a self-administered questionnaire covering sociodemographic characteristics, HIV knowledge, gender awareness, exposure to and favourable attitudes toward risky behaviours. Results: On a 13-item HIV knowledge test, participants answered an average of 7 questions correctly (mean = 7.21; standard deviation = 2.63). Female respondents from rural areas demonstrated significantly lower levels of HIV knowledge, while college and university students demonstrated higher levels. HIV knowledge differed significantly by sources of information, with peeracquired information associated with more accuracy, while HIV information from parents or health centres was associated with a lower score. Youths with more egalitarian gender views also demonstrated higher knowledge levels, whereas youths approving of drug use showed lower levels of HIV knowledge. Conclusion: HIV education programmes in Jordan should focus on females and youths living in rural areas. Educational institutions have been shown to be effective in providing accurate information to students, while parents and health professionals should also be included in HIV prevention programmes in order to reduce misconceptions and raise the level of HIV knowledge among Jordanian youths

The Silk Road Health Project: How Mobility and Migration Status Influence HIV Risks among Male Migrant Workers in Central Asia

Objectives We examined whether mobility, migrant status, and risk environments are associated with sexually transmitted infections (STIs) and HIV risk behaviors (e.g. sex trading, multiple partners, and unprotected sex). Methods We used Respondent Driven Sampling (RDS) to recruit external male migrant market vendors from Kyrgyzstan, Uzbekistan, and Tajikistan as well internal migrant and non-migrant market vendors from Kazakhstan. We conducted multivariate logistic regressions to examine the effects of mobility combined with the interaction between mobility and migration status on STIs and sexual risk behaviors, when controlling for risk environment characteristics. Results Mobility was associated with increased risk for biologically-confirmed STIs, sex trading, and unprotected sex among non-migrants, but not among internal or external migrants. Condom use rates were low among all three groups, particularly external migrants. Risk environment factors of low-income status, debt, homelessness, and limited access to medical care were associated with unprotected sex among external migrants. Conclusion Study findings underscore the role mobility and risk environments play in shaping HIV/STI risks. They highlight the need to consider mobility in the context of migration status and other risk environment factors in developing effective prevention strategies for this population

Children and Violence in Burkina Faso: the study protocol

This study evaluates a combined economic empowerment and child rights intervention to prevent violence against children and exploitation of children in ultra-poor communities in Burkina Faso. A three-arm randomized control trial with baseline and one-year follow-up includes 360 households (120 households per arm). Extreme poverty heightens risks of violence and exploitation of children, particularly girls, who may end up in the worst forms of child labor (e.g., slavery, debt bondage, forced or hazardous work in gold mines, cotton fields, or plantations in the Ivory Coast or in the South of Burkina Faso, involving physical deprivation and violence). About 1.25 million (or 37.8%) of children ages 5-14 in Burkina Faso are working to augment the incomes of their families, or because their families are too poor to support them. Adolescent girls being sent away to work as maids, facing risks of sexual exploitation and abuse. Boys being sent to religious schools madrassas, where they are made to do unpaid and/or hazardous work including begging in the street, and are subject to physical abuse

Faith-Based Institutions as Project Implementers: An Innovative Economic Empowerment Intervention for Care and Support of Aids-Orphaned and Vulnerable Children in Rural Uganda

Faith-Based Institutions as Project Implementers: An Innovative Economic Empowerment Intervention for Care and Support of Aids-Orphaned and Vulnerable Children in Rural Ugand

More assets, more decision-making power? Mediation model in a cluster-randomized controlled trial evaluating the effect of the graduation program on women's empowerment in Burkina Faso

To promote women’s empowerment, numerous programs provide economic services meant to increase women’s access to economic resources in the household. However, women’s access to economic resources does not always translate into improved bargaining power, and effects of economic strengthening interventions may vary across different decision-making domains. There is little robust evidence, particularly in sub-Saharan Africa, showing the effect of improved access to economic resources on specific domains of decision-making within a family and very little is known about variation in this effect between monogamous and polygynous families. Furthermore, very few assessments explicitly examine specific pathways from participation in economic strengthening interventions to improved decision-making power in the household for women.Our study aims to address these gaps by examining—in the context of a randomized controlled trial administered in rural Burkina Faso—the effect of an economic strengthening intervention on specific domains of women’s decision-making power and how it relates to monogamous/polygynous family structures and challenges to intra-household gender roles and responsibilities. Furthermore, we examine a specific pathway to better understand whether increased access to economic resources from this intervention translates into improved decision-making power for women.We use repeated-measures data collected from 360 adult female caregivers in the 3-arm cluster-randomized controlled trial conducted among households living in abject poverty in Burkina Faso. We ran multilevel mixed-effects logistic regression models to examine the effect of the intervention on different domains of women’s involvement into household-level decision-making and variation of this effect by family structure (i.e. polygamous vs. monogamous families). We fit a structural equation model to examine whether access to assets mediates the effect of the intervention on different domains of women’s involvement into household-level decision-making.We found that economic empowerment intervention increased women’s involvement in making decisions about their children’s well-being, but had no effect on women’s say in making decisions about general household economy. We found most effects to be stronger in the treatment arm that received economic strengthening combined with family coaching offered to the whole household and directly targeting normative beliefs related to child wellbeing and gender norms. We also found no evidence that increased access to assets mediates the effect of intervention on improving women’s decision-making power in different domains.Our findings suggest that to improve decision-making power for women in their household it is important to address structural gender inequalities and gender norms rooted in patriarchy, alongside the efforts to economically empower women

More assets, more decision-making power? Mediation model in a cluster-randomized controlled trial evaluating the effect of the graduation porogram on women's empowerment in Burkina Faso

To promote women’s empowerment, numerous programs provide economic services meant to increase women’s access to economic resources in the household. However, women’s access to economic resources does not always translate into improved bargaining power, and effects of economic strengthening interventions may vary across different decision-making domains. There is little robust evidence, particularly in sub-Saharan Africa, showing the effect of improved access to economic resources on specific domains of decision-making within a family and very little is known about variation in this effect between monogamous and polygynous families. Furthermore, very few assessments explicitly examine specific pathways from participation in economic strengthening interventions to improved decision-making power in the household for women.Our study aims to address these gaps by examining—in the context of a randomized controlled trial administered in rural Burkina Faso—the effect of an economic strengthening intervention on specific domains of women’s decision-making power and how it relates to monogamous/polygynous family structures and challenges to intra-household gender roles and responsibilities. Furthermore, we examine a specific pathway to better understand whether increased access to economic resources from this intervention translates into improved decision-making power for women.We use repeated-measures data collected from 360 adult female caregivers in the 3-arm cluster-randomized controlled trial conducted among households living in abject poverty in Burkina Faso. We ran multilevel mixed-effects logistic regression models to examine the effect of the intervention on different domains of women’s involvement into household-level decision-making and variation of this effect by family structure (i.e. polygamous vs. monogamous families). We fit a structural equation model to examine whether access to assets mediates the effect of the intervention on different domains of women’s involvement into household-level decision-making.We found that economic empowerment intervention increased women’s involvement in making decisions about their children’s well-being, but had no effect on women’s say in making decisions about general household economy. We found most effects to be stronger in the treatment arm that received economic strengthening combined with family coaching offered to the whole household and directly targeting normative beliefs related to child wellbeing and gender norms. We also found no evidence that increased access to assets mediates the effect of intervention on improving women’s decision-making power in different domains.Our findings suggest that to improve decision-making power for women in their household it is important to address structural gender inequalities and gender norms rooted in patriarchy, alongside the efforts to economically empower women.<br/

Trauma of separation: The social and emotional impact of institutionalization on children in a post-soviet country

Background: In the former Soviet Union (fSU) region, which has the highest rate of institutional care worldwide, 'social orphans' -indigent children who have one or both parents living-are placed in publicly run residential institutions to receive education, food, and shelter. Few studies have focused on understanding the emotional effects of separation and life in an institutional environment on children who grow up with their families. Methods: Semi-structured qualitative interviews (N = 47) were conducted with 8- to 16-year-old children with a history of institutional care placement and their parents in Azerbaijan. Semi-structured qualitative interviews were conducted with 8- to 16-year-old children (n = 21) involved in the institutional care system in Azerbaijan and their caregivers (n = 26). Trained interviewers collected narratives about children's experiences prior to being separated from their families while living in an institution, as well as the impact of institutional placement on their emotional well-being. We applied thematic analysis with inductive coding. Results: Most of the children entered institutions around the school entry age. Prior to entering institutions, children had already experienced disruptions within their family environments and multiple traumatic events, including witnessing domestic violence, parental divorce, and parental substance abuse. Once institutionalized, these children may have had their mental health further impaired by a sense of abandonment, a strictly regimented life, and insufficiencies of freedom, privacy, developmentally stimulating experiences, and, at times, safety. Conclusion: This study illustrates the emotional and behavioral consequences of institutional placement and the need to address accumulated chronic and complex traumatic experiences that occurred before and during institutional placement, which may affect emotion regulation and the familial and social relationships of children who lived in institutions in a post-Soviet country. The study identified mental health issues that could be addressed during the deinstitutionalization and family reintegration process to improve emotional well-being and restore family relationships.</p