Intervention (Hidden)
Her Spaces
Her Spaces will comprise a set of activities leveraging the Her Spaces curriculum and program model which includes curriculum-based sessions for 11-13 year old girls, with 40 sessions delivered weekly over the course of 10 months. The curriculum used in the Her Spaces program was created by Girl Effect with funding from the Department for International Development (DFID). Her Spaces is a girl-focused, safe spaces program that works with girls to provide them with the skills and supportive network to successfully navigate adolescence. The curriculum covers the domains of health, education, safety, economic security, and voice and participation.
In the Her Spaces intervention arm, there is a fairly standard light-touch engagement strategy with parents and male peers of program participants, as well as community stakeholders. Sensitization meetings to raise awareness of and familiarity with the program will be held at the kebele level, approximately twice. Parents, male peers, and community stakeholders will generally meet, respectively, at the beginning of implementation and again at the end to talk about the intent of the program and the main themes covered in the girl group meetings.
Act With Her
Act With Her was designed to facilitate adolescent transitions to adulthood via improvements across the six GAGE domains (education, bodily integrity, health, psychosocial well-being, voice and agency, and economic empowerment). Project activities fall into three main categories: curriculum-based programming with adolescent girls and boys, community transformation, and systems strengthening. Act With Her will work with 10-13 year old girls and boys for 10 months and implement community-level and high-level system strengthening work up to 24 months (in rural and pastoralist areas).
Act With Her has developed project-specific, gender-transformative curricula for boys and girls, which comprehensively address key topics across the six GAGE domains. The curricula have been refined and adapted to the Ethiopian context. Girls between the ages of 10 and 13 participate in near-peer female mentor-led girls’ groups each week for 10 months (40 sessions). Near-peer male mentor-led groups for boys aged 10 to 13 run concurrently, meeting approximately twice a month (18 sessions). Topics covered in boys’ and girls’ groups will be temporally aligned and four sessions will bring boys’ and girls’ groups together. Additionally, the AWH consortium developed a parents’ guide which outlines six sessions to orient parents to the topics covered in the adolescent curricula and help them to create a supportive environment for their adolescent.
Applying a socioecological approach which recognizes the influence that social norms and systems have on adolescent health, Act With Her will implement high-level systems strengthening activities in addition to this direct adolescent programming.
High-level systems strengthening refers to strategically engaging key stakeholders across multiple sectors at the national, regional, and woreda levels, with the objective of raising the visibility, prioritization, and subsequent improvement of adolescent-responsive systems and services. A secondary objective is to improve the levels and frequency of dialogue and connections between stakeholders in multiple sector systems, ideally leading to improved coordination and linkages between them in ways that better serve the needs of adolescents. Policymakers and other key decision-makers who are potential future AWH implementers and eventual end-users of the research (including representatives from youth-led organizations) will help generate political will and also advise the program during key reflection points during implementation. Through collaboration with these multi-sector actors, Act With Her will seek out windows of opportunity for catalyzing enhanced adolescent-related policies, guidelines, or capacity for service delivery. Key systems targeted for this high-level stakeholder engagement include health, education, S/GBV, and child protection.
Overall the proposed focus of national-level systems strengthening is as follows: Policy dialogues, stakeholder engagement, and multi-sector networking re: child protection, justice, education (re: violence reduction), and health (re: MHM)
The community-level systems strengthening activities will focus on activities that a) establish locally-led mechanisms for discussing social norms in ways that initiate shifts in them over time (including past the project timeline), and b) enhance local capacity for social accountability. Work on catalyzing social norms shifts will primarily be focused on applying CARE’s Social Analysis and Action (SAA) approach to gender and social transformation. Implemented for more than 10 years in multiple program models by CARE, SAA seeks to enable communities to identify for themselves the linkages between social factors and well-being, and then determine actions that will help improve them. The approach allows communities to lead reflection on gender, social, and power norms through participatory tools and discussion. The Act With Her SAA group will meet monthly to discuss harmful socio-cultural norms relevant to their local community, identified and agreed upon beforehand by a diverse set of key ‘power holders’ and gatekeepers in the community. After discussing the norms and reflecting on what elements of health or well-being they may be negatively contributing to, the group devises an action plan as to how they can be combatted. It is expected that the SAA groups will start within 6 weeks of when the first girls’ groups start and will run for up to 2 years in each kebele. The objective of using SAA in Act With Her is to spark shifts in the enabling environment that will complement and positively reinforce the improved agency, knowledge, and behaviors demonstrated by adolescents.
Overall the proposed focus of community-level systems (and services) strengthening is as follows: enhance WASH/MHM and violence reduction within schools; improve local child protection and anti-HTP measures (eg, raising visibility of violence response mechanisms and/or providing age/gender sensitivity training to local officials); foster better linkages between school, health, and social protection platforms; enhance social systems and norms via SAA and community score card activities (the latter for health clinics and schools)
Strengthening local capacity for social accountability will be achieved through application of CARE’s Community Score Card (CSC) approach. The main goal of the Community Score Card is to positively influence the quality, efficiency and accountability with which services are provided in a particular community. Used throughout CARE’s programming, the Community Score Card offers a way to increase participation, accountability and transparency between service users, providers and decision makers. Moreover, the government of Ethiopia has its own Community Score Card used to solicit feedback on health services. In Act With Her, a CSC will be used that blends the format of the government and CARE templates (focused on health service delivery) to also include considerations for education, S/GBV, and/or child protection services. Particular attention will be paid to ensuring that adolescent girls and boys directly participate in the CSC processes. The objective of CSC in Act With Her is to improve local stakeholders’ ability, including young people themselves, to hold providers of key services for adolescents accountable for optimal access and quality.
Act With Her + Asset Transfer
This arm will implement the Act With Her program described above, using program curricula with 10-13-year-old girls and boys over 10 months and conducting community-level systems strengthening up to 24 months. Additionally, the girls participating in this arm will receive one of three asset transfer options. The packages will be of equal value (115 USD) – one will include school supplies, one will include hygiene supplies, and will be a combination of both. Each adolescent girl will choose which package she would like to receive and will receive components of the package at 3 timepoints over the course of the first 10 months of the project.
The asset package will be introduced at recruitment. At week 1, adolescents select their package. It should be indicated that this will be happening at recruitment. If they do not show up, they will get assigned the combined package. The first package will be given near the start of the program (first month), the second package prior to the start of the school year (late august, 5th month), and the third one near the end of the program (ninth month). The timing of only the first transfer will be announced. If a girl misses a transfer day, she will only receive missed transfers at the conclusion of the If a girl misses a transfer day, she will only receive missed transfers at the conclusion of the program if her attendance was >=75%.
Act With Her (curriculum only)
This arm will implement the Act With Her curricula described above with 10-13 year old girls and boys over 10 months. The adolescent groups will follow the same model (near-peer, same-sex mentors, 40 weekly meetings for girls, 18 meetings for boys, 4 of which are joint sessions for boys and girls, 6 sessions for parents), but will not include community-level systems strengthening activities (e,g, SAA groups or the CSC approach).