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Adolescent Girls Initiative - Kenya (AGI-K)
Last registered on November 19, 2015

Pre-Trial

Trial Information
General Information
Title
Adolescent Girls Initiative - Kenya (AGI-K)
RCT ID
AEARCTR-0000962
Initial registration date
November 19, 2015
Last updated
November 19, 2015 2:13 AM EST
Location(s)

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Primary Investigator
Affiliation
Population Council
Other Primary Investigator(s)
PI Affiliation
African Population and Health Research Center
PI Affiliation
African Population and Health Research Center
PI Affiliation
African Population and Health Research Center
PI Affiliation
Middlebury College
PI Affiliation
Population Council
PI Affiliation
Population Council
Additional Trial Information
Status
On going
Start date
2015-01-13
End date
2019-12-31
Secondary IDs
Abstract
Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education status, health, and general well-being. The Adolescent Girls Initiative–Kenya (AGI-K) will deliver multi-sectoral interventions for over 5,000 girls ages 11–14 in two marginalized areas of Kenya: 1) Kibera slums in Nairobi and 2) Wajir County in Northeastern Kenya. These interventions will be implemented for two years and will comprise a combination of girl-level, household-level, and community-level interventions. A randomized controlled trial (RCT) will be used to compare the impact of four different packages of interventions, including a cost-effectiveness component, in order to assess if and how intervening in early adolescence will impact girls’ life chances. Using a longitudinal design, quantitative data collection will be consist of a baseline survey, a midline survey (at the end of the 2 year intervention), and a follow-up survey (2 years post-intervention).
External Link(s)
Registration Citation
Citation
Abuya, Benta et al. 2015. "Adolescent Girls Initiative - Kenya (AGI-K)." AEA RCT Registry. November 19. https://doi.org/10.1257/rct.962-1.0.
Former Citation
Abuya, Benta et al. 2015. "Adolescent Girls Initiative - Kenya (AGI-K)." AEA RCT Registry. November 19. https://www.socialscienceregistry.org/trials/962/history/6094.
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
The goal of AGI-K is to test multi-sectoral packages of interventions in four sectors: violence prevention, education, health and wealth creation. The violence-prevention intervention is a community-level intervention that uses the community dialogues and contracts strategy based on the UNDP/Concern Worldwide model (1). The education intervention is a conditional cash transfer (CCT) based on 80% attendance over the course of a term. The health intervention will follow the Council’s Safe Spaces model (2) in which girls meet in groups once a week under the guidance of a female mentor from the community. The wealth-creation intervention is composed of financial education, which is delivered during Safe Spaces meetings, as well as savings through individual bank accounts (Nairobi) or home banks (Wajir) and a small savings incentives. The following packages of interventions will be tested:
1) Violence Prevention
2) Violence Prevention + Education
3) Violence Prevention + Education + Health
4) Violence Prevention + Education + Health + Wealth Creation

1. UNDP (2005) Leadership for Results UNDP’s response to HIV/AIDS: Community Capacity Enhancement Strategy Note. New York: UNDP. At; http://www.undp.org/HIV/docs/prog_guides/ldp_strategy_note.pdf

2. Austrian K, Ghati D. Girl centered program design: A toolkit to develop, strengthen & expand adolescent girls programs: Population Council; 2010. At; http://www.popcouncil.org/uploads/pdfs/2010PGY_AdolGirlToolkitComplete.pdf
Intervention Start Date
2015-06-22
Intervention End Date
2017-07-31
Primary Outcomes
Primary Outcomes (end points)
The primary outcome measures for the study, to be assessed after 2 years and then again after 4 years, are increased age at first birth, increased age at first sex and increased age at first marriage.

Secondary outcomes include the following:

1. Violence Prevention - Decreased experience of gender-based violence and improved gender norms related to violence

2. Education - Increased mean grade of schooling and increased rate of primary school completion

3. Health - Increased knowledge on sexual and reproductive health and improved decision-making skills

4. Wealth Creation - Increased knowledge on financial education, increased saving and increased participation in income generating activities
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The overall, long-term goal of the interventions is to reduce adolescent fertility by improving the well-being of girls in program sites. AGI-K will test multi-sectoral packages of interventions to answer the following research question:

Which combination(s) of interventions produce(s) the greatest change in the well-being of adolescent girls?

Due to the difference in context, cultures, and cost-structures, this study consists of two sub-studies with independent datasets: the Wajir sub-study and the Urban Nairobi Slums sub-study. The research design for the study is a randomized controlled trial (RCT). The unit of randomization is different for the two sites: cluster randomization in Wajir and individual-level randomization in Nairobi. In Wajir, which is less densely populated, a cluster-level design allows for randomization to different combinations of interventions at the community level, while reaching a similar number of girls. In addition, a nonexperimental external control site was included in the design for the Nairobi sub-study to enable comparison of intervention arms with a similar area that did not receive any of the four program interventions.

The project will be evaluated using data from behavioral surveys conducted at baseline, midterm (after 2 years), and endline (after 4 years); a cost-effectiveness and value-for-money costing study; a qualitative study to provide insights into the results shown in the quantitative data regarding the impact of the interventions; and program-monitoring data to track program attendance and participation.
Experimental Design Details
Not available
Randomization Method
Nairobi - randomization was done using the Excel random number generator. A unique ID was assigned to each girl and the list was randomly ordered, then then divided into 4 groups based on this order. Community stakeholders randomly selected a card with the study arm for each group.

Wajir - randomization was stratified by district: Wajir West (20 clusters), Wajir East (28 clusters) and Wajir South (32 clusters). Using a public lottery method and stratified by district, randomization was done by having a designated community member from each village randomly select a card indicating the study arm.
Randomization Unit
Nairobi - the randomization was conducted at the individual level.
Wajir - randomization was conducted at the cluster level, stratified by district.
Was the treatment clustered?
Yes
Experiment Characteristics
Sample size: planned number of clusters
Nairobi - no clusters (individual randomization)
Wajir - 80 clusters (school-catchment areas) with 20 clusters per arm
Sample size: planned number of observations
Nairobi - 2,400 girls in study site and 600 girls in external control site at baseline; Wajir - 2,160 girls at baseline
Sample size (or number of clusters) by treatment arms
Nairobi - 600 girls per arm at baseline
Wajir - 20 clusters (school-catchment areas) per arm and 27 girls per cluster at baseline
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
Nairobi: Data from the Nairobi Cross-Sectional Slum Survey were used to obtain baseline estimates for childbearing and education in Nairobi. Assuming that 15.4% of girls in the violence prevention only arm would have given birth by endline: we would detect a statistically significant difference of 6.3 percentage points between the violence prevention only arm and each of the other three arms. Assuming a correlation coefficient of 0.33, we would detect a statistically significant difference of 0.55 grade of schooling between any two arms. Wajir: The estimate of the intra-cluster correlation (ICC) and the baseline estimates for childbearing and education were based on data on the Northeastern Province from the 2008/09 Kenya Demographic and Health Survey. Assuming that 17.6% of girls in the violence prevention only arm would have given birth by endline, we would detect a statistically significant difference of 6.9 percentage points between the violence prevention only arm and each of the other three arms. Assuming a correlation coefficient of 0.26, we would detect a statistically significant difference of 0.49 grade of schooling between any two arms.
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Population Council Institutional Review Board
IRB Approval Date
2014-09-10
IRB Approval Number
661
IRB Name
AMREF Ethical and Scientific Review Committee
IRB Approval Date
2014-11-19
IRB Approval Number
P143/2014