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Registration

Field Before After
Trial Status on_going completed
Last Published November 19, 2015 02:13 AM February 22, 2025 11:15 AM
Study Withdrawn No
Intervention Completion Date December 31, 2017
Data Collection Complete Yes
Final Sample Size: Number of Clusters (Unit of Randomization) See publications - all open access - for details across the two sites
Was attrition correlated with treatment status? Yes
Final Sample Size: Total Number of Observations See publications - all open access - for details across the two sites
Final Sample Size (or Number of Clusters) by Treatment Arms See publications - all open access - for details across the two sites
Is there a restricted access data set available on request? Yes
Restricted Data Contact Harvard Dataverse - searching on Adolescent Girls Initiative-Kenya for respective Wajir and Kibera-Nairobi data sets
Program Files No
Data Collection Completion Date November 30, 2019
Is data available for public use? No
Keyword(s) Education, Health Education, Health
Pi as first author No Yes
Building on Existing Work No
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Papers

Field Before After
Paper Abstract Abstract Background: Early adolescence is a critical window for intervention when it is possible to lay a foundation for a safe transition to adulthood, before negative outcomes occur. The Adolescent Girls Initiative–Kenya randomized trial tested the effects of combinations of interventions for young adolescent girls in two sites – the Kibera informal settlement in Nairobi and rural Wajir County in the Northeastern region. Methods: The interventions included community dialogues on the role and value of girls (violence prevention), a conditional cash transfer (education), weekly group meetings for girls with health and life skills training (health), and training and incentives for financial literacy and savings activities (wealth creation). Participants were randomized to one of four study arms: 1) violence prevention only, 2) violence prevention and education, 3) violence prevention, education and health or 4) violence prevention, education, health and wealth creation. An intent-to-treat (ITT) analysis was conducted using longitudinal data to estimate the impact of each combination of interventions and various sensitivity analyses conducted addressing potential attrition bias and multiple hypothesis testing concerns. Results: In Kibera, the education conditional cash transfer had small effects on grade attainment but larger impacts on completion of primary school and the transition to secondary school in the most comprehensive arm; the health intervention improved sexual and reproductive health knowledge and condom self-efficacy; and the wealth intervention improved financial literacy and savings behavior. In Wajir, the education conditional cash transfer increased school enrollment and grade attainment, and the wealth intervention improved savings behavior. Conclusions: The results indicate that when trying to improve a range of outcomes related to adolescent wellbeing for young girls, a multisectoral intervention with components addressing household economic constraints is a promising approach. Trial registration: Trial Registry: ISRCTN, ISRCT N7745 5458. Registered 24/12/2015 - Retrospectively registered.
Paper Citation “Impacts of two-year multisectoral cash plus interventions on young adolescent girls’ education, health and economic outcomes: AGI-K randomized trial.” Austrian, K., E. Soler-Hampejsek, B. Kangwana, Y.D. Wado, B. Abuya and J.A. Maluccio. BMC Public Health, 2021, 21(2159).
Paper URL https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-12224-3
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Field Before After
Paper Abstract Background The vast majority of adolescent births occur in low- and middle-income countries and are associated with negative outcomes for both the mother and her child. A multitude of risk factors may explain why few programs have been successful in delaying childbearing and suggest that multisectoral interventions may be necessary. This study examines the longerterm impact of a two-year (2015–17) multisectoral program on early sexual debut and fertility in an urban informal settlement in Kenya. Methods The study used a randomized trial design, longitudinally following 2,075 girls 11–14 years old in 2015 until 2019. The interventions included community dialogues on unequal gender norms and their consequences (violence prevention), a conditional cash transfer (education), health and life skills training (health), and financial literacy training and savings activities (wealth). Girls were randomized to one of four study arms: 1) violence prevention only (V-only); 2) V-only and education (VE); 3) VE and health (VEH); or 4) all four interventions (VEHW). We used ANCOVA to estimate intent-to-treat (ITT) impacts of each study arm and of pooled study arms VE, VEH, and VEHW relative to the V-only arm, on primary outcomes of fertility and herpes simplex virus-2 (HSV-2) infection, and secondary outcomes of education, health knowledge, and wealth creation. Post-hoc analysis was carried out on older girls who were 13–14-years-old at baseline. In 2018, in the VEHW arm, in-depth qualitative evaluation were carried out with adolescent girls, their parents, school staff, mentors, community conversation facilitators, and community gatekeepers. The trial is registered at ISRCTN: ISRCTN77455458. Results At endline in the V-only study arm, 21.0 percent of girls reported having had sex, 7.7 percent having ever been pregnant and 6.6 percent having ever given birth, with higher rates for the older subsample at 32.5 percent, 11.8 percent, and 10.1 percent, respectively. In the full sample, ever having given birth was reduced by 2.3 percentage points (pp) in the VE and VEHW study arms, significant at 10 percent. For the older subsample there were larger and significant reductions in the percent ever having had sex (8.2 pp), HSV-2 prevalence (7.5 pp) and HSV-2 incidence (5.6 pp) in the VE arm. Two years after the end of the interventions, girls continued to have increased schooling, sexual and reproductive health knowledge, and improved financial savings behaviors. Qualitatively, respondents reported that girls were likely to have sex as a result of child sexual exploitation, peer pressure or influence from the media, as well as for sexual adventure and as a mark of maturity. Conclusion This study demonstrates that multisectoral cash plus interventions targeting the community and household level, combined with interventions in the education, health, and wealth-creation sectors that directly target individual girls in early adolescence, generate protective factors against early pregnancy during adolescence. Such interventions, therefore, potentially have beneficial impacts on the longer-term health and economic outcomes of girls residing in impoverished settings.
Paper Citation “Impacts of multisectoral cash plus programs after four years in an urban informal settlement: Adolescent Girls Initiative-Kenya (AGI-K) randomized trial.” Kangwana, B., K. Austrian, E. Soler-Hampejsek, N. Maddox, R.J. Sapire, Y.D. Wado, B. Abuya, E. Muluve, F. Mbushi, J. Koech and J.A. Maluccio. PLoS ONE, 2022, 17(e0262858).
Paper URL https://doi.org/10.1371/journal.pone.0262858
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Field Before After
Paper Abstract Purpose: Early marriage has multiple drivers including cultural and social norms alongside lack of educational and economic opportunities. This complexity may explain why few programs have demonstrated marriage delays and suggests multisectoral interventions are necessary. This study examined a 2-year multisectoral program designed to delay marriage in a marginalized setting. Methods: The study used a prospective 80-cluster randomized trial following up 2,147 girls aged 11e14 years from 2015 to 2019. Interventions included community dialogs about inequitable gender norms (violence prevention), a conditional cash transfer (education), weekly group meetings with health and life skills training (health), and financial literacy training (wealth creation). Villages were randomized to one of four study arms: (1) violence prevention only (V-only); (2) violence prevention and education (VE); (3) VE and health (VEH); or (4) all four interventions (VEHW).We used analysis of covariance to estimate intent-to-treat impacts of each study arm with an education component, as well as a pooled study arm combining the VE, VEH, and VEHW arms, in reference to V-only, 2 years after the intervention ended, when girls were 15e18 years old. Results: There were small but insignificant reductions on primary outcomes in unadjusted analyses that were larger and significant in adjusted analyses. Effects were particularly large for girls not in school at baselinedthe pooled study arm reduced marriage by 18.0 and pregnancy by 15.6 percentage points, a relative reduction of 34% and 43%, respectively. Discussion: The article demonstrates the potential for multisectoral interventions with education components to delay early marriage in an impoverished, socially conservative, pastoral setting.
Paper Citation “Impacts of multisectoral cash plus programs on marriage and fertility after four years in pastoralist Kenya: a randomized trial.” Austrian, K., E. Soler-Hampejsek, B. Kangwana, Y.D. Wado, B. Abuya, H. Mohammed, A. Aden and J.A. Maluccio. Journal of Adolescent Health, 2022, 70: 885–94.
Paper URL https://doi.org/10.1016/j.jadohealth.2021.12.015
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Post Trial Documents

Field Before After
Description Post trial comments from authors regarding published papers cited above
File
AEA-registry 962 Post Trial Comments (December 2024).pdf
MD5: 9fe30518b8ebb65178f5c553478d0e4d
SHA1: 170474fcb6fb21a6ef16f9ee1a5fb58aed24e733
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