Siyakha Nentsha: An experiment to build Social, Health and Financial capabilities of vulnerable girls and boys in KwaZulu-Natal, South Africa K Hallman, M Calderon, K Govender, E Roca, E Mbatha, M Rogan, H Taboada, S Siema, J Fauls, R Brown Making Cents Conf. – 12 Sept. 2012

Evolution to project  Multivariate work with “Transitions to Adulthood” panel study in KZN (2003/now)  Gendered factors on adolescent sexual behaviors: Residing in relative poverty Having thin social networks Being an orphan Feeling unsafe/disconnected from community  Program inventory in Durban metro area (2005/6)  Most single-dimension, imported, little M or E  Pilot study in a test community (2006/7)

Siyakha Nentsha (SN) study  Funding from ESRC/Hewlett joint scheme (Nov 2007-Nov 2009) and ABBA RPC ( )  Target outcomes: (80 hrs max exposure Jun08-May09) Social support: peers and mentors social grants ID documents  Knowledge of effective HIV prevention and treatment options  Saving behavior  Critical given local burden of HIV and AIDS

Siyakha Nentsha features  Nationally accredited certification Skills and a nationally-endorsed documentation of these skills Skills and a nationally-endorsed documentation of these skills  Maximum use of existing infrastructure Local secondary grads (M&F) trained to deliver Local secondary grads (M&F) trained to deliver  Role models, mentors, confidants Worked in pairs within classroom Worked in pairs within classroom Auxiliary social worker salary Auxiliary social worker salary  Eye toward scale-up DOE participation from inception DOE participation from inception

Siyakha Nentsha program design  Incorporated into school day Least selective sample Least selective sample  Included all learners in each study school Sessions occur 2-3 times/week Sessions occur 2-3 times/week Each session is one hour in length Each session is one hour in length  Grade 10 and 11 learners 7 secondary schools 7 secondary schools Randomization at the classroom level Randomization at the classroom level  Females and males included Male attitudes, behaviors and future prospects Male attitudes, behaviors and future prospects

Photo: Eva Roca

Siyakha Nentsha timeline

Siyakha Nentsha study design Arm 1  Control group standard life skills delayed SN modules Arm 2  HIV/SRH education  Social support  Stress reduction Arm 3  HIV/SRH education  Social support  Financial education

Siyakha Nentsha study arms SN social/health/financialSN social/health/stress Nutrition, healthy and balanced diets Communication Knowing yourself STIs, HIV and AIDS Rights and responsibilities Numeracy and data collection Stress (definition, causes, ways of dealing with stress) Personal finance, budgeting, savings and investments Business skills Design HIV prevention campaign Reduction of violence against women and children

Photo: Eva Roca

Siyakha Nentsha survey  Interviews conducted in learner HHs Fielded by private independent company Fielded by private independent company  945 participants interviewed at baseline Only 9 learners refused original survey Only 9 learners refused original survey  716 found at follow-up (76%)  715 complete interviews at follow-up  GIS coordinates on participant households

Siyakha Nentsha sample GirlsBoys Total Control SN social/health/stress SN social/health/financial Irregular school attenders (<10 sessions) Total Number of learners by intervention arm and gender

SN baseline characteristics Girls (N=359) Boys (N=356) Mean difference boys - girls Mean Learner’s age (y) *** % orphaned % ever pregnant 5.79 % not enough money for basic necessities % with electricity connection % did not eat morning of survey ** % walk to school *** % worked for pay past 12 months ** # members in household % female-headed households # assets owned by household, out of p<0.10; * p<0.05; ** p<0.01; *** p<0.001

Photo: Eva Roca

SN evaluation results  Controls included: age, age squared, gender, socioeconomic status  SEs corrected for clustering at classroom level  Impact estimates corrected for panel attrition 229 learners lost between rounds 229 learners lost between rounds

SN impact on social and economic - Girls + p<0.10; * p<0.05; ** p<0.01

SN impact on cognitive skills (Raven test) - Girls + p<0.10; * p<0.05; ** p<0.01

SN impact on self-reported sexual behaviors - Girls

Other results SN  No significant SN impact on condom use at last sex or consistent use for either boys or girls  SN  SN girls who received financial education reported feeling greater levels of social inclusion in their communities when the SEs were not clustered at the classroom level

Conclusions  Program with actionable skills appears to have potential to: increase girls’ skills to access benefits, interact w banks & save money improve girls’ cognitive abilities  Impacts differed by gender: girls’ cognitive & economic skills improved boys reported safer sexual behaviors & more knowledge about social grants  No detectable statistical impact 6 mos post on: girls’ reported sexual behaviors boys’ access to financial services or savings condom use (last sex or consistent) for either females or males

Thank you! Our funders: ESRC/Hewlett Joint Scheme, DFID through the ABBA RPC, Hewlett support to the Population Council Photo: Eva Roca

Siyakha Nentsha randomization Control SN social/health/stress SN social/health/financial Total Sikhwama 2 Inwabi 22 Fundinduku 24 Khulabebuka 22 Mhawu 45 Nomavimbela 22 Sobonakhona 6 Total Number of classrooms by school and intervention arm

Survey attrition AllGirlsBoys Total Control SN social/health/stress SN social/health/financial % of learners found at second round

Survey attrition (cont) (1) Attriters (n=229) (2) Non- attriters (n=716) (2) - (1) mean diff meanSDmeanSD Learner's age (y) *** 1 if girl if lives with mother * 1 if lives with father if orphan (any parent) SES if missing SES Learner's grade p<0.10; * p<0.05; ** p<0.01; *** p<0.001

SN evaluation  Identification strategy: difference in difference framework pre and post intervention periods treatment w financial literacy (FL), treatment w stress reduction (LS), and control groups β 0 = financial literacy group specific effect β 1 = stress reduction group specific effect β 2 = time trend β 3 = SN impact on financial literacy group β 4 = SN impact on stress reduction group

SN evaluation (cont)  β 3 (and β 4 ) coefficient of interest the estimate one would get from an OLS regression (for continuous outcomes)  We can interpret this coefficient as a double difference:

SN impact on social and economic - Boys + p<0.10; * p<0.05; ** p<0.01

SN impact on cognitive skills (Raven test) - Boys

SN impact on self-reported sexual behaviors - Boys + p<0.10; * p<0.05; ** p<0.01