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Adolescent girls, school, HIV, and pregnancy: evidence from Kenya Michael Kremer, Harvard University Esther Duflo, Pascaline Dupas, Samuel Sinei; Edward Miguel and Rebecca Thornton
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Context Poor, rural region in Western Kenya Most children start primary school, but drop out before secondary school Free primary education Teen childbearing (DHS) 16% of 17-year old women have begun childbearing 46% of 19-year old women Two randomized evaluations
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Reproductive health programs Teacher training on HIV/AIDS curriculum Government curriculum Limited discussion of condoms Debate on condoms and essay on protecting self against HIV/AIDS Information about HIV age profile (Dupas) Reducing cost of education
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Teacher training in HIV/AIDS curriculum No significant/limited impact on knowledge, self-reported sexual behavior, childbearing Increases marriage conditional on childbearing by 6 %
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Debate on condoms/ Essay on protecting self No increase in self-reported sexual activity Increases knowledge of and self- reported use of condoms Waiting for childbearing outcomes
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Information about age-profile of infection Large gender differences in age profile imply cross-generational sex is key route of infection Girls not aware Information on age profile of infection by gender (delivered by NGO workers) Video
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Outcomes Reduces girls’ childbearing by 32% Reduces childbearing with adult men by 65%
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Reducing cost of education Primary education is free, but de facto costs (uniforms) School vs. childbearing tradeoff Reduces dropout by 13.5% Increases confidence in girls for saying “No” if partner wants to have sex by 5% Reduces probability of reporting ever having had sex by 13% Reduces teen childbearing by 10%
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Targeted merit scholarships Policy challenge: secondary education – how allocate funds Prior to FPE; merit scholarships for girls scoring well in 6 th grade exams Girl Scholarship Program (GSP) in two districts in Western Kenya
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Girls Scholarship Program Overall incentive effect: test-score gains of 0.14 sd (~6 percentage points) Teacher attendance up Girls with low pre-test scores gain No evidence of weakened intrinsic motivation/gaming Effects persist Heterogeneous program effect by district In successful district: test scores increase 0.25 s.d., gains for boys too, student attendance up In other district: cannot reject zero program impact
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Conclusion Cost effective programs exist Informing girls about risks of relationships with older men Reducing cost of education Secondary school scholarships? Jury out? HIV/AIDS education training for new teachers Debates on condoms and essays on protecting self How to expand access to secondary education?
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Outcomes of interest HIV education in schools Knowledge and attitudes Condom use Teenage childbearing Marriage Drop-out
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HIV education: Improvement in students’ knowledge?
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HIV education: Improvement in students’ attitudes?
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HIV education: Self-reported sexual behavior
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HIV education: Childbearing rates
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HIV education: Dropout
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HIV education: Relative risk information
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