November 30, 2018

Programs and interventions focused on reducing the risk of HIV and early pregnancy, improving school attendance, and empowering girls can have significant and powerful effects for adolescent girls. Simultaneously, these programs may have unanticipated effects that inhibit the program's success.

Troy D. Moon, M.D., M.P.H., and Ann F. Green, M.P.H., are Vanderbilt authors on a manuscript recently published by a multidisciplinary team of investigators led by FHI360 and includes Vanderbilt's in-country NGO Friends in Global Health (FGH), on the unanticipated effects of the program Women First, an economic and social empowerment intervention for young women ages 13-19 years in Zambézia Province, Mozambique implemented by International Relief and Development (IRD) and World Vision. The program evaluation was conducted by VIGH and FGH staff and faculty. The intervention intended to reduce the risk of HIV and experiences of gender-based violence, improve girls' school attendance, and promote girls' empowerment. 

Changes in behavior from the intervention were examined through perceptions of intervention participants, their heads of household, influential men in their lives, and community members. Results from respondents provide evidence there is a perceived causal relationship between participation in Women First and being a "good girl" who is respectful and well-behaved. Girls' respectfulness was described by showing deference and obedience to parents and others, being productive and serving others, being sexually abstinent or chaste, and dressing modestly. Overall, these outcomes aligned with gender norms that were not part of the intended goals of the intervention. To maximise the positive impacts of sexual and reproductive health programming, formative research should be conducted to understand existing gender norms and the degree to which girls and communities position themselves as rigidly aligned with prevalent norms—particularly those that are potentially detrimental to positive sexual and reproductive health outcomes—compared to those that are more fluid or more egalitarian. Empowering girls and young women will require changes in communities and social institutions.

Read the full article and learn more about the program evaluation.