Africa Impact Evaluation Program on AIDS (AIM-AIDS) Cape Town, South Africa March 8 – 13, 2009

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NIGERIA Family Life Health Education

Alex OgundipeAlex Ogundipe

Adaoha AkubuiroAdaoha Akubuiro

Dayo LajideDayo Lajide

Uche OnyebuchiUche Onyebuchi

Sheikh TaiwoSheikh Taiwo

Ato SelbyAto Selby

Stephen Ayisi-AddoStephen Ayisi-Addo

Nancy PadianNancy Padian

Jean-Louis ArcandJean-Louis Arcand

Intervention - Family Life Health Education

• Unit of intervention: LGA• Planned Coverage: 12 states – 2 in each geopolitical

zone – 1 LGA with intervention and 1 without intervention in each state (12 with and 12 without nation-wide) –

• Matching Criteria for the LGAs

- STI, HIV and Pregnancy rates similar in the LGAs

- Socioeconomic status similar

- Urban/Rural mix

- Public/Private school balance

Cont.’d

• Within LGA, do a random sample of schools that have a mix of both public and private schools

• Target group: In- school youths 12 – 18yrs (Secondary schools)

- Randomly pick intervention class from each arm (1 from JSS 1, 1 from SS1, 1 from SS2)

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Cont.’d

• Criteria for inclusion – mix of both private and public schools – public control, public intervention, private control and private intervention

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Policy QuestionsPROBLEM STATEMENT: • There is a high rate of pregnancy among in school youths and an increase

in school drop-out rate. There is a high rate of STIs and HIV as well as low level of knowledge among youths on HIV/AIDS education

QUESTIONS:• How do we address this problem amongst in-school youths?• Are there relevant policies/guidelines to change/revise?• What specific activities do we have to undertake to address these

problems?• What resources do we need to address these problems? • How do we sustain these activities to ensure a good impact?

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Indicators

Intermediate and Final Indicators

• Increase in abstinence rates reported

• Increased age at sexual debut

• Reduction in STI incidence

• Reduction in rates of unwanted pregnancy

• Reduction in HIV incidence

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Sample and Data

• In school youths (JSS3-SS3) attending schools in the selected LGAs where the FLHE intervention will be taking place.

• Data: NARHS, DHS, IBBSS, ANC

• New survey plans: Baseline data and follow up data on selected indicators including biological outcomes

• Field work: Field Reports

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Sample and Data 2

• Random selection of classes. Within the classes, all students are selected. Start at the last year of Junior Secondary School into the last year of Senior Secondary School.

• SS3 students are followed for 1 year• SS2 students are followed for 2 years• SS1 students are followed for 3 years• JS3 students are followed for 4 years• SS = Senior Secondary• JS = Junior Secondary

Hypotheses

• Ho: FLHE intervention does not have an effect on

– Abstinence

– Sexual debut

– STI cases

– Unwanted pregnancy

– HIV

• H1: FLHE has a significant effect on

– Abstinence

– Sexual debut

– STI cases

– Unwanted pregnancy

– HIV

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Results/Causal pathway

Increased rates of reported abstinence

 

Increase age at sexual debut

 

Reduced incidence of STI cases

 

Decreased incidence of unwanted pregnancy

 

Reduced incidence of HIV

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Evaluation Design

ARM ROUND1 ROUND2 ROUND3 ROUND4

SS3 1

SS2 1 2

SS1 1 2 3

JSS3 1 2 3 4

Evaluation Design

• Examine outcomes comparing ‘treatment’ & ‘control’

• Examine if impact differs by– Yrs of exposure– Private/public settings– Urban/rural location

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Evaluation Design – Important Covariates

• Student characteristics – ethnicity, religion etc

• Parent characteristics – socioeconomic status, religion etc

• Teacher characteristics – level of education, experience, discipline

• Examine initial matching criteria at LGA level

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Staffing Plan

• Nigerian AIDS Research Network (NARN)• SACA M&E staff• NACA zonal M&E staff• Federal Ministry of Education• LACA• DFID/British Council• Measure Evaluation• World Bank• UN Agencies

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Planning Timeline

• Constitution of Program design team

• Completion of Program design

• Advocacy and resource mobilization

• Constitution of Evaluation Advisory Board & team

• Community/stakeholder Preparedness

• Conduct Baseline: Ahead of program implementation

• Conduct Annual follow-up surveys for 3yrs (control & treatment)

• Analyze data & write report annually

• Dissemination of reports

• Policy dialogue for Program expansion & Sustainability

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Budget/Potential Sources

• Development Partners– WB, DFID, USG,UNDP

• Government– Federal( MDG, DRG etc), State & Local– Educational Authorities

Enhanced design possibilities

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Alternative scenarios

• Plan B:– Same design but insufficient power

• Increase the number of LGAs

• Plan C– For logistical, political or resource constraints

• Fewer states, but more LGAs

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Thank You