Reproductive Health Effects of a Safe Spaces, Financial Education and Savings Program for Vulnerable Adolescent Girls in Uganda

Adolescent girls in Uganda face considerable reproductive health risks – including early marriage, teenage pregnancy, early and unprotected sexual activity, non-consensual sex and HIV and other Sexually Transmitted Infections (STIs).  However, current programs for this population typically offer limited interventions that do not address the social, health and economic root causes of their health risks.  The study purpose was to evaluate the effect of a multi-dimensional intervention for slum-dwelling girls ages 10-19 that included weekly girls group meetings, reproductive health and financial education and opening savings accounts.  Data was collected through face-to-face interviews at baseline and after 24 months.  The analysis compares girls who received the full intervention, or savings accounts only, with girls in the comparison group (n=1555).  Overall the full intervention group showed an increase in economic assets, self-esteem and knowledge on contraception and HIV prevention methods.  Logistic regression was used to analyze the change between baseline and endline, controlling for intervention groups and socio-demographic variables.  The results showed that among girls who had not reported ever having had sex at baseline, girls in the full intervention were less likely to have initiated sex (OR .411, p=0.009). For those who did initiate sex between baseline and endline, girls in the full intervention were more likely to report that their first sexual experience was wanted (OR 3.646, p=0.041).  There was no similar effect on participants in the "saving only" group.  These findings support the recommendations that programs for adolescent girls combine social, health and economic components.