Alex Ogundipe Adaoha Akubuiro Dayo Lajide Uche Onyebuchi Sheikh Taiwo Ato Selby
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Transcript of Alex Ogundipe Adaoha Akubuiro Dayo Lajide Uche Onyebuchi Sheikh Taiwo Ato Selby
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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
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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
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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
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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
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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
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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