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Published in: Trials 1/2016

Open Access 01-12-2016 | Study protocol

Effectiveness of a girls’ empowerment programme on early childbearing, marriage and school dropout among adolescent girls in rural Zambia: study protocol for a cluster randomized trial

Authors: Ingvild Fossgard Sandøy, Mweetwa Mudenda, Joseph Zulu, Ecloss Munsaka, Astrid Blystad, Mpundu C. Makasa, Ottar Mæstad, Bertil Tungodden, Choolwe Jacobs, Linda Kampata, Knut Fylkesnes, Joar Svanemyr, Karen Marie Moland, Richard Banda, Patrick Musonda

Published in: Trials | Issue 1/2016

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Abstract

Background

Adolescent pregnancies pose a risk to the young mothers and their babies. In Zambia, 35% of young girls in rural areas have given birth by the age of 18 years. Pregnancy rates are particularly high among out-of-school girls. Poverty, low enrolment in secondary school, myths and community norms all contribute to early childbearing. This protocol describes a trial aiming to measure the effect on early childbearing rates in a rural Zambian context of (1) economic support to girls and their families, and (2) combining economic support with a community intervention to enhance knowledge about sexual and reproductive health and supportive community norms.

Methods/design

This cluster randomized controlled trial (CRCT) will have three arms. The clusters are rural schools with surrounding communities. Approximately 4900 girls in grade 7 in 2016 will be recruited from 157 schools in 12 districts. In one intervention arm, participating girls and their guardians will be offered cash transfers and payment of school fees. In the second intervention arm, there will be both economic support and a community intervention. The interventions will be implemented for approximately 2 years. The final survey will be 4.5 years after recruitment. The primary outcomes will be “incidence of births within 8 months of the end of the intervention period”, “incidence of births before girls’ 18th birthday” and “proportion of girls who sit for the grade 9 exam”. Final survey interviewers will be unaware of the intervention status of respondents. Analysis will be by intention-to-treat and adjusted for cluster design and confounders. Qualitative process evaluation will be conducted.

Discussion

This is the first CRCT to measure the effect of combining economic support with a community intervention to prevent adolescent childbearing in a low- or middle-income country. We have designed a programme that will be sustainable and feasible to scale up. The findings will be relevant for programmes for adolescent reproductive health in Zambia and similar contexts.

Trial registration

ISRCTN registry: ISRCTN12727868, (4 March 2016).
Appendix
Available only for authorised users
Footnotes
1
First conducted November 2013, updated in November 2014, using the search query (((pregnancy in adolescence [MeSH]) OR (Adolescent or teen or youth or youths or girls) AND (Pregnancy [MeSH] or pregnant* or birth* or childbirth OR marriage or Marriage [MeSH])) AND ((intervention or program or programme or trial or experiment or experimental) AND (random*) OR (Controlled Clinical Trial [MeSH] or Clinical Trial [MeSH] or Clinical Trial, Phase III [MeSH] or Randomized Controlled Trial [MeSH]))).
 
2
Medline, Embase, Web of Science, PsycINFO, ERIC, EconLit, Campbell collaboration, Cochrane, CINAHL, POPLINE, LILACS, African Index Medicus, Index Medicus for the Eastern Mediterranean Region, Global Development Finance, Economic Outlook Database, and World Bank e-library.
 
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Metadata
Title
Effectiveness of a girls’ empowerment programme on early childbearing, marriage and school dropout among adolescent girls in rural Zambia: study protocol for a cluster randomized trial
Authors
Ingvild Fossgard Sandøy
Mweetwa Mudenda
Joseph Zulu
Ecloss Munsaka
Astrid Blystad
Mpundu C. Makasa
Ottar Mæstad
Bertil Tungodden
Choolwe Jacobs
Linda Kampata
Knut Fylkesnes
Joar Svanemyr
Karen Marie Moland
Richard Banda
Patrick Musonda
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Trials / Issue 1/2016
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-016-1682-9

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