Siyakha Nentsha: An experiment to build Social, Health and Financial capabilities of vulnerable...

Siyakha Nentsha: An experiment to build

Social, Health and Financial capabilities of vulnerable

girls and boys in KwaZulu-Natal, South Africa

K Hallman, M Calderon, K Govender, E Roca, E Mbatha, M Rogan, H Taboada, S Siema, J Fauls, R Brown

Making Cents Conf. – 12 Sept. 2012

Evolution to project

Multivariate work with “Transitions to Adulthood” panel study in KZN (2003/now) Gendered factors on adolescent sexual behaviors:

• Residing in relative poverty• Having thin social networks• Being an orphan• Feeling unsafe/disconnected from community

Program inventory in Durban metro area (2005/6) Most single-dimension, imported, little M or E

Pilot study in a test community (2006/7)

Siyakha Nentsha (SN) study

Funding from ESRC/Hewlett joint scheme (Nov 2007-Nov 2009) and ABBA RPC (2010-11)

Target outcomes: (80 hrs max exposure Jun08-May09)

• Social support: • peers and mentors• social grants• ID documents

Knowledge of effective HIV prevention and treatment options

Saving behavior

Critical given local burden of HIV and AIDS

Siyakha Nentsha features

Nationally accredited certification• Skills and a nationally-endorsed documentation of these skills

Maximum use of existing infrastructure• Local secondary grads (M&F) trained to deliver

Role models, mentors, confidants

• Worked in pairs within classroom• Auxiliary social worker salary

Eye toward scale-up• DOE participation from inception

Siyakha Nentsha program design Incorporated into school day

• Least selective sample Included all learners in each study school

• Sessions occur 2-3 times/week• Each session is one hour in length

Grade 10 and 11 learners• 7 secondary schools• Randomization at the classroom level

Females and males included• Male attitudes, behaviors and future prospects

Photo: Eva Roca

Siyakha Nentsha timeline

J an Apr MayJ une Dec J an May NovDecJ an J uneJ uly Dec

2008 2009 2010

Evaluation survey

Grade 11Grade 10

focus groups

Baseline survey SN intervention

Grade 12Grade 11

Siyakha Nentsha study design

Arm 1

Control group• standard life skills• delayed SN modules Arm 2

HIV/SRH education Social support Stress reduction

Arm 3

HIV/SRH education Social support Financial education

Siyakha Nentsha study armsSN social/health/financial SN social/health/stress

Nutrition, healthy and balanced diets

Communication

Knowing yourself

STIs, HIV and AIDS

Rights and responsibilities

Numeracy and data collectionStress (definition, causes, ways

of dealing with stress)Personal finance, budgeting, savings and investments

Business skills

Design HIV prevention campaign

Reduction of violence against women and children

Photo: Eva Roca

Siyakha Nentsha survey

Interviews conducted in learner HHs• Fielded by private independent company

945 participants interviewed at baseline• Only 9 learners refused original survey

716 found at follow-up (76%)

715 complete interviews at follow-up

GIS coordinates on participant households

Siyakha Nentsha sample

Girls Boys Total

Control 100 69 169

SN social/health/stress 145 136 281

SN social/health/financial 85 126 211

Irregular school attenders (<10 sessions) 29 25 54

Total 359 356 715

Number of learners by intervention arm and gender

SN baseline characteristics Girls (N=359)

Boys (N=356) Mean

difference boys -

girlsMean

Learner’s age (y) 17.05 17.66 0.61***

% orphaned 38.8 44.4 5.60

% ever pregnant 5.79

% not enough money for basic necessities 63.9 58.4 -5.50

% with electricity connection 95.5 96.5 1.00

% did not eat morning of survey 15.7 8.47 -7.23**

% walk to school 75.4 86.5 11.10***

% worked for pay past 12 months 3.98 10.3 6.32**

# members in household 8.01 7.47 -0.54+

% female-headed households 41.6 41.4 -0.20

# assets owned by household, out of 22 9.52 9.65 0.13

+ p<0.10; * p<0.05; ** p<0.01; *** p<0.001

Photo: Eva Roca

SN evaluation results

Controls included: age, age squared, gender, socioeconomic status

SEs corrected for clustering at classroom level

Impact estimates corrected for panel attrition • 229 learners lost between rounds

SN impact on social and economic - Girls

+ p<0.10; * p<0.05; ** p<0.01

# Social grants knowledge Attempted to open bank account in past year

Is saving

-0.5

-0.3

-0.1

0.1

0.3

0.5

0.7

0.9

1.1

1.3

SN social/health (v. control) SN social/health/financial (v. control) SN combined (v. control)

SN social/ health/financial (v. SN social/ health)

+ + *

**

**

(Yt2

- Y

t1)

- (Y

c2 -

Yc1

)

SN impact on cognitive skills (Raven test) - Girls

+ p<0.10; * p<0.05; ** p<0.01

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

SN social/health (v. control) SN social/health/financial (v. control) SN combined (v. control)

SN social/ health/financial (v. SN social/ health)

+

*

Yt2

-

Yc2

SN impact on self-reported sexual behaviors - Girls

Had sex past year # of sexual partners in past year

-0.8

-0.7

-0.6

-0.5

-0.4

-0.3

-0.2

-0.1

0

SN social/health (v. control) SN social/health/financial (v. control) SN combined (v. control)

SN social/ health/financial (v. SN social/ health)

(Yt2

- Y

t1)

- (Y

c2 -

Yc1

)

Other results

No significant SN impact on condom use at last sex or consistent use for either boys or girls

SN girls who received financial education reported feeling greater levels of social inclusion in their communities when the SEs were not clustered at the classroom level

Conclusions Program with actionable skills appears to have

potential to:• increase girls’ skills to access benefits, interact w banks &

save money• improve girls’ cognitive abilities

Impacts differed by gender:• girls’ cognitive & economic skills improved• boys reported safer sexual behaviors & more knowledge

about social grants

No detectable statistical impact 6 mos post on:• girls’ reported sexual behaviors• boys’ access to financial services or savings• condom use (last sex or consistent) for either females or

males

Thank you!

Our funders: ESRC/Hewlett Joint Scheme, DFID through the ABBA RPC, Hewlett support to the Population Council

Photo: Eva Roca

Siyakha Nentsha randomization

Control SN social/health/stressSN

social/health/financialTotal

Sikhwama 2

Inwabi 2 2

Fundinduku 2 4

Khulabebuka 2 2

Mhawu 4 5

Nomavimbela 2 2

Sobonakhona 6

Total 6 12 17 35

Number of classrooms by school and intervention arm

Survey attrition

All Girls Boys

Total 75.8 76.5 76.2

Control 69.5 75.2 62.7

SN social/health/stress 83.1 81.7 84.6

SN social/health/financial 82.0 83.8 81.4

% of learners found at second round

Survey attrition (cont)(1) Attriters

(n=229)

(2) Non-attriters (n=716) (2) -

(1) mean diffmean SD mean SD

Learner's age (y) 17.81 1.85 17.36 1.69 -0.45***

1 if girl 0.50 0.50 0.50 0.50 0.004

1 if lives with mother 0.63 0.48 0.70 0.46 0.07*

1 if lives with father 0.42 0.49 0.42 0.49 0.005

1 if orphan (any parent) 0.46 0.50 0.42 0.49 -0.046

SES 0.005 1.78 0.014 1.63 0.010

1 if missing SES 0.13 0.33 0.11 0.31 -0.018

Learner's grade 10.52 0.51 10.54 0.50 0.020+ p<0.10; * p<0.05; ** p<0.01; *** p<0.001

SN evaluation

Identification strategy: difference in difference framework • pre and post intervention periods• treatment w financial literacy (FL), treatment w stress

reduction (LS), and control groups

• β0 = financial literacy group specific effect

• β1 = stress reduction group specific effect

• β2 = time trend

• β3 = SN impact on financial literacy group

• β4 = SN impact on stress reduction group

SN evaluation (cont)

β3 (and β4) coefficient of interest • the estimate one would get from an OLS

regression (for continuous outcomes)

We can interpret this coefficient as a double difference:

SN impact on social and economic - Boys

+ p<0.10; * p<0.05; ** p<0.01

# Social grants knowledge Attempted to open bank account in past year

Is saving

-0.5

-0.3

-0.1

0.1

0.3

0.5

0.7

0.9

1.1

1.3

SN social/health (v. control) SN social/health/financial (v. control) SN combined (v. control)

SN social/ health/financial (v. SN social/ health)

+

*

(Yt2

- Y

t1)

- (Y

c2 -

Yc1

)

SN impact on cognitive skills (Raven test) - Boys

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

SN social/health (v. control) SN social/health/financial (v. control) SN combined (v. control)

SN social/ health/financial (v. SN social/ health)

Yt2

-

Yc2

SN impact on self-reported sexual behaviors - Boys

+ p<0.10; * p<0.05; ** p<0.01

Had sex past year # of sexual partners in past year

-0.8

-0.7

-0.6

-0.5

-0.4

-0.3

-0.2

-0.1

0

SN social/health (v. control) SN social/health/financial (v. control) SN combined (v. control)

SN social/ health/financial (v. SN social/ health)

+**

+

*(Yt2

- Y

t1)

- (Y

c2 -

Yc1

)