می توانید دارایی های اقتصادی خطر ابتلا دختران به آزار و اذیت جنسی را افزایش می دهد؟ نتایج ارزیابی از اجتماعی، بهداشتی و مداخله دارایی سازی اقتصادی برای دختران نوجوان آسیب پذیر در اوگاندا

Abstract For adolescent girls in Sub-Saharan Africa, social isolation and economic vulnerability are critical problems that prevent a healthy transition from girlhood into womanhood. This study examines the effect of a multi-dimensional intervention on social, health and economic assets, as well as experiences of sexual harassment, among vulnerable adolescent girls aged 10–19 living in the low income areas of Kampala, Uganda. The study compares two treatment groups to a comparison group. The first treatment group received the full intervention – safe spaces group meetings with reproductive health and financial education plus savings accounts – while the second group only received a savings account. Findings indicate that the full intervention was associated with improvement in girls' health and economic assets. While girls who only had a savings account increased their economic assets, they were also more likely to have been sexually touched (OR = 3.146; P < 0.01) and harassed by men (OR = 1.962; P < 0.05). This suggests that economic asset building on its own, without the protection afforded by strengthening social assets, including social networks, as well as reproductive health knowledge, can leave vulnerable girls at increased risk of the sexual violence.

1. Introduction This study examines the effect of a multi-dimensional intervention on social, health and economic assets, as well as experiences of sexual harassment, among vulnerable adolescent girls aged 10–19 living in the low income areas of Kampala, Uganda. For adolescent girls in Sub-Saharan Africa, social isolation and economic vulnerability are critical problems that prevent a healthy transition from girlhood into womanhood. The issues that girls are confronted with – high rates of gender based violence, unsafe sex that puts girls at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income generating options, lack of agency and participation – are linked with one another through their root causes. Therefore, the solutions must be interconnected as well, helping girls to build their social, health and economic assets.

. Results 6.1. Demographic characteristics Descriptive characteristics of the sample at baseline by treatment group are shown in Table 1. There are significant differences between groups in regard to age, religion, education status, socioeconomic status, identification and literacy. Savings PLUS and Savings Only girls were generally similar, but they differed from comparison girls. Approximately half of Savings PLUS (59%) and Savings Only girls (52%) were between the ages of 10 and 14, compared to 72% of comparison girls. Girls in the comparison area were more likely to be Catholic (40%) than those girls in treatment groups and less likely to be Muslim (25%). About a quarter of girls who participated in intervention groups (23% Savings PLUS, 25% Savings Only) were Catholic, while two-fifths (38% Savings PLUS, 41% Savings Only) were Muslims. Very few respondents had ever been married (1% Savings PLUS, 1% Savings Only, 0.6% comparison) and about two-fifths of girls were residing with both parents. The age differences across groups were associated with differences in education status and literacy. Only 5% of comparison girls were not in school at the time of the survey, compared to 10% of Savings PLUS and 9% of Savings Only girls. More than half of girls were able to easily read a sentence (57% Savings PLUS, 65% Savings Only, 53% comparison). Comparison girls also appeared to be more disadvantaged in regard to household assets. They were significantly less likely to report that their households had electricity (67% Savings PLUS, 72% Savings Only, 54% comparison) or a radio (78% Savings PLUS, 78% Savings Only, 65% comparison) and less likely to personally own a mobile phone (13% Savings PLUS, 15% Savings Only, 4% comparison). 6.2. Sexual harassment As shown in Table 2, among Savings PLUS girls, there was no significant change in the proportion of girls who experienced indecent touching (7% to 8%) or who were teased by members of the opposite sex (23% to 24%) from baseline to endline. For Savings Only girls, the proportion who experienced indecent touching significantly increased from 9% to 15% (P < 0.05), while the proportion who had been teased by males increased from 19% to 25% at endline (P < 0.1). Table 2. Proportion of girls experiencing sexual harassment by study group at baseline and endline. Baseline Endline Savings PLUS (N = 451) Savings Only (N = 300) Comparison (N = 311) Savings PLUS (N = 451) Savings Only (N = 300) Comparison (N = 311) Touched indecently in last 6 months 7%⁎⁎ 9%⁎⁎⁎ 11% 8% 15%⁎ 8% Teased by people of the opposite sex 23% 19% 23% 24% 25%† 20% ⁎⁎⁎ p < .001. ⁎⁎ p < .01. ⁎ p < .05. † p < 0.10. Table options Table 3 shows multivariate results for changes in both indicators of sexual harassment. While there was no significant difference between Savings PLUS girls and comparison girls in regard to experience of harassment, Savings Only girls were significantly more likely to report harassment. Compared to girls in the comparison area, Savings Only girls were more likely (OR = 3.146; P < 0.01) to say they had been touched indecently within the previous six months, and 96% more likely to say they had been teased by people of the opposite sex (P < 0.05). Table 3. Sexual harassment: multivariate logistic random-intercept model results showing differences between study groups and comparison group from baseline to endline.a Change from baseline to endline Ref = Comparison group (N = 311) Savings PLUS (N = 451) Savings Only (N = 300) OR [95% CI] O 0052 [95% CI] Touched indecently in last 6 months b 1.801 0.814–3.989⁎⁎⁎ 3.146⁎⁎ 1.397–7.082 Is teased by people of the opposite sexa 1.300† 0.766–2.203 1.962⁎ 1.088–3.540 a Models control for age, religion, school status, years of schooling and socioeconomic status. ⁎⁎⁎ p < .001. ⁎⁎ p < .01. ⁎ p < .05. † p < 0.10. Table options 6.3. Financial assets Table 4 shows multivariate, difference in difference results from random-intercept models controlling for age, religion, school status and socio-economic status. The odds-ratios represent the change between baseline and endline for each intervention group versus the comparison group. There was no significant difference in the odds of having a savings plan. Savings Only girls were significantly less likely to be able to name reasons for saving (OR = 0.442; P < 0.01). Savings PLUS and Savings Only girls were at least two times as likely to have a budget as girls in the comparison area (P < 0.01). As compared to comparison girls, Savings PLUS girls (OR = 2.125; P < 0.01) showed a greater improvement in saving than Savings Only girls (OR = 1.691; P < 0.05). Among girls who saved any money, both intervention groups showed more than a 99% significant decrease in the use of informal savings methods only (P < 0.001). Table 4. Financial education and savings: multivariate logistic random-intercept model results showing differences between study groups and comparison group from baseline to endline.a Change from baseline to endline Ref = Comparison group (N = 311) Savings PLUS (N = 451) Savings Only (N = 300) OR [95% CI] OR [95% CI] Has a plan for saving money 1.470 0.937–2.307 1.382 0.845–2.263 Has a budget 2.318⁎⁎ 1.441–3.729 2.442⁎⁎ 1.448–3.121 Can correctly name two reasons for saving money 1.104† 0.657–1.856 0.442⁎⁎ 0.250–0.783 Has saved any money in the last six months 2.125⁎⁎ 1.336–3.381 1.691⁎ 0.025–2.790 Saved using informal method only a 0.006⁎⁎⁎ 0.001–0. 050 0.005⁎⁎⁎ 0.001–0.038 a Models control for age, religion, school status, years of schooling and socioeconomic status. ⁎⁎⁎ p < .001. ⁎⁎ p < .01. ⁎ p < .05. † p < 0.10. Table options 6.4. Social assets Three indicators were used to measure social assets: having a place to meet friends outside of the home or school, having someone to borrow money from, and having a female mentor. Based on multivariate results shown in Table 5, for all three indicators, there were no significant differences between intervention groups and the comparison group. Table 5. Social assets: multivariate logistic random-intercept model results showing differences between study groups and comparison group from baseline to endline.a Change from baseline to endline Ref = Comparison group (N = 311) Savings PLUS (N = 451) Savings Only (N = 300) OR [95% CI] OR [95% CI] Has a place to meet girl friends other than house or school 1.049⁎ 0.676–1.626 1.304 0.805–2.114 Has someone to borrow money from if needed money urgently 1.335⁎⁎⁎ 0.863–2.067 1.155 0.716–1.862 Has a female adult/mentor who she meets with regularly 1.120⁎⁎ 0.706–1.774 1.143† 0.690–1.894 a Models control for age, religion, school status, years of schooling and socioeconomic status. ⁎⁎⁎ p < .001. ⁎⁎ p < .01. ⁎ p < .05. † p < 0.10. Table options 6.5. Reproductive health assets Table 6 shows multivariate results for changes in reproductive health indicators, including HIV knowledge, HIV testing and knowledge of contraceptive methods. Savings PLUS girls were more likely to know that HIV can be transmitted through sexual intercourse (OR = 3.412; P < 0.01), and more likely to know at least one HIV prevention method (OR = 4.156; P < 0.001) than girls in the comparison area. Savings PLUS girls were also more likely to know a contraceptive method (OR = 2.609; P < 0.01) as compared to girls in the comparison area. There were no significant differences in knowledge of where to get an HIV test and in odds of having received an HIV test between Savings PLUS and comparison girls. Table 6. Reproductive health: multivariate logistic random-intercept model results showing differences between study groups and comparison group from baseline to endline.a Change from baseline to endline Ref = Comparison group (N = 311) Savings PLUS (N = 451) Savings Only (N = 300) OR [95% CI] OR [95% CI] Knows HIV can be transmitted through sexual intercourse 3.412⁎⁎ 1.703–6.834⁎ 1.007 0.497–2.041 Knows at least one HIV prevention method 4.156⁎⁎⁎ 1.891–9.132 1.103 0.500–2.430 Knows where to get an HIV test 1.067 0.634–1.797 1.233 0.686–2.215 Has had an HIV test 1.117† 0.601–2.075 0.606 0.309–1.886 Knows a contraceptive method 2.609⁎⁎ 1.485–4.587 0.882 0.485–1.606 a Models control for age, religion, school status, years of schooling and socioeconomic status. ⁎⁎⁎ p < .001. ⁎⁎ p < .01. ⁎ p < .05. † p < 0.10. Table options 6.6. Additional analysis To further test the theory of change, we examined the impact of improvement in social and reproductive health assets on the risk of experiencing sexual harassment among girls who participated in the full intervention (Savings PLUS). Due to the small proportion of girls experiencing indecent touching, the analysis focused on the experience of verbal harassment as the dependent variable. Controlling for age and education, separate models were estimated to assess the effect of each of the social asset indicators in Table 5 and each of the reproductive health asset indicators in Table 6. Changes in the following indicators were not significantly associated with verbal harassment: having a place to meet friends outside of the home, having a female mentor, knowing at least one HIV prevention method, and knowing where to go to get an HIV test. Table 7 shows the remaining indicators that were significantly associated with verbal harassment. For girls who showed improvements from baseline to endline, knowing someone to borrow money from decreased the odds of verbal harassment by 52% (P < 0.05). Improvement in reproductive health knowledge indicators – knowledge of sexual transmission of HIV and knowledge of a contraceptive method – decreased the odds of experiencing verbal harassment by 65% (P < 0.05%). Girls who had gotten an HIV test at endline but not at baseline had 50% lower odds of experiencing harassment (P < 0.05) than those who had not. Table 7. multivariate logistic random-intercept model results showing selected indicators associated with experience of sexual harassment from baseline to endline for girls participating in full intervention (Savings PLUS).a Change from baseline to endline Savings PLUS (N = 451) OR [95% CI] Has someone to borrow money from if needed money urgently 0.480⁎ 0.242–0.951⁎⁎ Knows HIV can be transmitted through sexual intercourse 0.345⁎ 0.121–0.980⁎⁎⁎ Has had an HIV test 0.500⁎ 0.259–0.968† Knows a contraceptive method 0.353⁎ 0.151–0.824 a Models control for age and years of schooling. ⁎⁎⁎ p < .001. ⁎⁎ p < .01. ⁎ p < .05. † p < 0.10.