UNICEF New Series of Research Methods briefs to Strengthen Evidence on Adolescents

Of the 1.6 MILLION adolescents living with HIV in sub-Saharan Africa, approximately 1.2 million are located in Eastern and Southern Africa (UNICEF, 2015d). Adolescents is a period of physical, intellectual and social developmental changes that may put an adolescent at a higher risk of vulnerability. Especially for adolescents living in poor resource settings and those living with or affected by HIV.

New HIV infection rate in adolescents is the only age-group in which there has been little progress, as such there has been a recent focus on to call for programmes and policies that are sensitive the specific needs of adolescents wellbeing. Despite this comprehensive data collection systems and research for effective interventions were lacking.

With the aim of improving efforts to collect rigorous evidence for programmes and policies on adolescent health and well-being. UNICEF Innocenti in partnership with Columbia University and experts from the Lancet Commission on Adolescent Health and Well-being recently released a series of briefs. These briefs provide a review of contemporary research methodologies for adolescent well-being in low- and middle-income countries and will assist a wide range of professionals and stakeholders who conduct, commission or interpret research findings to make decisions about programming, policy and advocacy.

1. Improving the methodological quality of research in adolescent well-being
2. Data and indicators to measure adolescent health, social development and well-being 
3. Inclusion with protection: Obtaining informed consent when conducting research with adolescents 
4. Research with disadvantaged, vulnerable and/or marginalized adolescents 
5. Adolescent participation in research: Innovation, rationale and next steps 
6. How to measure enabling and supportive systems for adolescent health 
7. Methodologies to capture the multidimensional effects of economic strengthening interventions -

This initiative was funded by the UK Department for International Development. The Editors of the series were John Santelli, MD, MPH, Columbia University and Nikola Balvin, PsyD, UNICEF Office of Research – Innocenti.

Source: https://www.unicef-irc.org/article/1590/

“She Cannot Just Sit Around Waiting to Turn Twenty” Understanding Why Child Marriage Persists in Kenya and Zambia

The findings of the 2016 report by the International Center on Research for Women (ICRW), confirm that adolescent girls in diverse communities of Kenya and Zambia face many of the same challenges as girls in areas where more evidence about child marriage exists. These include challenges in deciding when and whom to marry, in achieving their aspirations and in feeling supported by their parents and communities. However, the pathways to child marriage, and therefore the types of interventions that could be used to interrupt those pathways, are contextually-specific. Innovation and adaptation of existing programs will be necessary to meet the unique needs of adolescent girls, their families and communities in Kenya and Zambia, particularly guaranteed access to quality education. Click here to download the report

Zimbabwe Population-based HIV Impact Assessment 2015–2016: A Summary of Preliminary Findings

The Zimbabwe Population-Based HIV Impact Assessment (ZIMPHIA), a household-based national survey is the first in Zimbabwe to measure national HIV incidence and viral load suppression.  Viral suppression is greatest among older adults- over 45 years and lowest among children and young adults (0-34 yrs), especially boys. The results provide information on national and subnational progress toward control of the HIV epidemic.

Click here to download the Summary Sheet

Zimbabwe 2015 Demographic and Health Survey HIV Fact Sheet

The factsheet provides a snapshot view of HIV prevalence in Zimbabwe by age; sex; marital status and provinces. Click here to download the Factsheet

Social Protection and HIV: Research Implications for Policy

UNICEF and partners including RIATT-ESA have developed policy briefs based on the latest evidence on HIV-sensitive social protection and cash-plus programming.

The key overarching message in the six briefs is that combination social protection is an important way to improve HIV outcomes in adolescents by ameliorating the socioeconomic deprivations that increase risk of HIV infection and treatment access and non-adherence. It is most effective for girls in deprived areas. Social protection is highly acceptable by populations, and countries in eastern and southern Africa can afford to expand their existing programmes. 

These conclusions stem evidence from randomised trials; observational studies; a longitudinal study; and interviews and analyses with HIV positive and negative male and female adolescents in urban and rural settings in the region.

The policy briefs are attached below. Click here for RIATT-ESA publication on the topic. 

• How can social protection reduce adolescent HIV-risk?
• Combination social protection improves adolescent ART-adherence
• Combination social protection reduces HIV-risk in adolescents
• Social Protection: Potential for improving HIV outcomes among adolescents
• Social Protection and the Sustainable Development Goals
• Combination social protection lowers unprotected sex in HIV-positive adolescents

Ending Child Marriage and Stopping the Spread of HIV: Opportunities and challenges for action

This desk review by the African Union Commission and RIATT-ESA examines some of the existing literature to highlight what is known about the links between child marriage and HIV, and spotlights opportunities for further action.

Very few studies have explicitly explored the two phenomena. Given recent increases in the number of adolescent girls who are HIV-positive and the high numbers and rates of child marriage in countries with high HIV prevalence, the data do suggest a correlation between ending child marriage and stopping the spread of HIV/AIDS. Concerted action on both is undoubtedly needed. Ending child marriage should immediately be included in HIV programming, and can likely contribute to preventing, treating, stopping and eradicating HIV/AIDS. 

Click here to download the full report. 

HIV Stigma: Perspectives from Kenyan Child Caregivers and Adolescents Living with HIV

Stigma shapes all aspects of HIV prevention and treatment, yet there are limited data on how HIV-infected youth and their families are affected by stigma in sub-Saharan Africa. The authors of this research conducted a qualitative study using focus group discussions among 39 HIV-infected adolescents receiving care at HIV clinics in western Kenya and 53 caregivers of HIV-infected children.

It was found that despite the high prevalence of HIV and increasing access to HIV-related services, HIV-infected adolescents and caregivers in western Kenya describe an environment in which HIV/AIDS-related stigma remains a major part of everyday life for HIV infected and affected individuals. These findings are critical to inform next steps and to move toward ending HIV/AIDS-related stigma and discrimination.

Click here to download the full research report

A foot in the door

A report on the Child Community Care study evaluating the effect of Community Based Organisation support on Child wellbeing in HIV affected communities. 

This report highlights the important role CBO's play in providing support and services for children living in high HIV affected environments who are exposed to a number of risks and who are highly vulnerable to risks to their psychosocial development.

Some of the key findings include: 

• Cash transfers show promise for enhancing child wellbeing. When cash is combined with good care, the effects are enhanced. CBOs have multiple possibilities for contributing to
• the care elements and these should be included in cash transfer programmes to maximize their impact.
• Cognitive and developmental challenge for children infected, affected and living in high HIV environments is a challenge. CBOs are well placed to provide support and this should be a priority.
• In the HIV response, children infected with HIV, exposed to HIV in utero and those living in a household with any member who is HIV positive should be prioritized for care.
• Mental health of caregivers is an important factor in child development. CBOs are well placed to provide support for caregivers and a family approach which is inclusive and extends to wider family members should be routine

Ongoing funding for such organisations is an important provision to ensure the holistic
provision of direct services to young children and the families.

Click here to download the full report

2nd EAC Child Rights Conference Recommendations

The 2nd EAC Child Rights Conference concludedin Nairobi, Kenya, 26 August 2016 with the participants formulating several recommendations that reaffirm the strong commitment of the region in promoting, protecting and fulfilling the rights of all children in the bloc.

Click here to download recommendations