The Drum Beat 822 - Meeting the Need for SBC Impact Data

• 1. Neonatal Mortality Reduced: 30 vs. 44 per 1,000
   
• Effect of Participatory Women's Groups Facilitated by Accredited Social Health Activists on Birth Outcomes in Rural Eastern India: A Cluster-Randomised Controlled Trial
• by Prasanta Tripathy, Nirmala Nair, Rajesh Sinha, et al.
• This cluster RCT aimed to test the effect of participatory women's groups facilitated by Accredited Social Health Activists (ASHAs) on birth outcomes, including neonatal mortality, in rural Jharkhand and Odisha, eastern India. The meeting cycle followed rules of participatory learning and action. In short: "ASHAs successfully supported women's groups through a cycle of participatory learning and action meetings at high coverage, achieving a 31% reduction in neonatal mortality rate during 2 years, and with especially strong reductions among the most marginalised mothers." [Jan 2016]
• Full summary is here.
   
• 2. 18% Reduction in Neonatal Mortality Risk
   
• Birth Preparedness and Complication Readiness (BPCR) Interventions to Reduce Maternal and Neonatal Mortality in Developing Countries: Systematic Review and Meta-analysis
• by Dieudonné Soubeiga, Lise Gauvin, Marie A Hatem, and Mira Johri
• Developing countries have invested in behaviour change and community mobilisation interventions to reduce maternal and neonatal risks following the concept of birth preparedness and complication readiness (BPCR). This systematic review sought to evaluate the impact of BPCR interventions involving women, families, and communities during the prenatal, postnatal, and neonatal periods. Meta-analyses of the 14 studies (292,256 live births) showed that exposure to BPCR interventions was associated with a statistically significant reduction of 18% in neonatal mortality risk (12 studies) and a non-significant reduction of 28% in maternal mortality risk (7 studies). Subgroup analyses suggested that combining home visits and community-based women's group sessions would have a greater impact than would either one alone. [Apr 2014]
• Full summary is here.
   
• 3. 23% Reduction in Odds of Under-5 Wasting
   
• The Effects of Community Home Visit and Peer Group Nutrition Intervention Delivery Platforms on Nutrition Outcomes in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis
• by Amynah Janmohamed, Nazia Sohani, Zohra S Lassi, and Zulfiqar A Bhutta
• Emerging evidence indicates that preventing the adverse effects of undernutrition requires programmes that enhance the coverage and effectiveness of direct nutrition interventions, particularly those focused on actions during the first 1,000 days of life. Community health worker/lay counselor home visits and mother/peer groups emerged as the most widely used community-based platforms for delivering nutrition education/behaviour change communication to mothers/caregivers of young children. One finding: A 23% reduction in the odds of under-5 wasting (OR: 0.77; 95% CI: 0.67, 0.89) was observed across 4 studies that used the home visit and group platform, compared to usual care. [Feb 2020]
• Full summary is here.
   
• 4. Neonatal Mortality Down 32%
   
• Women's Groups Practising Participatory Learning and Action to Improve Maternal and Newborn Health in Low-resource Settings: A Systematic Review and Meta-analysis
• by Audrey Prost, Tim Colbourn, Nadine Seward, et al.
• Women's groups have the potential to increase appropriate care-seeking (including antenatal care and institutional delivery) and appropriate home prevention and care practices for mothers and newborns. This systematic review of RCTs found that, in meta-regression analyses, the proportion of pregnant women in groups was linearly associated with reduction in both maternal and neonatal mortality (p=0.019 and p=0.009, respectively). It is thought that the intervention builds the capacities of communities to organise and mobilise to take individual, group, and community action to address the structural and intermediary determinants of health. [May 2013]
• Full summary is here.
   

• 5. 8% Higher Prevalence of Paying School Fees
   
• Impact of the Child-Optimized Financial Education (COFE) Curriculum among Savings Group Participants in Uganda: A Cluster Randomised Controlled Trial
• by Eunsoo Timothy Kim, Yunji Zhou, Levicatus Mugenyi, et al.
• This RCT showed that when comparing in absolute terms the overall proportion of children with paid school fees was 8% significantly higher for caregivers within Savings and Lending Communities who received a Child-optimized Financial Education (COFE) curriculum compared to those who did not receive the specialised training. This means that in relative terms, children of caregivers that participated in the training were 1.17 times more likely to have had all the required school fees paid as a product of the training, compared to children whose caregivers did not participate. [Jul 2022]
• Full summary is here.
   
• 6. Increase in School Enrolment among Children Aged 11-14
   
• The Impact of Zambia's Unconditional Child Grant on Schooling and Work: Results from a Large-scale Social Experiment
• by Sudhanshu Handa, Luisa Natali, David Seidenfeld, and Gelson Tembo
• This paper reports on the impact on child schooling and work of the Government of Zambia's Child Grant Program (CGP), an unconditional cash transfer programme for households with children under age 3 years in 3 remote districts of the country. It finds a significant impact among children aged 11-14, which coincides with the exact age range where sharp dropout begins to occur in Zambia, with point estimates in the range of 7-8 percentage points. [Jul 2016]
• Full summary is here.
   
• 7. Girls' Literacy Improved
   
• Effects of an E-Reader Intervention on Literacy, Numeracy and Non-Verbal Reasoning among Adolescent Girls in Zambia: Evidence from a Randomised Controlled Trial
• by Barbara S. Mensch, Nicole Haberland, Erica Soler-Hampejsek, et al.
• GirlsRead! Zambia is an e-reader intervention for students in Grade 7 embedded in safe space groups, which are designed to build girls' assets and lessen their social isolation. A 3-arm RCT found that scores on the basic literacy assessment increased for all arms but more so for the arm that included the e-reader and facilitated book group: 0.233 (56.3%) for the e-reader arm compared with 0.155 (44.8%) for the safe spaces only arm and 0.140 (34.9%) for the control arm. The research also showed that exposure to the e-reader improved non-verbal reasoning: Girls in the e-reader arm scored .363 points (2.3%) higher than girls in the control arm. [Sep 2021]
• Full summary is here.
   

• 8. 1.9 Times Lower Rate of Sexual Initiation
   
• Effect of the PREPARE Intervention on Sexual Initiation and Condom Use among Adolescents Aged 12-14: A Cluster Randomised Controlled Trial in Dar es Salaam, Tanzania
• by Elia John Mmbaga, Lusajo Kajula, Leif Edvard Aarø, et al.
• The PREPARE intervention aimed to impact key mediators of the behaviour change process such as self-efficacy, social norms, attitudes, and action planning. This RCT among school-based adolescents aged 12-14 years in Dar es Salaam, Tanzania, found that the rate of sexual initiation at 12 months following the PREPARE intervention was almost 2 times higher among the control schools as compared to the intervention schools [adjusted relative risk (ARR) = 1.9, p = 0.027]. Similarly, females from the control arm were 1.6 times more likely to initiate sex as compared to those from the intervention arm. The intervention also positively influenced action planning to use condoms for both sexes. [Apr 2017]
• Full summary is here.
   
• 9. Reduced Relative Odds of Sexual Debut among 15- to 25-Year-Olds by 31%
   
• The Government of Kenya's Cash Transfer Program Reduces the Risk of Sexual Debut among Young People Age 15-25
• by Sudhanshu Handa, Carolyn Tucker Halpern, Audrey Pettifor, and Harsha Thirumurthy Cash transfers may reduce the risk of HIV by addressing structural risk factors - specifically, poverty, vulnerability, and low human capital. The Government of Kenya's Cash Transfer for Orphans and Vulnerable Children (CT-OVC) programme provides an unconditional transfer of US$20 per month directly to the main caregiver to be used toward the care of OVC living in the household. The results show that CT-OVC reduces the relative odds of sexual debut among young people by 31%, with larger impacts among females (42%) relative to males (26%). In relation to the mean, this implies a 23% reduction in the likelihood of sexual debut among the full sample, and 35% and 18% for females and males, respectively. [Jan 2014]
• Full summary is here.
   

• 10. 16% of Regressive Attitudes Converted
   
• Reshaping Adolescents' Gender Attitudes: Evidence from a School-Based Experiment in India
• by Diva Dhar, Tarun Jain, and Seema Jayachandran
• This paper shares an RCT of Breakthrough's Taaron ki Toli, or Legion of Stars, initiative, which engaged seventh-tenth graders in classroom discussions about gender equality, trained teachers, facilitated optional youth clubs, and held school-wide activities in Haryana, India. The RCT found that, 3.5 months after the programme ended, Taaron ki Toli made attitudes more supportive of gender equality by 0.18 standard deviations or, equivalently, converted 16% of regressive attitudes. Put another way: In the treatment group, on average, 29.9% of views are gender regressive, compared to 35.4% in the control group. There was a continued large effect on attitudes - 0.16 standard deviations - 2 years after the programme ended. [Mar 2022]
• Full summary is here.
   
• 11. Contraceptive Use Increased 1.57x
   
• Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India
• by Anita Raj, Mohan Ghule, Julie Ritter, et al.
• This cluster RCT was conducted to evaluate the impact of CHARM [Counseling Husbands to Achieve Reproductive health and Marital equity] in rural areas of Thane district, Maharashtra, India. The intervention involved 3 gender-, culture-, and contextually-tailored gender equity (GE) + family planning (FP) counseling sessions delivered over a 3-month period by trained male village healthcare providers. One finding: Contraceptive use doubled by 18-month follow-up among those participating in male-only sessions (AOR = 1.96, 95% CI = 1.18, 3.27) and in male and couple sessions (AOR = 2.00, 95% CI = 1.26, 3.17), relative to those receiving no intervention sessions. [May 2016]
• Full summary is here.
   
• 12. Improved Physical Health for Adolescent Girls
   
• A Psychosocial Resilience Curriculum Provides the "Missing Piece" to Boost Adolescent Physical Health: A Randomized Controlled Trial of Girls First in India
• by Katherine Sachs Leventhal, Lisa M. DeMaria, Jane E. Gillham, et al.
• CorStone's Girls First - Bihar works to empower girls aged 12-16 in Bihar, India, through two evidence-based curricula: the Girls First Resilience Curriculum (RC) and the Girls First Health Curriculum (HC). The RCT found that the biggest detected effects were for the combined RC+HC curricula - e.g., an increase in 5.11 units in the health knowledge scale used (0-14 scale) and a 4.62 increase in the 0-32 score of the gender equality score applied when compared to schools without any intervention. [May 2016]
• Full summary is here.
   
• 13. Knowledge Improvement: 15.8 Percentage Points
   
• Improving Menstrual Health Literacy Through Life-Skills Programming in Rural Ethiopia
• by Sarah Baird, Joan Hamory, Kiya Gezahegne, Kate Pincock, Tassew Woldehanna, Workneh Yadete, and Nicola Jones
• This paper describes a cluster RCT that was conducted to assess the impact of a gender-transformative life-skills intervention called Act With Her-Ethiopia (AWH-E) on the menstrual health literacy and menstrual hygiene management (MHM) practices of very young adolescents in two diverse regions of Ethiopia. The quantitative findings highlight large and statistically significant improvements on norms around menstruation, knowledge about menstruation and biological function, and knowledge and behavior related to menstrual hygiene management. For example, adolescent girls in AWH-E communities were significantly more likely to report talking to their mothers about menstruation (22 percentage points over a base of 14.5%, p < 0.001). This impact is large - corresponding to a 151% increase. [Jul 2022]
• Full summary is here.
   
• 14. 46% Less Likely to Be Married
   
• Girl Empower - A Gender Transformative Mentoring and Cash Transfer Intervention to Promote Adolescent Wellbeing: Impact Findings from a Cluster-Randomized Controlled Trial in Liberia
• by Berk Özler, Kelly Hallman, Marie-France Guimond, et al.
• This parallel cluster RCT examines the potential of adding a cash transfer component to a gender-transformative mentoring intervention in Nimba County, Liberia. Girl Empower was implemented in 2 variations, called "GE" and "GE+"; the GE+ variation added an incentive payment to caregivers tied to girls' participation in weekly sessions. Both intervention arms had moderate and statistically significant effects on 3 domains: gender attitudes, life skills, and sexual and reproductive health (SRH). The effect size on the SRH index, as well as each of its components, was approximately 50% higher in GE+ than GE. [Dec 2019]
• Full summary is here.
   

• 15. Significant Reduction in Peer Violence
   
• Right To Play's Intervention to Reduce Peer Violence among Children in Public Schools in Pakistan: A Cluster-Randomized Controlled Trial
  by Rozina Karmaliani, Judith McFarlane, Hussain Maqbool Ahmed Khuwaja, et al.
• Right To Play's Positive Child and Youth Development Programme (also called Red Ball Child Play) has been translated and adapted for different settings. This cluster RCT found that, for peer violence victimisation, the reductions in the intervention and control arms were: 33.3% versus 27.8% for boys and 58.5% versus 21.3% for girls. For peer violence perpetration, the reductions were: 25.3% versus 11.1% for boys and 55.6% versus 27.6% for girls in the intervention and control arms, respectively. The mean depression score in boys dropped by 4.8% in the control versus 7.2% in the intervention arm; in girls, it dropped by 5.6% in the control versus 9.5% in the intervention arm. Also, gender attitudes changed significantly for boys and girls. [Apr 2017]
• Full summary is here.
   
• 16. Reduced Women's Experiences of IPV, Depression, and Partner Controlling Behaviour
   
• Evaluation of the Rural Response System Intervention to Prevent Violence against Women: Findings from a Community-Randomised Controlled Trial in the Central Region of Ghana
  by Deda Ogum Alangea, Adolphina A. Addo-Lartey, Esnat D. Chirwa, Yandisa Sikweyiya, Dorcas Coker-Appiah, Rachel Jewkes, and Richard M. K. Adanu
• In Ghana, the Gender Studies and Human Rights Documentation Centre designed the Rural Response System (RRS) intervention in 2002 to reduce violence against women and girls. RRS's main mechanism is community-based action teams, whose members are respected male and female members of the community. Sample finding: During the past year, based on a difference between levels before and after the intervention, women experienced significant reduction of 9.3% less sexual intimate partner violence (IPV) in communities where the intervention happened compared to communities without the intervention. [Jan 2020]
• Full summary is here.
   
• 17. 5% Reduction of Reported IPV
   
• Religious Leaders Can Motivate Men to Cede Power and Reduce Intimate Partner Violence: Experimental Evidence from Uganda
  by Christopher Boyer, Elizabeth Levy Paluck, Jeannie Annan, et al.
• An intervention in Uganda, Becoming One (B1), that works with religious leaders to introduce a range of relationship skills as part of their traditional role as couples' counsellor saw a 5% reduction of reported IPV a year later after the intervention compared to couples who did not participate. There was also a 1% reduction in the number of women reporting hitting their partner and a 4% reduction of reports of disciplinary violence against children. The study also had significant results related to additional measures in power dynamics, with increases in women's control and decision making (1.7% increase) and in joint financial planning (240% increase) and reduced income hiding (3.6%) of the participants compared to those in control groups. [Jul 2022]
• Full summary is here.
   

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