Youth Impact (No Sugar).
Location
Botswana
Sector
Gender
Type of Investment
Grant
Project Stage
Test & Transition
Length of Investment
2016-2017
Investment Overview
NGO Youth Impact rigorously tested its 'No Sugar' intervention to reduce age-disparate transactional sex, unwanted pregnancies and related HIV infections among adolescent girls in Botswana.
The Development Challenge
Almost one in four new HIV infections in Botswana occur among young women and adolescent girls. Girls are at a higher risk of contracting HIV at a young age, diverging from their male peers since they often date older partners who are more likely to have HIV. In Botswana nearly 45% of forty year-old men are infected with HIV, nine times higher than young boys. However, girls are frequently unaware of this higher risk, mistakenly regarding older partners as a safer, more mature option. Closing this knowledge gap to reduce girls’ engagement with older partners could prove to be a cost-effective intervention to reduce HIV and unwanted pregnancies.
The Innovation
'No Sugar', was a standardised curriculum delivered as a one-hour class to adolescent girls with the aim of reducing age-disparate transactional sex, unwanted pregnancies and related HIV infections. Sessions aimed to show adolescent girls the dangers of engaging in transactional sex with middle-aged men. The hypothesis was that girls mistakenly see older men as safer partners, and such information would empower them to avoid higher-risk partners and feel more confident in negotiating safe sex practices. The programme facilitators revealed the statistical risks of HIV infection for different age groups of men, screened a short video about sugar daddies, and led an interactive discussion about the dangers of sugar daddies. The innovation built on evidence from a successful randomized controlled trial in Kenya in 2005 that showed that girls who were told about the danger of sugar daddies were 28% less likely to be pregnant at year end than girls who were simply told to abstain or received no sex education beyond that offered in school.
Our Investment
GIF’s grant of USD363K supported Youth Impact in developing organisational capacity for a potential scale up of No Sugar, with support from Evidence Action as a scaling and technical adviser. This took place alongside an RCT of No Sugar conducted by J-PAL with Youth Impact to prepare them for scale, if the results were positive.
Progress to date
Youth Impact agreed a pre-analysis plan which set out what evaluation outcomes would be regarded as successful enough to be scaled, in partnership with all parties including the Government of Botswana. The plan highlighted that there would need to be a statistically significant reduction in pregnancy rates, retention of knowledge about HIV prevalence of different age groups, and a downward shift in the age of girls’ sexual partners.
However, the actual RCT results were more mixed with self-reported pregnancies decreasing, but slightly increasing according to visual checks in one treatment group. Other findings included a mismatch between the campaign messaging, which discouraged relationships with ‘sugar daddies’ in their 40s, and the reality of these relationships in Botswana, which often occurred between adolescent girls and men in their 20s; the importance of finding a credible messenger, whereby peers were more effective than teachers; and quick knowledge decay. More information on this can be found in two blogs published by Evidence Action here and here.
Nonetheless, the RCT and implementation experience provided enough promising results to inform adaptations and red-design of the model by Youth Impact, which now is called “Zones”. While GIF decided to not support the programme further following the ambiguous results, we made an introduction to Global Affairs Canada, who alongside the Government of Botswana, continued to partner with Youth Impact to adapt, test and implement the Zones programme.
Youth Impact (No Sugar) in numbers
GIF grant