Africa Impact Evaluation Program on AIDS
(AIM-AIDS)
Cape Town, South Africa
March 8 – 13, 2009
NIGERIA
Family Life Health Education
Alex Ogundipe
Adaoha Akubuiro
Dayo Lajide
Uche Onyebuchi
Sheikh Taiwo
Ato Selby
Stephen Ayisi-Addo
Nancy Padian
Jean-Louis Arcand
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Intervention - Family Life Health
Education
• Unit of intervention: LGA
• Planned Coverage: 12 states – 2 in each geopolitical
zone – 1 LGA with intervention and 1 without
intervention in each state (12 with and 12 without
nation-wide) –
• Matching Criteria for the LGAs
- STI, HIV and Pregnancy rates similar in the LGAs
- Socioeconomic status similar
- Urban/Rural mix
- Public/Private school balance
Cont.’d
• Within LGA, do a random sample of schools that have a
mix of both public and private schools
• Target group: In- school youths 12 – 18yrs (Secondary
schools)
- Randomly pick intervention class from each arm (1
from JSS 1, 1 from SS1, 1 from SS2)
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Cont.’d
• Criteria for inclusion – mix of both private
and public schools – public control,
public intervention, private control and
private intervention
4
Policy Questions
PROBLEM STATEMENT:
• There is a high rate of pregnancy among in school youths and an increase
in school drop-out rate. There is a high rate of STIs and HIV as well as low
level of knowledge among youths on HIV/AIDS education
QUESTIONS:
• How do we address this problem amongst in-school youths?
• Are there relevant policies/guidelines to change/revise?
• What specific activities do we have to undertake to address these
problems?
• What resources do we need to address these problems?
• How do we sustain these activities to ensure a good impact?
5
Indicators
Intermediate and Final Indicators
• Increase in abstinence rates reported
• Increased age at sexual debut
• Reduction in STI incidence
• Reduction in rates of unwanted pregnancy
• Reduction in HIV incidence
6
Sample and Data
• In school youths (JSS3-SS3) attending schools
in the selected LGAs where the FLHE
intervention will be taking place.
• Data: NARHS, DHS, IBBSS, ANC
• New survey plans: Baseline data and follow up
data on selected indicators including biological
outcomes
• Field work: Field Reports
7
Sample and Data 2
• Random selection of classes. Within the classes, all
students are selected. Start at the last year of Junior
Secondary School into the last year of Senior Secondary
School.
• SS3 students are followed for 1 year
• SS2 students are followed for 2 years
• SS1 students are followed for 3 years
• JS3 students are followed for 4 years
• SS = Senior Secondary
• JS = Junior Secondary
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Hypotheses
• Ho: FLHE intervention does not have an effect on
–
–
–
–
–
Abstinence
Sexual debut
STI cases
Unwanted pregnancy
HIV
• H1: FLHE has a significant effect on
–
–
–
–
–
Abstinence
Sexual debut
STI cases
Unwanted pregnancy
HIV
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Results/Causal pathway
Increased rates of reported abstinence
Increase age at sexual debut
Reduced incidence of STI cases
Decreased incidence of unwanted pregnancy
Reduced incidence of HIV
10
Evaluation Design
ARM
ROUND1
ROUND2
ROUND3
SS3
1
SS2
1
2
SS1
1
2
3
JSS3
1
2
3
ROUND4
4
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Evaluation Design
• Examine outcomes comparing ‘treatment’ &
‘control’
• Examine if impact differs by
– Yrs of exposure
– Private/public settings
– Urban/rural location
12
Evaluation Design – Important Covariates
• Student characteristics – ethnicity, religion etc
• Parent characteristics – socioeconomic status,
religion etc
• Teacher characteristics – level of education,
experience, discipline
• Examine initial matching criteria at LGA level
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Staffing Plan
•
•
•
•
•
•
•
•
•
Nigerian AIDS Research Network (NARN)
SACA M&E staff
NACA zonal M&E staff
Federal Ministry of Education
LACA
DFID/British Council
Measure Evaluation
World Bank
UN Agencies
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Planning Timeline
•
•
•
•
•
•
•
Constitution of Program design team
Completion of Program design
Advocacy and resource mobilization
Constitution of Evaluation Advisory Board & team
Community/stakeholder Preparedness
Conduct Baseline: Ahead of program implementation
Conduct Annual follow-up surveys for 3yrs (control &
treatment)
• Analyze data & write report annually
• Dissemination of reports
• Policy dialogue for Program expansion & Sustainability
15
Budget/Potential Sources
• Development Partners
– WB, DFID, USG,UNDP
• Government
– Federal( MDG, DRG etc), State & Local
– Educational Authorities
16
Enhanced design possibilities
• Intervention
LGA
• Intervention
LGA
• Control
LGA
Incentive
Incentive
NoIncentive
NoIncentive
• Control
LGA
17
Alternative scenarios
• Plan B:
– Same design but insufficient power
• Increase the number of LGAs
• Plan C
– For logistical, political or resource constraints
• Fewer states, but more LGAs
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Thank You
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