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  • Comparing four service delivery models for adolescent girls and young women through the ‘Girl Power’ study: protocol for a multisite quasi-experimental cohort study

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Global health
Protocol
Comparing four service delivery models for adolescent girls and young women through the ‘Girl Power’ study: protocol for a multisite quasi-experimental cohort study
  1. Nora E Rosenberg1,2,
  2. Audrey E Pettifor2,
  3. Laura Myers3,
  4. Twambilile Phanga1,
  5. Rebecca Marcus3,
  6. Nivedita Latha Bhushan1,2,
  7. Nomtha Madlingozi3,
  8. Dhrutika Vansia1,
  9. Avril Masters3,
  10. Bertha Maseko1,3,
  11. Lulu Mtwisha3,
  12. Annie Kachigamba4,
  13. Jennifer Tang1,2,
  14. Mina C Hosseinipour1,2,
  15. Linda-Gail Bekker3
  1. 1 University of North Carolina Project, Lilongwe, Malawi
  2. 2 University of North Carolina, Chapel Hill, North Carolina, USA
  3. 3 Desmond Tutu HIV Foundation, Mowbray, South Africa
  4. 4 Lilongwe District Health Office, Lilongwe, Malawi
  1. Correspondence to Dr Nora E Rosenberg; Nora_Rosenberg{at}unc.edu

Abstract

Introduction In sub-Saharan Africa, adolescent girls and young women (AGYW) face a range of sexual and reproductive health (SRH) challenges. Clinical, behavioural and structural interventions have each reduced these risks and improved health outcomes. However, combinations of these interventions have not been compared with each other or with no intervention at all. The ‘Girl Power’ study is designed to systematically make these comparisons.

Methods and analysis Four comparable health facilities in Malawi and South Africa (n=8) were selected and assigned to one of the following models of care: (1) Standard of care: AGYW can receive family planning, HIV testing and counselling (HTC), and sexually transmitted infection (STI) syndromic management in three separate locations with three separate queues with the general population. No youth-friendly spaces, clinical modifications or trainings are offered, (2) Youth-Friendly Health Services (YFHS): AGYW are meant to receive integrated family planning, HTC and STI services in dedicated youth spaces with youth-friendly modifications and providers trained in YFHS, (3) YFHS+behavioural intervention (BI): In addition to YFHS, AGYW can attend 12 monthly theory-driven, facilitator-led, interactive sessions on health, finance and relationships, (4) YFHS+BI+conditional cash transfer (CCT): in addition to YFHS and BI, AGYW receive up to 12 CCTs conditional on monthly BI session attendance.

At each clinic, 250 AGYW 15–24 years old (n=2000 total) will be consented, enrolled and followed for 1 year. Each participant will complete a behavioural survey at enrolment, 6 months and 12 months . All clinical, behavioural and CCT services will be captured. Outcomes of interest include uptake of each package element and reduction in HIV risk behaviours. A qualitative substudy will be conducted.

Ethics/dissemination This study has received ethical approval from the University of North Carolina Institutional Review Board, the University of Cape Town Human Research Ethics Committee and Malawi’s National Health Sciences Research Committee. Study plans, processes and findings will be disseminated to stakeholders, in peer-reviewed journals and at conferences.

  • epidemiology
  • international health services
  • public health
  • child protection

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-018480

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    Footnotes

    • Contributors NER, AEP, L-GB, RM, JT, MCH, AK and LaM designed the study. TP, NM, NLB, DV, AM, BM and LuM were responsible for study coordination and data acquisition. All authors either wrote or made substantial edits to the draft, approved the final version and take responsibility for the work.

    • Funding The Girl Power study is funded by Evidence for HIV Prevention in Southern Africa (EHPSA), a Department of International Development (DFID) programme managed by Mott MacDonald. NER is supported by the National Institutes of Health (R00MH104154).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval This study was approved by the University of North Carolina Institutional Review Board (IRBIS 15–2901) and two local regulatory bodies: the Malawi NHSRC (15/7/1447) and the University of Cape Town Human Research Ethics Committee (815/2015).

    • Provenance and peer review Not commissioned; externally peer reviewed.