Last updated September 2009

Author:
Will Dow

Abstract:
This project will evaluate the impact of a combined economic and psycho-social intervention on individual and household level economic outcomes and sexual/reproductive health outcomes,  among youth and young people aged 18-30 in a rural area of southern Tanzania. In addition to assessing impact using standard indicators of sexual/reproductive health and economic well-being, we will examine linkages between gender-based power and increased control in the domain of sexual and reproductive health attributable to the intervention on economic outcomes. We thus explore a key and understudied pathway linking sexual/reproductive health investments to microeconomic outcomes, including earnings, patterns of household consumption, and levels of savings and investment.
 
The economic component of the intervention involves the use of “conditional cash transfers” (CCT) to prevent HIV, other sexually-transmitted infections (STIs), and unintended pregnancy by linking cash payments to negative laboratory test results, assessed on a quarterly basis. The psycho-social component involves gender-based counseling and “life-skills” training to increase basic financial literacy, address gender/power inequities, and to encourage deliberate decision-making in sexual and reproductive health (including the prevention of HIV, other STIs, and unintended pregnancy). We will test the hypothesis that a system of rapid feedback and positive reinforcement using cash as a primary incentive to reduce risky sexual behavior, coupled with counseling and life-skills training, will result in enhanced economic well-being in both the immediate/short term and medium term in the lives of study participants (males and females), in addition to improved sexual/reproductive health outcomes.
 
This three-year study will involve a randomized control trial with two main arms: a treatment arm which revives the full sexual/reproductive health intervention (CCT + gender-based counseling and life skills training) and the control arm which receives the counseling and life skills training but not the CCT. The treatment arm will further allow sub-study of the effect of varying sizes of cash transfers. The 3,000 study participants will be randomly selected from the Kilombero/Ulanga district Demographic Surveillance System (DSS) managed by the Ifakara Health Research and Development Centre (IHRDC) in Tanzania.
 
Contact Information:
Will Dow, wdow@berkeley.edu, University of California, Berkeley