ErulkarDifferentiale xposure

Differential exposure to peer education programs among adolescents in Addis Ababa : 

Differential exposure to peer education programs among adolescents in Addis Ababa Annabel S. Erulkar PhD Population Council Regional Office for sub-Saharan Africa Accra, Ghana Tekle-Ab Mekbib, Population Council, Addis Ababa, Ethiopia Africa Regional Forum on Youth RH and HIV June 6-9, 2006 Dar es Salaam, Tanzania

Background: 

Background Evaluations of youth programs tend to focus on individual programs Examine changes in participants More limited information on what is the profile of program beneficiaries versus non-beneficiaries In many parts of sub-Saharan Africa – especially urban areas – peer education programs are increasingly popular and many young people live in the vicinity of programs

Research question…: 

Research question… In a setting where a number of youth peer education programs are being implemented, which youth are most likely to be directly reached by peer education programs and which youth are least likely to be reached? Are the most vulnerable youth being reached by programs?

Context: 

Context Population-based study of adolescents aged 10 to 19 in slum areas of Addis Ababa (Merkato and Kazanchis), as well as a similar study in a rural area in Amhara Study sought to understand broad context of young lives, not only exposure to youth programs, which was one component Source: Erulkar AS, Mekbib T, Simie N, Gulema T. 2004. “The experience of adolescence in rural Amhara region Ethiopia” Accra: Population Council.; Erulkar AS, Mekbib T, Simie N, Gulema T. 2004. “Adolescent life in low-income and slum areas of Addis Ababa Ethiopia” Accra: Population Council.

Methodology: 

Methodology Population-based survey of adolescent boys and girls aged 10 to 19 in slum areas of Addis Ababa (Mercato and Kasanchis – Kebeles 10 and 13) Household listing and random selection of 1200 adolescents (1100 adolescents interviewed) Largely structured instrument with limited open-ended questions, with responses recorded verbatim Topics included living arrangements, education , work, migration, social networks and support, exposure to youth programs, sex, marriage, and parenthood Asked question, “Have you had contact with peer educator in last year?” Inventory of existing youth programs in two kebeles

Results: Youth Programs: 

Results: Youth Programs A total of 8 youth peer education programs were operational in the study area; 553 peer educators 5 programs run by Ethiopian NGOs; 3 programs by international NGOs Most were focused on HIV/RH Differing target groups: 5 of 8 programs included younger adolescents (10 to 14) in target group 7 of 8 programs included older adolescents (15 to 19) in target group

Percentage of adolescents who have had exposure to peer education and youth centers in the last year: 

Percentage of adolescents who have had exposure to peer education and youth centers in the last year

Characteristics of boys  exposed to peer education programs (results of logistic regression): 

Characteristics of boys exposed to peer education programs (results of logistic regression) Age: Boys aged 15 to 19 are 2 ½ as likely to have been exposed to peer program compared to boys 10 to 14 (OR=2.53) Friends: Boys reporting “many friends” are nearly twice as likely to have been exposed to peer program compared to boys who do not report many friends (OR=1.95)

Characteristics of girls  exposed to peer education programs (results of logistic regression): 

Characteristics of girls exposed to peer education programs (results of logistic regression) Sexually experienced: Sexually experienced girls over three times as likely to be exposed (OR=3.10) Workload: Girls with heavy workloads (over 40 hours) one third as likely to be exposed (OR=0.36) Friends: Girls reporting “many friends” are twice as likely to have been exposed to peer program compared to girls who do not report many friends (OR=2.08) Mobility: Girls with high mobility in community over twice as likely to be exposed compared to low mobility (OR=2.10)

Focus on vulnerable sub-groups of youth: 

Focus on vulnerable sub-groups of youth 15 percent of the female sample were domestic workers Indicators of vulnerability and sense of well being, by sex and working status

Focus on vulnerable sub-groups of youth: Child domestic workers: 

Focus on vulnerable sub-groups of youth: Child domestic workers Working conditions of adolescents by sex and type of work

Differential exposure to youth programs among young people in various circumstances: 

Differential exposure to youth programs among young people in various circumstances Exposure to youth or HIV programs in the last year, by sex and working status

Domestic workers are isolated and not likely to be reached by conventional programs: 

Domestic workers are isolated and not likely to be reached by conventional programs At the place where I used to work, they [employers] never used to let me wash myself and they’d not give me any food -- I used to starve to death. And because I was not able to wash my body, I had sores. I was carrying so much water on my back, I used to fall down… (Female domestic worker, age 10, never been to school, migrated from Amhara region with employers at age 9, worked 91 hours in last week, earns $2.30 per month) I hate the job because I am not allowed to go outside and also they insult me… Most of the time, the child of the employers beats me without having a reason. When I ask him why he does that, he beats me again. (Female domestic worker, age 14, 2 years education, migrated from SNNP at age 5, worked 49 hours in last week, earns $3.70 per month)

Domestic workers are isolated and not likely to be reached by conventional programs: 

Domestic workers are isolated and not likely to be reached by conventional programs One guy came and asked me what I was doing on the street and I told him that I had a fight with my employer and was thrown out of my house. Then he told me I should spend the night with him. I said ‘no’ and he beat me. He hit my nose and it swelled up... I didn’t say a word - I was scared he might kill me. That night, he forced me to have sex with him many times… The next day I told her [employer] what happened, and the woman allowed me to return…So after that even if the lady hits me or nags me, I just keep quiet because I don’t want to go out to the streets. (Addis Ababa domestic worker, age 17, migrated from Amhara Region, formerly married)

Conclusions: 

Conclusions The study examined exposure to peer education and other types of youth programs in the last year in a defined geographical catchment area where programs were ongoing We did not examine the quality of individual programs We did not examine profile of peer educators Did not take into account indirect exposure (i.e. beneficiaries relaying information to their friends) Did not examine impact of programs

Conclusions: 

Conclusions In this urban setting where a number of programs were operating, 20 percent of adolescents were reached by peer educators and 12 percent were reached by youth centers Both models disproportionately reach older boys, compared to girls 32 percent of boys 15 to 19 have had contact with peer educator in the last year

Conclusions: 

Conclusions Specific sub-groups of vulnerable youth may have less exposure to programs (e.g. domestic workers, married adolescents, migrant workers,etc.) Specialized strategies to reach these most vulnerable young people Specialized programmatic content and support Most critical question: “Who is NOT being reached?”