Assessing the Vulnerability and Risks of Adolescent Girls and Young Women in East and Southern Africa: A Preliminary Review of the Tools in Use
2. Materials and Methods
- The programme context in which they have they been used (e.g., screening in PMTCT service delivery points)
- The point in the programme development when they were used (e.g., initial planning; expansion)
- The purpose of the tool (e.g., seeking improvement in resource allocation and/or programme impact)
- The resources are required to implement tools/methods (human and financial)
- How the effectiveness of the tool has been assessed (dependent on its purpose)
3.1. Overall Results and Effectiveness of the Tools
- The piloting of a tool that successfully identified AGYW who were likely to discontinue school in Eswatini .
- The piloting of the Sauti vAGYW tool that reliably stratified out-of-school AGYW in Tanzania, based on individual and structural HIV risks .
- The development of tool(s) used to gain an in-depth understanding of adolescents’ needs, barriers, and motivations to use contraceptives, summarized in a report on the resulting programme design in Ethiopia .
3.2. Content of the Tools
- Behavioral risk factors: sexual activity; transactional sex; multiple partners
- Biological risk factors: HIV status; ever/current pregnancy
- Structural risk factors: experiences of abuse and GBV; schooling
- Household: parental presence/support.
3.3. Processes in Undertaking the Risk and Vulnerability Assessments
3.4. Varying Priorities and Differing Needs for Information
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Stakeholder Function||Focus of Enquiry||No.|
|Funders, technical supporters of programmes||15|
|Users of tools||13|
|Establish beneficiary eligibility/continuation for programmes||10|
|Establish need for additional support/interventions||4|
|Record of eligibility (risk) criteria at service planning or delivery||2|
|Provide ‘baseline’ information for use in monitoring & evaluation||1|
|Enumeration of AGYW at risk in community||1|
|Service delivery monitoring||1|
|Market segmentation to differentiate strategies for service delivery and/or product use||1|
|Routine or clinical enquiry for service provision/referral||1|
|Categories of Risk Factors||Topics in Tools||No. of tools|
|Substance use (incl. alcohol)||8|
|Use/non-use of HIV/pregnancy prevention practices||7|
|Gaps in knowledge (prevention)||3|
|High viral load of male partners (knowledge of partner HIV status)||7|
|STI/RTIs (AGYW or partner)||6|
|Low prevalence MC (knowledge about partner MC)||2|
|Structural||(low) school attendance||15|
|Child sexual/physical abuse||10|
|Barriers to service use||3|
|Labour migration (AGYW or partner)||2|
|Household||House head characteristics & support||9|
|Family characteristics (numbers, illness)||8|
|Responsibilities for family||3|
|Characteristics of dwelling||2|
|Personal situation||Health status (incl. mental)||8|
|Aspirations for the future||5|
|Sufficiency of income||4|
|A||How many sexual partners have you had in the last 12 months?||Open-ended|
|(Asked in relation to 3 most recent sexual partners)|
|Is this person same age, younger or older than you?||Close-ended, categorical|
|Is this partner circumcised?||Close-ended, categorical|
|Do you know this partner’s HIV status?||Close-ended, dichotomous|
|How often did/do you use a condom with this partner?||Close-ended, categorical|
|B||During the past year have you had more than one sexual partner?||Close-ended, dichotomous|
|Do you think, or know, that your sexual partner(s) has other sexual partner(s)?||Close-ended, dichotomous|
|C||Have you ever had sex with more than one sexual partner in the last 12 months?||Close-ended, dichotomous|
|Have you ever had sex with more than one partner in a day?||Close-ended, dichotomous|
|Have you ever had sex with more than one partner in a week?||Close-ended, dichotomous|
|Scoring of fixed response choices. Rating of Scores: 0-No risk, 1-Low risk, 2-Moderate risk, 3-High risk|
|House head characteristics|
|A||Who is the head of your household?||Close-ended, categorical|
|How old is the head of the household?||Open-ended|
|Is your mother/father alive?||Close-ended, categorical|
|Is any of your parent/guardian chronically ill (including HIV)?||Close-ended, categorical|
|B||Are you living with your mother and father or with other family members?||Close-ended, dichotomous|
|Who else is living in the house with you?||Open-ended|
|How many people live in the house with you?||Open-ended|
|Tell me a bit more about your living arrangements?||Open-ended|
|[If she is not living with father/mother] Does your father/mother live elsewhere?||Close-ended, categorical|
|Tell me a bit about your household circumstances. Who pays the bills in your household or who is working?||Open-ended|
|Is someone getting a grant in your house?||Close-ended, categorical|
|How are the finances going in your household?||Open-ended|
|Are you working?||Close-ended, dichotomous|
|C||Do you have to provide anything for your family members like food, fees, medical care, clothing etc. (if yes, specify)||Close-ended, dichotomous|
|Is there an adult person that you seek emotional and or financial support from?||Close-ended, dichotomous|
|Who is the head of the family?||Close-ended, categorical|
|Age of head of family||Close-ended, categorical|
|Scoring of fixed response choices. Rating of Scores: 0-No risk, 1-Low risk, 2-Moderate risk, 3-High risk|
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Ferguson, J.; Mathur, S.; Armstrong, A. Assessing the Vulnerability and Risks of Adolescent Girls and Young Women in East and Southern Africa: A Preliminary Review of the Tools in Use. Trop. Med. Infect. Dis. 2021, 6, 133. https://doi.org/10.3390/tropicalmed6030133
Ferguson J, Mathur S, Armstrong A. Assessing the Vulnerability and Risks of Adolescent Girls and Young Women in East and Southern Africa: A Preliminary Review of the Tools in Use. Tropical Medicine and Infectious Disease. 2021; 6(3):133. https://doi.org/10.3390/tropicalmed6030133Chicago/Turabian Style
Ferguson, Jane, Sanyukta Mathur, and Alice Armstrong. 2021. "Assessing the Vulnerability and Risks of Adolescent Girls and Young Women in East and Southern Africa: A Preliminary Review of the Tools in Use" Tropical Medicine and Infectious Disease 6, no. 3: 133. https://doi.org/10.3390/tropicalmed6030133