Abstract
Background
The Yathu Yathu (“For Us, By Us”) cluster-randomized trial (CRT) evaluated a peer-led communitybased sexual and reproductive health (SRH) intervention implemented to address persistent barriers to SRH service use among adolescents and young people (AYP). We report the impact of the intervention on coverage of key SRH services among AYP.
Methods
The trial was conducted from Jul 2019-Oct 2021 in two urban communities in Lusaka, Zambia, divided into 20 zones (~2350 AYP/zone). Zones were randomly allocated to intervention (N=10) or control (N=10) arm. In all zones, a census was conducted and all AYP aged 15-24-years offered participation.
The intervention consisted of peerled community-based hubs providing SRH services; a prevention points card (PPC) system to incentivize and track SRH service use and community engagement. This paper reports on the outcome of coverage (accessing at least one key SRH service), comparing intervention and control arms using PPC data and standard methods of analysis for CRTs.
Results
Among enumerated AYP, 93.6% (14,872/15,894) consented to participate from intervention zones and 95.1% (14,500/15,255) from control zones. Among those who accepted a PPC, 63.8% (9,493/14,872) accessed at least one key SRH service during the study period in the intervention arm, compared to 5.4% (776/14,500) in the control arm (adjPR 12.3 95%CI 9.3–16.2, p<0.001)
The Yathu Yathu (“For Us, By Us”) cluster-randomized trial (CRT) evaluated a peer-led communitybased sexual and reproductive health (SRH) intervention implemented to address persistent barriers to SRH service use among adolescents and young people (AYP). We report the impact of the intervention on coverage of key SRH services among AYP.
Methods
The trial was conducted from Jul 2019-Oct 2021 in two urban communities in Lusaka, Zambia, divided into 20 zones (~2350 AYP/zone). Zones were randomly allocated to intervention (N=10) or control (N=10) arm. In all zones, a census was conducted and all AYP aged 15-24-years offered participation.
The intervention consisted of peerled community-based hubs providing SRH services; a prevention points card (PPC) system to incentivize and track SRH service use and community engagement. This paper reports on the outcome of coverage (accessing at least one key SRH service), comparing intervention and control arms using PPC data and standard methods of analysis for CRTs.
Results
Among enumerated AYP, 93.6% (14,872/15,894) consented to participate from intervention zones and 95.1% (14,500/15,255) from control zones. Among those who accepted a PPC, 63.8% (9,493/14,872) accessed at least one key SRH service during the study period in the intervention arm, compared to 5.4% (776/14,500) in the control arm (adjPR 12.3 95%CI 9.3–16.2, p<0.001)
| Original language | English |
|---|---|
| Article number | 1424 |
| Journal | BMC Public Health |
| Volume | 24 |
| Issue number | 1 |
| Number of pages | 13 |
| ISSN | 1471-2458 |
| DOIs | |
| Publication status | Published - 2024 |
Keywords
- Adolescents and young people
- Coverage
- HIV testing
- Implementation science
- Sexual and reproductive health