Girl-Only Clubs’ Influence on SRH Knowledge, HIV Risk Reduction, and Negative SRH Outcomes among Very Young Adolescent Girls in Rural Malawi

Abstract

BackgroundEarly adolescence is an important period to lay the foundation for positive sexual health development that can overcome sexual and reproductive health challenges faced by very young adolescents (VYAs) as they reach puberty and sexual debut. We report on first-hand accounts of experiences of VYA girls who participated in girl-only clubs, and explore the club participation influence on their SRH knowledge to reduce the risk for HIV and negative sexual health outcomes. MethodsThis was a qualitative study in which twenty-three in-depth interviews were conducted with VYA girls aged 12-14 years. These girls were enrolled in girl-only clubs in two rural southern districts in Malawi. The clubs were a part of larger comprehensive HIV prevention project called DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) which provided an evidence-based core package of interventions to VYAs to prevent HIV. Interventions included improved access to key health services, education support, social skills, asset building, and economic strengthening. Narrative inquiry was used to generate first-hand accounts of the girls’ experiences with club participation. A thematic analysis was used to generate themes from the transcribed stories. ResultsSix main themes were generated: 1) reasons for joining the clubs with desire to learn about SRH issues serving as the main motivation; 2) influence on gender norms and roles whereby participants described a change of gender roles and norms at home; 3) influence on child abuse practices whereby participants reported a decline in child abusive practices at home ;4) influence on life skills and social networks whereby participants described learning about networking; 5) influence of clubs on school attendance whereby out-of-school girls described how economic empowerment of their guardians facilitated their return to school; and 6) influence of clubs on SRH knowledge acquisition and behaviours whereby participants described acquiring knowledge on sexual health issues.Conclusion Girls-only HIV and SRH programs coupled with economic empowerment for their families can be effective in keeping VYA girls in school and improving SRH knowledge and health seeking behavior.

Social support and very young adolescent girl’s knowledge on sexual relationships: A comparative qualitative study of Girl Only Clubs’ participants and non-participants in rural Malawi

“…The GOCs offered an intervention to reduce HIV risk and increase the agency of AGYW at multiple levels of the SEM [32,39] For instance, at the individual level, GOCs facilitated the building of self-esteem, and provision of SH knowledge [39]. At the interpersonal level, the GOCs facilitated the building of social networks of VYA girls with peers, mentors, and adults [39]. At the institutional level the GOCs linked VYA girls to HIV services.…”

“…At the institutional level the GOCs linked VYA girls to HIV services. Moreover, at this level, the GOCs provided a forum where girls were able to meet and discuss SH issues [39]. At the systems and structure level the GOCs provided information that dealt with gender norms and abuse [39].…”