Intervention to Improve Developmental and Health Outcomes for Female Adolescents
Intervention to Improve Developmental and Health Outcomes for Female Adolescents
The primary goal of this pilot study (R21) is to address the urgent need for theoretically
 and empirically informed interventions that prevent poor female youth's rural-to-urban
 migration for child labor in low and middle-income countries. The study will address the
 following specific aims: Aim 1: Pilot test the (i) feasibility and acceptability of ANZANSI;
 and (ii) preliminary impact of ANZANSI by comparing the control arm to the treatment arm on
 specific child development outcomes; Aim 2: Explore multi- level factors (individual, family,
 and programmatic) impacting participation in and experiences with the ANZANSI.
The primary goal of this pilot study (R21) is to address the urgent need for theoretically
 and empirically informed interventions that prevent poor female youth's rural-to-urban
 migration for child labor in low and middle-income countries. The International Labor
 Organization (ILO) estimates that 11% of children (ages 5 to 17) worldwide are child
 laborers. ILO recently drew attention to migrant child laborers as an underreported, but more
 vulnerable group to adverse outcomes relative to children working locally. Sub-Saharan Africa
 (SSA) continues to be the continent with the highest rates of child labor, with Ghana
 registering one of the highest incidence rates at 22%, including unaccompanied child migrants
 engaged in labor. Adolescent girls make up the majority of unaccompanied rural-to-urban
 migrants in search of better economic opportunities. Studies document the myriad of serious
 threats to health and emotional well-being experienced by female adolescent migrants engaged
 in child labor. These threats underline the urgent need for theoretically-informed preventive
 interventions, specifically tailored to address the root causes of female child migrant labor
 and the needs of girls from economically insecure families and communities. Hence, this
 application titled ANZANSI Family Program focuses on girls before they drop out of school,
 but as they begin exhibiting possibility of dropping out. Specifically, ANZANSI is an
 innovative combination intervention program, combining an evidence-informed family-level
 economic empowerment (EE) aimed at creating and strengthening financial stability through the
 use of matched children savings accounts (CSA) and microfinance in poor households with a
 multiple family group (MFG) intervention addressing family functioning and parental beliefs
 around gender and child labor/ education. Informed by asset theory, parental ethnotheories
 framework; and the investigative team's research in SSA on child-wellbeing and poverty, the
 study uses a cluster randomized control design (N=10 schools; n=100 girls ages 11-14 at risk
 of dropping out of school and their caregivers), assigned to two study conditions (N= 5
 schools; n=50 children at risk of dropping out of school and their caregivers in each
 condition). The control group will receive bolstered usual care, including books and school
 lunch and treatment group will receive a combination intervention (Family EE+MFG) called
 ANZANSI, to address the following specific aims: Aim 1: Pilot test the (i) feasibility and
 acceptability of ANZANSI; and (ii) preliminary impact of ANZANSI by comparing the control arm
 to the treatment arm on specific child development outcomes; Aim 2: Explore multi- level
 factors (individual, family, and programmatic) impacting participation in and experiences
 with the ANZANSI. This study is aligned with NICHD's mission to support research relevant to
 the psychological, behavioral, and educational development and health of children worldwide.
 Ultimately, our findings may guide approaches to address youth's unaccompanied rural-to-urban
 migration and involvement in child labor in SSA, and the associated negative consequences.
Inclusion Criteria:

 Adolescent girls' inclusion criteria are:

 -  Enrolled in school and living within a family (defined broadly -not necessarily
 biological parents)

 -  Ages 11 to 14

 -  Capable of giving assent

 -  Skipping school in the past academic term (with at least 10% of unexcused absences).

 The caregiver inclusion criteria are:

 -  Self-identified as primary caregiver of the adolescent girl

 -  Capable of providing informed consent.

 Exclusion Criteria:

 -  Participants (girls and caregivers) that do not meet the criteria or exhibit a lack of
 understanding of the study procedures and hence not able to provide informed consent
 will be excluded.