@article{ref1,
title="Developing a framework for cash transfer programs that foster sustained economic empowerment to reduce sexual risk among adolescent girls and young women: a  qualitative study",
journal="BMC public health",
year="2021",
author="Noble-Campbell, Paul and Mulhausen, Jeff and Maman, Suzanne and Balvanz, Peter and Gangaramany, Alok and Wamoyi, Joyce and Prasad, Ram and Goetschius, Stephan and Gichane, Margaret Waruguru and Sharma, Krittika and Sharma, Saransh",
volume="21",
number="1",
pages="e122-e122",
abstract="BACKGROUND: Transactional sexual relationships contribute to a high incidence of HIV infection among adolescent girls and young women (AGYW) living in low-resource  settings. Cash transfers (CT) are a structural approach to reduce sexual risk  behaviors, but their positive economic effects frequently fade after the program  ends. We aimed to understand AGYW's decision-making processes related to sexual,  relationship, and financial decisions, in order to design a framework for a CT  program that could lead to long-term financial independence and reduced  transactional sex among AGYW. <br><br>METHODS: We conducted qualitative research with AGYW  participating in a CT program in Tanzania. Phase one was formative research to  understand the context and experiences of AGYW regarding sexual behavior,  relationships, and finances. Participants included 36 AGYW (15-23 years old), 15  influencers of AGYW (mothers and male partners) and 10 financially empowered women  (FEW - women aged 20-30 with a sustained, reliable source of income independent of  their partner). Decisions and decision-making contexts of AGYW that we identified in  phase one informed the content of phase two. In phase two we simulated scenarios for  decision-making and economic goals with 80 AGYW and 40 FEW, in order to identify key  principles or intervention opportunities to guide development of a CT program  framework. <br><br>RESULTS: Through phases one and two of our research we identified three  key themes in AGYW's vision of their desired future economic state: 1) positive  social image, 2) power balance and respect, and 3) emotional and economic security. An important theme distinguishing AGYW from FEW was that AGYW lacked a vision to  build self-agency. <br><br>CONCLUSIONS: Our findings suggest that providing economic  resources to AGYW through CT without ensuring self-agency is unlikely to be an  effective long-term intervention for economic empowerment. Using these findings we  developed a framework for CT programs with three key pillars for developing  self-agency: 1) emotional efficacy, to increase AGYW's perception of rewards  associated with developing self-agency; 2) social efficacy, to build constructive  relationships and exit negative relationships that inhibit self-agency, and 3)  economic efficacy, to help AGYW build a resilient stream of financial resources.<p /> <p>Language: en</p>",
language="en",
issn="1471-2458",
doi="10.1186/s12889-020-10130-8",
url="http://dx.doi.org/10.1186/s12889-020-10130-8"
}