Bridges to the Future: Economic Empowerment for AIDS-Orphaned Children in Uganda
Condition: Poverty; Orphaned Children; AIDS Orphans
Study type: Interventional

Summary: 
      Bridges to the Future: Economic Empowerment for AIDS-Orphaned Children in Uganda, represents
      the first study that measures medium-term efficacy and cost-effectiveness of a family
      economic empowerment intervention for AIDS-orphaned children. The usual care provided to AIDS
      orphans in sub-Saharan Africa consists mainly of informal counseling as well as limited
      material support (e.g., specifically school lunches, textbooks for the required subjects, and
      note-books). Given the challenges facing these children and their caregivers, further
      supports are needed in order to help them successfully make the transition from primary
      school to secondary school and into adolescence. In the context of resource-poor countries,
      interventions that improve families' economic capabilities are likely to be particularly
      consequential. Both theory and prior research indicate that economic instability (including
      poverty) constitutes one of the primary risk factors for AIDS-orphaned children's risk-taking
      behaviors (including sexual risk-taking), poor mental health functioning, and poor
      educational outcomes. Thus, the lack of economic security constitutes an important risk
      factor for AIDS-orphaned children. Yet, to-date, few interventions aimed at care and support
      of AIDS-orphaned children have incorporated components to address family-level
      poverty/economic instability of the children and their caregiving families. Within this
      context, there is a need for innovative interventions that promote sustainable (more than
      short-term) economic and behavior change among AIDS-orphaned children and create the supports
      necessary to sustain these changes.
    

Detailed description: 
      The overall goal of the proposed research is to evaluate the efficacy and cost-effectiveness
      of an innovative family-based economic empowerment intervention for AIDS-orphaned children.
      This will be accomplished via a three-group cluster randomized control trial (RCT). The three
      groups are: Bridges, Bridges PLUS, and usual care for AIDS-orphaned children. There will be
      five assessment points: baseline (pretest), 12, 24, 36, and 48-months post-intervention
      initiation.

      The intervention, "Bridges to the Future" (Bridges) will be guided by asset-theory and both
      Bridges and Bridges PLUS will include the following intervention components tested in the two
      earlier pilot studies, SEED-Uganda and SUUBI-Uganda: 1) workshops focused on asset building,
      future planning, and protection from risks; 2) mentors to reinforce learning and build
      optimism; 3) a Child Development Account (CDA) that can be used for secondary education by
      the AIDS-orphaned child; and 4) a family income generating/micro-enterprise promotion
      component for children enrolled in Bridges and Bridges PLUS, and their families.
    

Intervention name(s): Bridges; Bridges PLUS; Usual Care
Intervention type(s): Behavioral; Behavioral; Other
Intervention description(s): Each child participant in the Bridges Arm will receive the usual care in addition to a Child Development Account (CDA) to be used for secondary education by the AIDS-orphaned child. The CDA will be a matched savings account held in the child's name in a financial institution registered by the Central Bank (Bank of Uganda). The account will be matched with money from the program at a match rate of 1:1. Additionally, participants will receive: 1) twelve 1-2 hour workshops focused on asset building, future planning, and protection from risks; 2) mentorship sessions to reinforce learning and build optimism; and 3) a family income-generating /micro-enterprise promotion component for children enrolled in Bridges and their families.; Each child participant in the Bridges PLUS Arm will receive the usual care in addition to a Child Development Account (CDA) to be used for secondary education by the AIDS-orphaned child. The CDA will be a matched savings account held in the child's name in a financial institution registered by the Central Bank (Bank of Uganda). The account will be matched with money from the program at a match rate of 2:1. Additionally, participants will receive: 1) twelve 1-2 hour workshops focused on asset building, future planning, and protection from risks; 2) mentorship sessions to reinforce learning and build optimism; and 3) a family income-generating /micro-enterprise promotion component for children enrolled in Bridges PLUS and their families.; Participants in the usual care condition will receive usual care for AIDS-orphaned children in the study area. This includes: counseling, school lunches, and scholastic materials (textbooks and notebooks). Counseling will be provided by priests in the community (as is currently done).
Other intervention name(s): Child Development Account; Child Development Account; Usual Services
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Orphaned children and youth; Economic empowerment; Uganda; HIV/AIDS; Sub-Saharan Africa