New RCT Shows SKILLZ Girl Helps More Girls Access Life-Saving Health Services

Nearly half of all adolescent deaths worldwide occur in Sub-Saharan Africa, and girls in the region face disproportionately high risk due to gender-based violence, unequal power in relationships, and barriers to accessing critical health services. Most adolescent girls don’t know their HIV status, and among those who need contraception, most are not accessing it. As a result, HIV and AIDS and pregnancy-related complications remain among the leading causes of death for girls. 

Having the health information, life skills, and support necessary to access HIV testing and modern contraception is critical for girls to navigate these structural barriers and live healthier lives. Grassroot Soccer’s SKILLZ Girl program provides holistic support to do just that.

Now, a randomized controlled trial (RCT) – the gold standard test for evidence that an intervention truly works – funded by the United States National Institutes of Health (NIH) shows that SKILLZ Girl is effective in empowering adolescent girls and boosting their long-term uptake of critical sexual and reproductive health (SRH) services, including improved HIV testing and contraceptive access.

SKILLZ Girl

SKILLZ Girl is Grassroot Soccer’s single-sex program for adolescent girls between the ages of 15 and 19 that turns the soccer pitch into a gender-transformative space where girls learn information about key sexual and reproductive health topics, build their self-confidence with the support of positive peers and mentors, and gain access to youth-friendly services. 

Girls make up more than 55% of Grassroot Soccer participants, and the 12-lesson SKILLZ Girl program engages adolescent girls around their most pressing health topics – including HIV prevention (HIV testing services, PrEP, condoms), mental health, pregnancy, contraception, STIs, sexual and gender-based violence, substance misuse, and navigating health services.

Led by an inspiring female mentor between the ages of 20 and 24 (a SKILLZ Coach) from the community where the program is implemented, the curriculum combines soccer language, metaphors, and activities to spark reflections and important discussions around gender norms and goal setting in a safe, judgment-free environment – as well as facilitate linkages to crucial, youth-friendly health services. 

RCT Results 

From 2021-2023, Grassroot Soccer, the Centre for Infectious Disease Research in Zambia (CIDRZ), Zambia’s Ministry of Health (MoH) and Ministry of General Education (MoGe), and the University of California, San Francisco conducted a cluster randomized controlled trial (RCT) to evaluate the impact of the SKILLZ Girl program. The study enrolled more than 2,150 adolescent girls split between intervention and control groups across 46 secondary schools in Lusaka, Zambia, with surveys measuring HIV testing, contraceptive use, sexual and reproductive health empowerment, and other outcomes administered before the intervention, and again 6 and 12 months after baseline.

The study found that SKILLZ Girl participants were 1.6x more likely to test for HIV at 6 months, compared to those in the control group, with effects sustained at 12 months.

Additionally, participants were 1.2x more likely to use contraception at 6 months and 1.3x more likely at 12 months, compared to the control group.

These sustained gains demonstrate that SKILLZ Girl is driving lasting behavior change in adolescent girls that can ultimately support those who are HIV-positive to access and stay on life-saving treatment, while helping those who are HIV-negative access effective biomedical prevention services such as PrEP and condoms.

Additionally, secondary results published in the peer-reviewed journal Reproductive Health show that SKILLZ Girl improved girls’ sexual and reproductive health agency – including their confidence to communicate about sexual and reproductive health, negotiate safer sex, and access health services. 

These positive shifts in empowerment indicators complement the study’s positive primary findings and strengthen the case for SKILLZ Girl’s ability to drive meaningful SRH behavior change in adolescent girls.

An additional manuscript stemming from this study on the primary results is currently under peer review. 

Please contact Grassroot Soccer Senior Director, Strategy & Innovation, Andy Dallos ([email protected]) and Grassroot Soccer Zambia Managing Director Boyd Mkandawire ([email protected]) for more information.