Mixed Methods Study of two-week SKILLZ Girl among Adolescent Girls and Young Women in Zambia

DETAILED SUMMARY

Importance

• Adolescent girls and young women in Zambia face high rates of gender-based violence, early pregnancy, and limited access to sexual and reproductive health services. Midline evidence of SKILLZ Girl is needed to understand participant experiences, program acceptability, and early outcomes to inform scale-up and sustainability.

Objective

• To evaluate whether SKILLZ Girl improves sexual and reproductive health knowledge, gender attitudes, self-concept, and access to services among adolescent girls and young women aged 15–24 years over a two-year implementation period in school and community settings in Zambia.

Study details

• Study design: Mixed methods study
• Data collection tools: Pre- and post-questionnaires; attendance registers; HIV testing data; focus group discussions, key informant interviews, routine monitoring data
• Participants: Adolescent girls and young women aged 15–24 years
• Implementation setting: Schools and community settings across three districts (Mongu, Nakonde, Chipata) in Zambia (predominantly rural)
• Study period: July 2021 to June 2023

Intervention

• SKILLZ Girl: Two-week sport-based curriculum delivered by trained Coaches to adolescent girls and young women, focusing on sexual and reproductive health, gender-based violence prevention, and human rights, followed by ongoing peer support through Teen Clubs and community advocacy activities.

Results

• A total of 7,314 adolescent girls and young women participated in SKILLZ Girl, of whom 6,047 graduated (83% completion rate).
• Focus group discussions suggest that participants gained confidence to make independent decisions, including refusing early marriage and continuing education.
• Qualitative findings indicate improved access to services, with over 2,200 referrals for HIV testing and additional referrals for gender-based violence and sexual and reproductive health services.
• Coaches reported increased self-confidence, public speaking skills, and stronger relationships with participants.
• Barriers to service uptake included stigma, parental consent requirements, and negative experiences with healthcare providers.
• Quote: “I have made a decision to finish school… I can’t allow my family to choose for me to get married.” (Adolescent girl)

Conclusions and implications

• Findings suggest that SKILLZ Girl is highly acceptable and contributes to improvements in sexual and reproductive health knowledge, gender attitudes, and self-efficacy among adolescent girls and young women, while also strengthening access to services and community engagement.