Introduction: Young Liberians, particularly undereducated young adults, face substantial sexual and reproductive
health (SRH) challenges, with low uptake of contraceptive methods, high rates of unintended pregnancy, and low levels of knowledge about HIV status. The purpose of this study was to assess the impact of a 6-day intensive group learning intervention combined with on-site SRH services (called HealthyActions) among out-of-school young adults,
implemented through an existing alternative education program, on uptake of contraception and HIV testing and
Methods: The intervention was implemented among young women and men ages 15–35 who were enrolled in alternative basic education learning sites in 5 counties of Liberia. We conducted a randomized evaluation to assess program impact. Baseline data were collected in January–March 2014, and endline data in June–July 2014. Key outcomes of condom use, contraceptive use, and HTC were estimated with difference-in-difference models using fixed effects. All analyses were conducted in Stata 13.
Results: We assessed outcomes for 1,157 learners at baseline and 1,052 learners at endline, across 29 treatment
and 26 control sites. After adjusting for potential confounders, learners in the HealthyActions intervention
group were 12% less likely to report never using a condom with a regular partner over the last month compared
with the control group. Female learners who received HealthyActions were 13% more likely to use any
form of modern contraception compared with learners in control sites, with the greatest increase in the
use of contraceptive implants. Learners in HealthyActions sites were 45% more likely to have received HTC.
Conclusion: Providing intensive group learning in a supportive environment coupled with on-site health services
improved SRH outcomes among participating learners. The focus of HealthyActions on participatory learning for low literacy populations presents an adaptable solution for health programming across Liberia and the region.
- Populations Served
- Adolescents and Youth
- Health Areas
- Contraception, HIV and Sexually Transmitted Infections
- Communicating for Social Change, Marketing Products and Services
- Resource Types
- Peer-Reviewed Publications
- HIV Testing Services (HTS), Injectable Contraception, Intra-Uterine Device (IUD), Long-Acting Reversible Contraception, Screening, Diagnosis, and Treatment, Short-Term Contraception