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A novel cash-plus intervention to safeguard sexual reproductive health and HIV vulnerabilities in young women in Cape Town, South Africa
Background Cash plus interventions augment cash transfers with other empowering interventions to influence behaviours. This research assesses the Women of Worth (WoW) program and evaluates the effectiveness of a cash transfer (CT) of ZAR300 ($22USD22) conditional on attending 12-session customised e...
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| Format: | Thesis |
| Language: | English |
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Department of Medicine
2023
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| _version_ | 1867614296509251584 |
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| access_status_str | Open Access |
| author | Naledi Tracey, Noncayana |
| author2 | Bekker, Linda-Gail |
| author_browse | Bekker, Linda-Gail Naledi Tracey, Noncayana |
| author_facet | Bekker, Linda-Gail Naledi Tracey, Noncayana |
| author_sort | Naledi Tracey, Noncayana |
| collection | Thesis |
| description | Background Cash plus interventions augment cash transfers with other empowering interventions to influence behaviours. This research assesses the Women of Worth (WoW) program and evaluates the effectiveness of a cash transfer (CT) of ZAR300 ($22USD22) conditional on attending 12-session customised empowerment interventions to improve SRH/HIV outcomes in young women (19-24yrs) in Cape Town, South Africa. Methods A multiphase, mixed-methods, experimental study targeting 10 000 Participants in two subdistricts was conducted. Participants were randomised 1:1 to receive the interventions with CT ("cash + care" or C+C) or without CT (“Care”). Phase 1a piloted the interventions, Phase 1b implemented an adapted intervention, and Phase 2 was an open label C+C only scale up demonstration phase. Logistic regression models were fitted with subject-specific random mixed effects, to estimate changes in self-reported HIV, behavioural and structural SRH risks from baseline to (a) end of WoW and (b) follow up (6-30months post-exposure) irrespective of WoW completion. Mixed research methods were used to optimise engagement, evaluate implementation fidelity and determine the pathways of effectiveness for the interventions. Results The Women of Worth empowerment programme was implemented with adequate fidelity however adaptative research methods were essential for ensuring a sustained programme. 8765 (87,7%) of the 9995 WoW initiators were evaluated with 904 (10,3%); 4212 (48,1%) and 3649 (41,6%) women in Phases 1a, 1b and 2 respectively. In Phase 1a & 1b, participants in the “C+C” group were 60 times (OR 60.37; 95%CI: 17.32; 210.50.p |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/38519 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:49:47.534Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/38519 A novel cash-plus intervention to safeguard sexual reproductive health and HIV vulnerabilities in young women in Cape Town, South Africa Naledi Tracey, Noncayana Bekker, Linda-Gail London, Leslie HIV vulnerabilities Background Cash plus interventions augment cash transfers with other empowering interventions to influence behaviours. This research assesses the Women of Worth (WoW) program and evaluates the effectiveness of a cash transfer (CT) of ZAR300 ($22USD22) conditional on attending 12-session customised empowerment interventions to improve SRH/HIV outcomes in young women (19-24yrs) in Cape Town, South Africa. Methods A multiphase, mixed-methods, experimental study targeting 10 000 Participants in two subdistricts was conducted. Participants were randomised 1:1 to receive the interventions with CT ("cash + care" or C+C) or without CT (“Care”). Phase 1a piloted the interventions, Phase 1b implemented an adapted intervention, and Phase 2 was an open label C+C only scale up demonstration phase. Logistic regression models were fitted with subject-specific random mixed effects, to estimate changes in self-reported HIV, behavioural and structural SRH risks from baseline to (a) end of WoW and (b) follow up (6-30months post-exposure) irrespective of WoW completion. Mixed research methods were used to optimise engagement, evaluate implementation fidelity and determine the pathways of effectiveness for the interventions. Results The Women of Worth empowerment programme was implemented with adequate fidelity however adaptative research methods were essential for ensuring a sustained programme. 8765 (87,7%) of the 9995 WoW initiators were evaluated with 904 (10,3%); 4212 (48,1%) and 3649 (41,6%) women in Phases 1a, 1b and 2 respectively. In Phase 1a & 1b, participants in the “C+C” group were 60 times (OR 60.37; 95%CI: 17.32; 210.50.p 2023-09-11T14:01:12Z 2023-09-11T14:01:12Z 2023 2023-09-11T14:00:31Z Doctoral Thesis Doctoral PhD http://hdl.handle.net/11427/38519 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | HIV vulnerabilities Naledi Tracey, Noncayana A novel cash-plus intervention to safeguard sexual reproductive health and HIV vulnerabilities in young women in Cape Town, South Africa |
| thesis_degree_str | Doctoral |
| title | A novel cash-plus intervention to safeguard sexual reproductive health and HIV vulnerabilities in young women in Cape Town, South Africa |
| title_full | A novel cash-plus intervention to safeguard sexual reproductive health and HIV vulnerabilities in young women in Cape Town, South Africa |
| title_fullStr | A novel cash-plus intervention to safeguard sexual reproductive health and HIV vulnerabilities in young women in Cape Town, South Africa |
| title_full_unstemmed | A novel cash-plus intervention to safeguard sexual reproductive health and HIV vulnerabilities in young women in Cape Town, South Africa |
| title_short | A novel cash-plus intervention to safeguard sexual reproductive health and HIV vulnerabilities in young women in Cape Town, South Africa |
| title_sort | novel cash plus intervention to safeguard sexual reproductive health and hiv vulnerabilities in young women in cape town south africa |
| topic | HIV vulnerabilities |
| url | http://hdl.handle.net/11427/38519 |
| work_keys_str_mv | AT naleditraceynoncayana anovelcashplusinterventiontosafeguardsexualreproductivehealthandhivvulnerabilitiesinyoungwomenincapetownsouthafrica AT naleditraceynoncayana novelcashplusinterventiontosafeguardsexualreproductivehealthandhivvulnerabilitiesinyoungwomenincapetownsouthafrica |