Peer-reviewed article

Adolescent Girls' Agency in an Integrated Sexual and Reproductive Health and Economic Empowerment Intervention Pilot.

Cutherell M, Odeh R, Atlie S, Grzeslo J, Phillips M et al. · 8 Jul 2025

Abstract

Introduction Adolescence is a time of unique vulnerability for many girls, however, when supported to strengthen their capabilities, resources, and agency, adolescents can thrive even in adverse situations. This study sought to evaluate agency outcomes (decision-making power, mobility, and self-efficacy) among girls aged 15-19 participating in integrated sexual and reproductive health and economic empowerment interventions in Ethiopia and Nigeria. Methods The study was a quasi-experimental prospective cohort design involving two questionnaires at baseline and endline, 9 months apart, administered to intervention and comparison groups. Program effect was assessed using a difference-in-differences approach, modeling using linear generalized estimating equations accounting for repeated observations at the individual level and adjusted for age, marital status, education, and parity. Results The evaluation demonstrated significant positive program effects on one agency outcome each among married girls in Ethiopia (self-efficacy) and northern Nigeria (decision-making power). In southern Nigeria significant positive program effects were demonstrated among unmarried girls across all agency outcomes: decision-making power, mobility, and self-efficacy. Conclusions The evaluation showed promising increases in agency for girls who participated in this integrated intervention. The positive program effects seen during this relatively short pilot suggest that agency-related gains can be made even in programs with limited implementation time.