A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

April 2017

This report is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Making Cents International through YouthPower: Evidence and Evaluation Task Order 1 (YouthPower Learning) AID Contract # AID-OAA-I-15-00034/AID-OAA-TO-15-00011. This report does not necessarily reflect the views of USAID or the United States Government. USAID’s YouthPower Learning generates and disseminates knowledge about the implementation and impact of positive youth development (PYD) and cross sectoral approaches in international youth development. We are leading research, evaluations, and events designed to build the evidence base and inform the global community about how to transition young people successfully into productive, healthy adults. PYD is defined by USAID as follows:

Positive youth development (PYD) engages youth along with their families, communities, and/or governments so that youth are empowered to reach their full potential. PYD approaches build skills, assets, and competencies; foster healthy relationships; strengthen the environment; and transform systems.

Visit us at YouthPower.org to learn more, and follow us on Facebook and Twitter for updates.

YouthPower.org YouthPower Learning @YPLearning

For public inquiries and additional information, please email [email protected] or mail to Making Cents International, Attention: YouthPower Learning, 1350 Connecticut Ave NW, Suite 410, Washington DC 20036 USA.

Photo credits:

Top left of cover: USAID, Morgana Wingard Page vi (Woman with fruit): Natalia Davidovich Top right of cover: ICRW, David Snyder All other photos: Shutterstock Page iii (Boys playing soccer): AU UN IST PHOTO / TOBIN JONES. (United Nations, Tobin Jones) Acknowledgments

This systematic review is the result of a collaborative effort by the YouthPower Learning team. It was prepared by Making Cents International, the International Center for Research on Women, Results for Development Institute, University of Melbourne, and University of Washington, under the authorship of Dr. Gina Alvarado, Dr. Chisina Kapungu, Ms. Caitlin Moss, Mr. Daniel Plaut, Dr. Nicola Reavley, and Dr. Martie Skinner.

The authors acknowledge and give thanks to our YouthPower Learning team colleagues who contributed to this review. They include Ms. Amira Adams, Ms. Kristina Bennett, Dr. Richard Catalano, Ms. Shubha Jayaram, Ms. Cassandra Jessee, Dr. Christy Olenik, Dr. George Patton, Dr. Suzanne Petroni, Dr. Susan Sawyer, Ms. Meroji Sebany, and Ms. Magnolia Sexton.

The team also acknowledges valuable input from the broader YouthPower community, especially YouthPower Action and members of the USAID YouthPower Steering Committee. In particular, the authors appreciate feedback and support from Ms. Laurel Rushton, Ms. Elizabeth Berard, and Ms. Catherine Lane from USAID’s Bureau for Global Health and Ms. Laurence Dessein from USAID’s Bureau for Economic Growth, Education, and Environment (E3).

Recommended Citation: Alvarado, G., Skinner, M., Plaut, D., Moss, C., Kapungu, C., and Reavley, N. (2017). A Systematic Review of Positive Youth Development Programs in Low-and Middle-Income Countries. Washington, DC: YouthPower Learning, Making Cents International.

Page vi (Woman with fruit): Natalia Davidovich All other photos: Shutterstock A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries i ii A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries ii A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Acronyms and Abbreviations

AIDS Acquired immunodeficiency syndrome ALP Accelerated Learning Program ASRH Adolescent sexual and reproductive health BALIKA Bangladeshi Association for Life Skills, Income, and Knowledge for Adolescents CFPA China Family Planning Association CHAMP Collaborative HIV/AIDS Prevention and Adolescent Mental Health Project CPS Cognitive Performance Scale CPYDS Chinese Positive Youth Development Scale DFID Department for International Development (UK) HIC High-income country HIV Human immunodeficiency virus ICRW International Center for Research on Women LGBTI Lesbian, gay, bisexual, transgender, and/or intersex LMICs Low- and middle-income countries NGO Nongovernmental organization P.A.T.H.S. Positive Adolescent Training through Holistic Social Programs PYD Positive youth development RCT Randomized clinical trial REAL Refuse, explain, avoid, and leave (strategies in keepin’ it REAL program) SRH Sexual and reproductive health STI Sexually transmitted infection TV Television UN United Nations UNDP United Nations Development Programme USAID United States Agency for International Development YRH Youth reproductive health YYC Yes, Youth Can

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries iii iiiiii A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries iv A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Table of Contents

Executive Summary...... 1 Introduction...... 7 Chapter 1. A Brief History of Positive Youth Development...... 9 PYD in the United States...... 9 USAID and PYD...... 11 PYD in LMICs...... 15 Chapter 2. Study Methods...... 17 Research Questions and Objectives...... 17 Analysis...... 18 Limitations...... 19 Chapter 3. Study Results...... 21 How have PYD approaches been implemented in LMICs?...... 21 What does the evidence say about PYD program efficacy in LMICs?...... 27 Chapter 4: Discussion...... 35 Chapter 5. Conclusions and Recommendations...... 39 Conclusions...... 39 Recommendations...... 42 References...... 47 Appendices...... 53 Appendix 1. Search Terms Used for the Systematic Review...... 54 Appendix 2. Seminal Papers...... 55 Appendix 3. Checklist for Blueprint Program Evaluation...... 56 Appendix 4. Information About Programs Identified through Nonexperimental Studies...... 58 Appendix 5. Studies Tabulated by Quality and PYD Domains and Constructs...... 61 Appendix 6. Studies without Evidence...... 62 Appendix 7. Studies Tabulated by Quality and Topics and Subtopics...... 76 Appendix 8. High-Quality Experimental Studies...... 77 Appendix 9. Lower-Quality Experimental Studies...... 84 Appendix 10. Nonexperimental Studies Addressing Health and Democracy and Governance and Economic Development and Education...... 93 Appendix 11. Nonexperimental Studies Addressing Democracy and Governance and Economic Development and Education...... 98 Appendix 12. Nonexperimental Studies Addressing Health and Democracy and Governance...... 100 Appendix 13. Nonexperimental Studies Addressing Health and Economic Development and Education...... 103 Appendix 14. Nonexperimental Studies Addressing Democracy and Governance...... 108 Appendix 15. Nonexperimental Studies Addressing Economic Development and Education...... 110 Appendix 16. Nonexperimental Studies Addressing Health...... 111

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries v vv A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries vi A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries FIGURES, TABLES AND BOXES

Table 1. Evolution of PYD Models and Frameworks in the United States...... 9

Table 2. PYD Constructs...... 12

Table 3. Study Classification and Scores According to the Blueprint Checklist...... 18

Figure 1. PYD Domains and Definitions...... 2

Figure 2. PYD Domains and Associated Constructs...... 14

Figure 3. Review Process...... 17

Figure 4. Number of Studies by Country...... 22

Figure 5. Settings of the Interventions...... 22

Figure 6. Percentage by Types of Implementing Organizations...... 23

Figure 7. Number of Programs by Type of Activities...... 24

Figure 8. Number of Studies in each PYD domain...... 25

Figure 9. Number of Studies by Sector...... 26

Figure 10. Number of Studies by Sector and Quality...... 27

Figure 11. Six Steps Toward Program Scale-up...... 44

Box 1. Some Evidence on PYD Outcomes: Positive Adolescent Training through Holistic Social Programs (P.A.T.H.S.)...... 29

Box 2. Positive Evidence on SRH Outcomes: Stepping Stones...... 32

Box 3. Evidence Shows Promising Results to Reduce Substance Use: keepin’ it REAL...... 33

Box 4. Positive Evidence About Gender Norms: Parivartan...... 34

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries vii vii A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries viii A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Executive Summary

This report presents the results of a rigorous analysis Based on the above definition of PYD, the YouthPower of existing evidence of positive youth development Learning team (hereafter the team) distilled the concept (PYD) in low- and middle-income countries (LMICs). of PYD into four domains grouping outcomes that Commissioned by the United States Agency for together contribute to reaching the main goal of projects International Development (USAID) through the using a PYD approach. These domains serve as the YouthPower Learning project, this systematic review aims overarching PYD framework: to document how PYD approaches have been applied • Assets: Youth have the necessary resources, skills, in LMICs, as well as what the evidence demonstrates and competencies to achieve desired outcomes. about the effectiveness of such programs. International implementing organizations can integrate lessons learned • Agency: Youth perceive and can employ their into practice as researchers continue to build knowledge assets and aspirations to make or influence their on the impacts of PYD programs. own decisions about their lives and set their own goals, as well as to act upon those decisions to What is Positive Youth Development? achieve desired outcomes, without fear of violence or retribution. The YouthPower Learning team developed the following definition of PYD, based on existing literature, expert • Contribution: Youth are engaged as a source of consultations, and key stakeholder surveys. change for their own and for their communities’ positive development. • Enabling Environment: Youth are surrounded PYD transitions away from traditional by an environment that maximizes their assets, agency, access to services, and opportunities, approaches of responding to young people as well as their ability to avoid risks, stay safe in a risk or problem frame and toward and secure, and be protected. An enabling environment encourages and recognizes youth proactively building skills, fostering healthy while promoting their social and emotional relationships, and supporting youth to be competence to thrive.

active partners in development efforts. It Figure 1 shows the theoretical connection between suggests that if young people have the the four PYD domains used in the framework: Assets, knowledge, skills, and support they need, Agency, Contribution, and Enabling Environment. The figure illustrates the central “constructs,” or outcomes, they will thrive as adults, enjoy good health, directly linked to the domains, that are core to PYD- succeed economically, and make meaningful focused youth programs. Like the domains, these contributions to their communities. constructs are grounded in the literature (Catalano, Berglund, Ryan, Lonczak, & Hawkins, 2002).

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 1 11 Figure 1. PYD Domains and Associated Constructs

assets • Training • Recognizing emotions • Formal education • Self-control • Interpersonal • Academic achievement skills (social and communication skills) • Higher-order thinking skills

hea lthy, agency productive and contribution • Positive identity engaged youth • Youth engagement • Self-efficacy hea • Ability to plan ahead/Goal-setting • Perseverance (diligence) pr l • Positive beliefs about futureandoductithy youth , en enabling g v environmenta e • Bonding • Youth responsiveg services • Opportunities for prosocial • Gender-responsiveed services involvement • Youth-friendly laws and • Support policies • Prosocial norms • Gender-responsive policies • Value & recognition • Physical safety • Psychological safety

The PYD framework was first developed in the 1990s peer-reviewed articles or grey literature reports (from an to identify key developmental assets and relationships initial list of 24,961) that met the criteria for inclusion in that, once established, enable youth to enhance their the review. These 108 studies reported on 97 programs knowledge, interests, skills, and abilities. While PYD being implemented across 60 countries. The quality of as a philosophy and approach is now well established in the evidence was assessed using an adapted version of the many high-income country (HIC) contexts (Catalano, Checklist for Blueprint Program Evaluation (Appendix Berglund et al., 2002), little is known about its reach 3), which sets standards for reviewing research designs, and impact in LMICs. This report, focusing on LMICs, measures, and analyses. aims to fill in this gap and to provide evidence to international implementing organizations, researchers Key Findings and donors to continue to build knowledge on the How Have PYD approaches been implemented in impacts and measurement of PYD programs. LMICs? Research Questions and Methodology • Although youth programs are implemented across the globe, few are explicitly identified This review aims to answer two main research questions: as PYD. Though all of the programs included • How have PYD approaches been implemented in the review met the criteria for PYD, only 11% in LMICs? described themselves using terminology specific to • What does the evidence say about the PYD. This could be an indication that program effectiveness of these approaches? implementers and evaluators are not aware of PYD as a distinct approach to youth programming. The review drew upon both peer-reviewed and grey • The team found almost 100 separate PYD literature published in English, Spanish, and French programs in 60 LMICs. Finding so few program from 1990 to 2015. Using an adapted systematic search evaluations of PYD programs in LMICs is strategy for peer-reviewed papers and a purposive search indicative of how very recently PYD strategies of online repositories, as well as a survey disseminated to have been introduced into youth programming in youth-serving organizations, development agencies, and LMICs. universities, the research team identified a total of 108

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 2 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries • Most programs that were reviewed address that programmatic outcomes, both at the level of multiple PYD domains, and nearly all individual youth and community-wide, may manifest programs help youth to build Assets. All but over a time horizon that is longer than the typical one of the included programs helped youth to duration of an intervention (e.g., over 2–3 years). build Assets in some form, and 35% of programs targeted all four PYD domains. Quality and availability of evidence related to PYD Most papers included in this review were classified as • PYD programs are implemented across sectors, offering a low or medium quality of evidence. While age groups, and genders. This review delineates this review found papers that described programs’ PYD programs by sectors, aligned with the USAID approaches and activities, there was a lack of robust and technical bureaus they most closely represent. consistent measurement of PYD outcomes, most likely Some 79% of reviewed papers addressed Health- because programs did not explicitly self-identify as being related programs1 while 46% addressed Economic PYD. Development and Education, and 44% addressed Democracy and Governance programs. Although • Though evaluations were available for a the team identified programs that targeted youth majority of programs, their quality varied. ages 10-29, programs most frequently targeted Only a small number (18%) of the 108 studies youth ages 10–19, and three-quarters of the met the criteria for “high quality evaluations.” The studies reported on programs targeting both male majority of those defined as “high quality” were in and female youth. the Health sector. • Programs implement a diverse array of activities • There is a lack of robust and consistent across multiple domains, distinguishing PYD measurement of PYD outcomes. Evaluations of from other approaches to youth development. PYD programs in LMICs tend to measure sector- While adult-led educational programs were the or topic-specific outcomes (e.g., HIV infection most frequently cited activity type (81%), no rates, labor market outcomes), rather than PYD programs conducted only one type of activity. outcomes, such as self-regulation, positive identity, Instead, all programs combined activities and they or self-efficacy of youth. varied widely. These included workshops led by • There are very few longitudinal studies or adults and after-school classes led by teachers. evaluations of PYD programs. Peer education was the second-most common category, followed by activities using media and The effects of PYD programs on youth development youth-friendly services that were not home based. outcomes Opinion leader-led activities, which rely on the The review confirms that there is only a limited amount program participation of opinion leaders to of evidence on PYD programs in LMICs, leaving disseminate messages, or parent/youth activities major questions about “what works” to improve youth and home-based services, such as those through development unanswered. There are a few pertinent which outreach program staff or volunteers findings, however: go to the youth’s home to provide counseling, • A number of high-quality studies of health- psychosocial services, or information, were the focused PYD programs show improved least common. knowledge, attitudes, and behaviors related to What does the evidence say about the SRH. Results include increased health service effectiveness of PYD approaches? utilization as well as increased contraceptive use, among other outcomes. Evidence related One of the most important findings from this review to outcomes in the areas of mental health and is that the evidence base regarding the effectiveness of physical activity is less conclusive. PYD programs in LMICs is rather thin, with little data comparing effectiveness of PYD programs against those • Some PYD programs have led to positive shifts that are not using a PYD approach, and infrequent in gender norms. Evidence, though limited, measurement of PYD outcomes. The existing literature suggests that some PYD-oriented programs have also does not capture the long-term effects of PYD improved the economic and social empowerment approaches on young people themselves. This is an of young women and reduced gender-based important gap to fill, as evidence from HICs suggests violence in diverse LMIC contexts.

1 i.e., human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), sexual and reproductive health (SRH), or mental health.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 3 33 • Lower-quality studies have demonstrated Recommendations positive effects of PYD programs on Based on the findings of this review, the team presents employment, skills development, and financial several recommendations centered on program design, behaviors. This review did not identify high- programmatic investment, and evaluation and learning. quality evaluations measuring outcomes of PYD programs related to economic development Recommendations for program design and education, but lesser-quality studies found • Leverage existing evidence on the effectiveness improvements in employment outcomes, of PYD programs in HICs, as well as growing expectations of employment, and savings, as well evidence from LMICs, to improve the design as improvements in employability, job quality, of programs that target youth. Even as the retention, and self-esteem. global community works to expand the evidence • Programs tend to report on outcomes in base regarding PYD in LMICs, program designers a single sector (e.g., Health, Economic and implementers should utilize the PYD Development, or Democracy and Governance). literature from HICs to inform and accelerate However, there is the potential to improve cross PYD programming in LMICs. Furthermore, sectoral outcomes (e.g., better health linked to several robustly evaluated programs included improvements in governance). in this review could inform the design and implementation of future PYD programming. Elements of PYD programs with positive results Funders and researchers can play an important Programs with positive evidence on sector-specific role in increasing awareness of PYD among outcomes had several common traits. In particular, such implementers in LMICs through programming programs: guidelines, measurement toolkits, peer learning, • Adopt a systemic approach to youth rigorous evaluations, and a focus on sectoral programming by engaging with numerous outcomes (both within and across sectors) as well stakeholders and working across multiple as PYD outcomes. settings. Many promising programs, especially • Engage youth and key community those addressing gender, work with community stakeholders throughout program design members and stakeholders, in addition to and implementation to garner buy-in and individual young people, to create an environment strengthen the enabling environment. PYD in which youth can thrive. Programs seen to be programming is most effective when it is shaped more effective are also implemented in multiple by young people’s own ambitions, desires, and settings, including schools, households, and interests. A number of effective PYD programs community centers, for example. involve multiple actors (youth as well as adults) • Teach transferable skills and knowledge to from targeted communities in the design and youth to support positive outcomes across implementation of their interventions. Program sectors. Rather than focusing solely on technical, implementers can use youth and community vocational, and academic skills, PYD approaches member inputs in the program design phase to also support the development of transferable foster increased buy-in and engagement. Such competencies, such as socioemotional and inputs can be gathered through surveys, focus problem-solving skills, as well as self-awareness, groups, and key informant interviews, among self-determination, leadership, and positive other methods. behaviors that contribute to the increased agency • Promote youth-led and youth-centered of youth. approaches. Focusing on youth-led, rather than • Include innovative, youth-centered, and youth- adult-led, activities, including peer mentorship led activities. While adult-led educational and youth centers, can help empower youth to activities were the most frequently implemented play a leading role in their own and their peers’ activity type, many promising programs enlist development and may also improve program youth to work alongside adults in serving as attendance and engagement. mentors, leading community discussion activities, and creating safe spaces.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 4 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Recommendations for programmatic investment Recommendations for evaluation and learning • Consider expanding PYD programs in those • Increase investment in process and impact areas where efficacy is supported by rigorous evaluations of PYD programs in LMICs. evidence. PYD programs have produced Substantial evidence gaps limit an understanding convincing evidence of impact on knowledge, of the effectiveness of PYD approaches. attitudes, and, in some cases, behaviors related to Obtaining more robust evidence on the impacts SRH and gender norms. PYD programs in these of PYD programs on both sector-specific and areas should be expanded. youth-focused outcomes is necessary. Gradual • Invest in expanding the evidence base by testing approaches to program design and testing can promising approaches. While some positive help ensure that programs can be evaluated at results have been linked to improvements in youth various stages of development and implementation employability and livelihoods, further testing and and support ongoing learning and adaptation evaluation of PYD programs focused in this topic throughout the program life cycle. This can area, as well as in other sectors and in cross sectoral ultimately prepare programs for experimental programming, are necessary. evaluation and implementation at scale. • Consider ways to make programs more • Ensure robust, holistic, and consistent inclusive of marginalized groups, including measurement of PYD outcomes. Many PYD lesbian, gay, bisexual, transgendered, and/or programs in LMICs primarily measure sector- intersex (LGBTI), indigenous, and disabled specific outcomes, such as increased knowledge youth, as well as ethnic minorities, youth of HIV, job placement rates, or reduction in offenders, and others. This review found conflict, and very few assess intermediary PYD major gaps in attention to or inclusion of outcomes, such as self-regulation, positive identity, LGBTI, indigenous, and disabled populations and interpersonal skills. To truly understand and investments in programs addressing the the potential of PYD as an approach, more marginalized youth. Filling these gaps is critical, comprehensive measurements of PYD outcomes and funders should consider providing incentives are required. This would also allow for a more for programs focused on inclusive approaches. robust understanding of the link between PYD outcomes and sector-specific outcomes. • Further gender integration in PYD programming is crucial. Overall, 43% of studies Conclusion reported information that indicated some level In high-income countries, PYD is a proven strategy of integration of gender issues in the programs. for building skills, fostering healthy relationships, Far more can be done to address gender in PYD and supporting youth to be active partners in their programming in addition to or beyond the communities’ development, which can result in positive traditional approach of including women and outcomes in health, education, and employment. girls only. Evidence in the current review suggests This review begins to shed some light on how PYD that programs that target activities to males and programs are implemented and what existing evidence females to address unequal gender norms were says about the effectiveness of these approaches in the most effective in reducing gender inequality. LMICs, providing timely insights into the breadth and Some promising approaches focus on changing quality of these programs. At the same time, it makes the attitudes and behaviors of young men. Male- startlingly clear that the existing evidence base for such only interventions, such as Parivartan (Miller et programs that are deliberately implemented using a PYD al., 2014), can focus on shifting the norms and framework in LMICs is insufficient, although there is behaviors of young men away from disrespectful some available evidence on outcomes from programs behavior toward girls and women though implementing approaches that fit within the definition discussion and examples set by older and respected of PYD. In other words, this review found programs men in the community. Mainstreaming gender that implement aspects of PYD approaches but do so in cross sectoral PYD programs also helps reach without a theoretical underpinning and understanding goals related to health outcomes or other sectors’ of PYD. In light of these findings, there is a tremendous outcomes.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 5 55 need to invest in advancing the field, piloting new research will provide an important contribution to the strategies, and rigorously evaluating and documenting field and that these findings and recommendations will programs that are being implemented. Though many lead to evidence-based programs and programmatic unanswered questions remain, the team hopes that this improvements to advance PYD across the world.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 6 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Introduction

Positive youth development (PYD) broadly refers to development are increasingly priorities for many donors childhood and adolescent developmental experiences that and development organizations taking a holistic approach provide optimal preparation for the attainment of adult to youth development. A body of research that provides potential and well-being. PYD views youth as having key insights into applying a PYD approach internationally assets to be supported, nurtured, and developed rather is thus important to strengthening the design and than as having problems to be solved and risks to be effectiveness of youth-focused projects, including those managed. Building the assets and skills of adolescents can supported by the United States Agency for International result in both immediate and long-term positive effects on Development (USAID) and other donors. the mental and physical health, economic development, and overall well-being of adolescents, their families, and Given the lack of evidence about the use and effectiveness their communities (Patton et al., 2016). Investments in of PYD approaches in LMICs, USAID commissioned the PYD translate to benefits for society, by increasing the YouthPower Learning project (www.youthpower.org) to connections of youth to civil society and helping youth undertake a meta-review, a type of literature review that make successful transitions to adulthood (World Bank, collects and critically analyzes multiple research studies, 2007). to synthesize what is known in the current literature and identify the gaps to inform future research in this area. For A relatively large body of scientific research in the United this review, the team developed a comprehensive plan and States and other high-income countries (HICs) has shown search strategy by identifying, appraising, and synthesizing the positive impacts of a PYD approach to programming relevant studies based on a working definition of PYD.3 across many aspects of life experience, including sexual The review aims to answer two main research questions: and reproductive health (SRH), mental health, education, • How have PYD approaches been implemented in and crime and violence (Catalano, Berglund et al., 2002; LMICs? Catalano, Gavin, & Markham, 2010; Roth & Brooks- Gunn, 2003). Unfortunately, less is known about the • What does the evidence say about the effectiveness short- and long-term effects of PYD programming in of these approaches? low- and middle-income countries (LMICs)2 because This report presents a summary of the results of an of the lack of longitudinal and experimental studies adapted systematic review, which drew upon both peer- in these settings. Cross-sectional studies of youth reviewed and grey literature in English, Spanish, and development in LMICs that do exist have found a direct French published after 1989. Chapter 1 provides a brief correlation between developmental assets and better history of PYD and presents a comprehensive framework literacy, numeracy, and availability of human, social, to understanding PYD in LMICs. Chapter 2 discusses the financial, and physical capital to generate income (Scales, methods used to conduct the systematic review. Chapter Roehlkepartain, & Fraher, 2012). Youth with more 3 presents the review’s findings in terms of how PYD developmental assets are more likely to do well in school, has been implemented and the latest evidence of what be civically engaged, have better health outcomes, and works in achieving positive youth-focused outcomes in value diversity than those with fewer assets (Scales et al., LMICs, along with a discussion of areas in need of further 2012). investigation. Finally, conclusions and recommendations are provided to inform future program design, Advancing youth health and well-being and promoting the implementation, and evaluation efforts. active involvement of young people in social and economic

2 For a list of LMICs as classified by the World Bank as of July 2016, see https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country- and-lending-groups 3 See definition of PYD in the next section.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 7 77 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 8 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Chapter 1 A Brief History of Positive Youth Development

PYD in the United States and youth (Benson et al., 1998). Progress was made in the early 2000s in defining developmental assets and The field of youth development has moved away from in clarifying and honing the essential components of a problem-based approach which focused narrowly what was becoming known as a “PYD” framework. on adolescent behavioral health problems, such as Richard Lerner developed a model of PYD called the delinquency and violence, mental health problems, Five Cs, which organized developmental assets into five risky sexual behavior, and substance use, to a strengths- core constructs: competence, confidence, connection, based approach which focuses on promoting protective character, and caring (Lerner, 2004). Contribution factors that mitigate risk and are more likely to ensure was later added as a sixth C. Additionally, research by positive and sustained outcomes for youth in sectors Catalano, Berglund, et al., (2002) identified 18 core such as health and education (Catalano, Berglund et al., concepts essential to PYD and organized them under 2002; Pittman, O’Brien, & Kimball, 1993). Studies of the domains of positive skills/competencies, agency, programs that take this more positive approach to youth and enabling environment. The National Research development are relatively new and have been conducted Council and the Institute of Medicine also identified primarily in HICs, including Australia and, most components or features of successful PYD programs commonly, in the United States (Patton et al., 2000, (Eccles & Gootman, 2002). Table 1 summarizes the key 2006). constructs, concepts, and features of leading PYD models In 1990, the Search Institute put forth a list of 40 assets and frameworks from the literature of the 1990s and deemed essential to positive development for children 2000s and shows the various ways that different scholars in the United States have conceptualized PYD.

Table 1. Evolution of PYD Models and Frameworks in the United States

PYD Framework Description

Developmental Focus on 40 developmental assets across eight broad areas of human development: Assets Profile ● Support

(Benson et al., ● Empowerment 1998) ● Boundaries and expectations

● Constructive use of time

● Commitment to learning

● Positive values

● Social competencies

● Positive identity

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 9 99 Table 1(continued from page 9)

Five Cs Model of Focus on developmental assets PYD Core constructs:

(Lerner, 2002, 2004) ● Competence: Social, cognitive, behavioral, emotional, and moral

● Confidence: Self-efficacy, self-determination, belief in the future, and clear and positive identity

● Connection: Bonding

● Character: Prosocial norms, spirituality

● Caring: Empathy and sympathy for others

18 Core Constructs ● Social, emotional, behavioral, cognitive and moral competencies of PYD ● Clear and positive identity

(Catalano, ● Strength of character Berglund, et al., ● Self-efficacy 2002) ● Self-determination

● Belief in the future

● Positive emotions

● Bonding

● Positive norms

● Opportunities for positive social involvement

● Recognition for positive behavior

● Spirituality

● Resiliency

● Life satisfaction

Key Features of ● Opportunities for skill building and mastery Successful PYD ● Supportive adult relationships Programs, From the National ● Engagement not only in community activities but also in program design, Research Council implementation and evaluation & the Institute of ● Clear expectations for behavior, as well as increasing opportunities to make Medicine decisions, participate in governance and rule-making, and take on leadership roles as one matures and gains more expertise (Eccles & Gootman, 2002) ● A sense of belonging and personal values ● Opportunities to develop social values and norms

● Opportunities to make a contribution to one’s community and to develop a sense of mattering

● Strong links among families, schools, and broader community resources

● Physical and psychological safety

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 10 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Roth and Brooks-Gunn (2003) drew on the above- youth participation and partnership by integrating youth outlined body of work when they proposed that PYD issues into its programming and engaging young people programs have a set of distinctive characteristics. First, across Agency initiatives (USAID, 2012). While youth they maintained that PYD programs can be identified development programs often focus on young people in by the types of opportunities and experiences that the 15-to-24-year-old range, USAID recognizes that are provided to youth. That is, PYD programs seek youth programs likely engage a broader cohort ranging to provide opportunities for youth to enhance their from 10 to 29 years old. This expanded age range interests, skills, and abilities at home, in school, and in recognizes the critical understanding that the transition their communities. Second, PYD programs help youth from childhood to adulthood varies across and within build skills through activities such as a competency- countries. The Youth in Development Policy represented building curriculum, direct academic instruction, a paradigm shift toward viewing youth as assets and homework help, and community service. Third, they resources and working with them comprehensively across provide opportunities for youth to engage in real and various sectors rather than focusing on single-sector issues. challenging roles and activities. Fourth, the atmosphere The policy provides guidance on how to intentionally around them is supportive and actively encourages facilitate youth development efforts based on the bonding among youth, program staff, and adults recognition that, historically, young people have been involved in the program. Fifth, youth are encouraged to central to bringing about social, political, and economic engage in useful roles, practice self-determination, and change to their countries. develop or clarify their goals for the future. Finally, PYD 5 programs tend to be stable and relatively long-lasting. YouthPower Learning developed a definition of PYD, That is, they last an entire school year or longer so that which aligns with the key elements of the USAID Youth youth have adequate time to build relationships and in Development Policy, the academic and grey literature, benefit from program activities. and existing definitions and frameworks of PYD. This definition can be broadly applied across youth age PYD programs in the United States have mostly been groups (ages 10 to 29), sectors, and settings in LMICs. conducted within school and family settings. The The research team held numerous consultations with school is usually the primary setting for implementing experts through which they solicited feedback, and also youth strategies, while a combination of approaches is undertook online surveys and presentations with a wide employed to engage the family (Catalano, Berglund, range of stakeholders, including USAID implementers, et al., 2002). The majority of programs operate in youth-serving and youth-led organizations, and PYD more than one setting, which may be a key factor in researchers and experts. The final definition reflects the their success (Catalano, Berglund, Ryan, Lonczak, & key elements of PYD and is both applicable for the low- Hawkins, 2004). Catalano, Berglund, et al., (2002) and middle-income country context and relevant for conducted a systematic review of PYD programs in USAID: the United States and found 24 programs that led to significant improvements in behavioral health, Positive youth development (PYD) engages including reductions in drug and alcohol use, school youth along with their families, communities, misbehavior, aggressive behavior, violence, truancy, high- risk sexual behavior, and smoking. Common aspects and/or governments so that youth are of effective programs included methods to strengthen empowered to reach their full potential. social, emotional, behavioral, cognitive, and moral PYD approaches build skills, assets, and competencies—building self-efficacy; shaping messages competencies; foster healthy relationships; from family and community about clear standards for youth behavior; increasing healthy bonding with adults, strengthen the environment; and transform peers, and younger children; expanding opportunities systems. and recognition for youth; providing structure and consistency in program delivery; and intervening with Based on this definition, YouthPower Learning then youth for at least nine months. distilled a set of PYD constructs into four critical components, or domains, which serve as the overarching USAID and PYD PYD framework. Figure 1 defines the four PYD USAID launched its seminal Youth in Development domains used in the framework: Assets, Agency, Policy4 in 2012, making a commitment to strengthen Contribution, and Enabling Environment.

4 https://www.usaid.gov/sites/default/files/documents/1870/Youth_in_Development_Policy_0.pdf 5 http://www.youthpower.org/

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 11 1111 Figure 1. PYD Domains and Definitions

These four domains encompass the essential aims of

These four domains encompass the essential aims of youth programs are directly linked to the domains. PYD that recognize youth have necessary skills and Constructs can be viewed as attributes of a person or resources to succeed, be empowered to make changes group of people that often cannot be measured directly. for themselves, be productive members of society and Like the domains, these constructs are grounded in contribute to positive well-being beyond themselves, and the literature (Catalano, Berglund, et al., 2002) but be surrounded by structures and people that positively are tailored for the context of low and middle-income reinforce them. Table 2 illustrates how the central countries. “constructs” or outcomes that are core to PYD-focused

Table 2. PYD Constructs

CONSTRUCT DEFINITION DOMAIN: ASSETS Training Training in skills specific to vocation, employment, or financial capacity (e.g., money management, business development, marketing). Formal education Exposure to formal education. Interpersonal The range of skills used to communicate and interact with others, including skills (social and communication (verbal and nonverbal and listening), assertiveness, conflict-resolution, communication and negotiation strategies. These are skills that help to integrate feelings, thinking, and skills) actions to achieve specific social and interpersonal goals. Higher-order The ability to identify an issue, absorb information from multiple sources, and evaluate thinking skills options to reach a reasonable conclusion. It includes problem solving, planning, decision making and critical thinking. Recognizing The ability to identify and respond positively to feelings and emotional reactions in emotions oneself and others. Self-control The ability to delay gratification, control impulses, direct and focus attention, manage emotions, and regulate one’s own behaviors. Academic Knowledge and mastery of academic subjects, such as math, written and spoken achievement language, history, geography, and sciences.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 12 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Table 2 (continued from page 12)

DOMAIN: AGENCY Positive identity Positive and coherent attitudes, beliefs, and values that one holds about oneself and one’s future. Self-efficacy Belief in one’s abilities to do many different things well (particularly the things that are the focus of the intervention). Ability to plan The motivation and ability to make plans and take action toward meeting a personal goal. ahead/goal setting Perseverance The capacity to sustain both effort and interest in long-term projects regardless of (diligence) perceived or real difficulties. Perseverance is the act of continual attempts to meet goals despite difficulties. Positive beliefs Having hope and optimism about one’s future potential, goals, options, choices, or plans. about the future DOMAIN: CONTRIBUTION Youth engagement Youth participate fully in democratic and development processes, play active roles in with civil society peace building and civil society, and are less involved in youth gangs, criminal networks, and insurgent organizations. Youth engagement Meaningful youth engagement is an inclusive, intentional, mutually respectful partnership between youth and adults whereby power is shared; respective contributions are valued; and young people’s ideas, perspectives, skills, and strengths are integrated into the design and delivery of programs, strategies, policies, funding mechanisms, and organizations that affect their lives and their communities, countries, and world. Meaningful youth engagement recognizes and seeks to change the power structures that prevent young people from being considered experts concerning their own needs and priorities, while also building their leadership capacities. Youth include a full spectrum of the population aged 10–29, regardless of socioeconomic status, ethnic identity, sexual orientation and gender identity, disability, political affiliation, or physical location.6 DOMAIN: ENABLING ENVIRONMENT Bonding The emotional attachment and commitment made to social relationships in the family, peer group, school, or community. Opportunities Opportunities for positive interactions and participation in family, peer groups, school, or for prosocial7 community. involvement Support The perception that one is cared for and supported by family, peer group, school, or community. Prosocial norms Youth hold healthy beliefs and clear standards for positive behavior and prosocial engagement. Value and Youth believe that they are of value in society and their positive contributions are recognition recognized and rewarded. Youth-friendly laws Youth have a strong voice in, and are well served by, local and national institutions, with and policies robust and youth-friendly policies. Youth are aware of these policies and believe that their implementation is effective, reliable, fair, and consistent. Youth-responsive Services are based on a comprehensive understanding of what young people want and services need and aim to deliver safe, affordable, accessible, and essential care.

6 Definition developed by the YouthPower Youth Engagement Community of Practice 7 The term “prosocial” refers to voluntary actions that primarily benefit others and can involve cooperativeness, helpfulness, sharing, or empathy.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 13 1313 Table 2 (continued from page 13)

Gender-responsive Services intentionally allow youth-identified gender issues to guide services, creating services through every stage of programming (site selection, staff selection, program development, content, and material) an understanding of how gender affects the realities of young people’s lives. Gender-responsive Societies in which young people live have balanced and fair gender norms and policies. policies Youth are aware of these policies and believe that their implementation is effective, reliable, fair, and consistent. Physical safety Youth feel safe in their immediate environment. Physical environment is free from violence, conflict, and crime. Psychological safety Youth feel free to express their ideas, thoughts, and feelings in their environment.

Figure 2 shows the theoretical connections between the four PYD domains and related constructs used in the framework.

Figure 2. PYD Domains and Associated Constructs

assets • Training • Higher-order thinking • Formal education skills • Interpersonal • Recognizing emotions skills (social and • Self-control communication skills) • Academic achievement

hea lthy, agency productive and contribution • Positive identity engaged youth • Youth engagement • Self-efficacy hea • Ability to plan ahead/Goal-setting • Perseverance (diligence) pr l • Positive beliefs about futureandoductithy youth , en enabling g v environmenta e • Bonding • Youth responsiveg services • Opportunities for prosocial • Gender-responsiveed services involvement • Youth-friendly laws and • Support policies • Prosocial norms • Gender-responsive policies • Value & recognition • Physical safety • Psychological safety

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 14 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries PYD in LMICs In LMICs, sector-specific data are often collected on the prevalence of youth risky behaviors, but rarely The context for PYD is different in LMICs as compared on PYD outcomes (Lippman, Moore, & McIntosh, to HICs because economic and sociocultural conditions 2009). Additional data are needed to assess how PYD in LMICs often have somewhat delayed or accelerated outcomes can be linked to sector-specific outcomes. the recognition of adolescence as a distinct life stage, International development agencies, nongovernmental and progression toward adulthood is often dependent organizations (NGOs), and governments are currently on cultural and historical contexts (Patton et al., engaged in systematic efforts to promote healthy child 2016). As these countries develop economically, there and adolescent development by drawing on individual, is a growing recognition of the need to foster positive family, community, and national strengths while development among young people. To this end, research addressing the most critical threats to development from HICs has recently begun to be applied to LMICs that occur in such contexts (Scales et al., 2012). Thus, through translation of existing approaches. However, an opportunity exists to incorporate insights from little academic attention has been paid to either PYD across sectors and foster the cross sectoral collaboration in LMICs or the mechanisms through which specific that is necessary to develop effective youth-focused programs affect youth-focused outcomes. programming in LMICs.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 15 1515 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 16 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Chapter 2 Study Methods

Research Questions and Objectives The objective of this review is to expand the knowledge about PYD programs in international development in order to develop the evidence base to support PYD interventions. This review aims to answer two main research questions: • How have PYD approaches been implemented in LMICs? • What does the evidence say about their effectiveness?

The research questions were developed in collaboration with USAID and reviewed by a team of PYD experts, hereafter called “advisers,” who provided recommendations to the main authors of this report during every step. In consultation with USAID and the advisers, the research team agreed to include grey literature as well as peer-reviewed studies to capture potentially innovative programs that may not have been formally published in academic journals. Figure 3 lays out the steps taken throughout the review process. Figure 3. Review Process

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 17 1717 Analysis Studies with evaluation results were divided into the following four categories, according to study design and As described in Figure 3, the screening process resulted quality score: in 64 peer-reviewed articles and 44 grey literature publications being included in the final review. These 108 studies covered 97 programs across a wide range of Table 3. Study Classification and Scores sectors and countries. The team created a database to According to the Blueprints Checklist capture relevant variables included in these 108 studies, Score According to the reflecting those that were relevant to answering the Study Quality Adapted Blueprints study’s primary research questions. Variables such as Classification Checklist country of the program being evaluated, implementer, target population, types of activities conducted, and High-quality a score of 6 to 8 program objectives were selected because of their utility experimental studies to answer the first guiding question of this review:How High-quality quasi- have PYD approaches been implemented in LMICs? a score of 6 to 8 experimental studies The database was also used to record the findings from Lower-quality a score below 6 the studies, the types of measures used, and the size of experimental studies the effects, when relevant. Other variables, such as the Low-quality type of design (whether it was a randomized control trial a score below 6 or other design), were included to help the team assess nonexperimental studies the quality of the evidence in the reports. This quality assessment was conducted using an adapted version Only the 39 papers with experimental and quasi- of the Checklist for Blueprint Program Evaluation (see experimental study designs that were classified as high- Appendix 3), hereafter called the Blueprints checklist. As quality were examined to answer the second question: such, studies received a score of 1 point for each criterion What does the evidence say about PYD program efficacy in they meet. The Blueprints checklist used assigns the LMICS? same weight to all the following elements: During the early stages of analysis, the team classified • Study used an experimental design (randomized programs by topic and grouped these topics in three controlled trial—RCT). main sectors—Health, Democracy and Governance, • The sample was clearly described.8 and Economic Development and Education —that • The reliability or validity of tests and measures was generally align with the three related USAID technical described. bureaus. Recognizing that some of these topics could fit under multiple sectors, for the purpose of this analysis, • The study used intention to treat analysis. the team included in the Health sector: HIV and AIDS, • The analysis was done at the proper level.9 sexual and reproductive health, mental health (including • The analysis controlled for baseline outcome suicide), smoking, alcohol and drug use, resilience, measures. breastfeeding, hepatitis, nutrition, physical fitness, breastfeeding, and child maltreatment or neglect. Topics • The analysis demonstrated baseline equivalence included in the Democracy and Governance sector are 10 between conditions. violence, youth capacity building, and child marriage. • The study demonstrated that attrition is The Economic Development and Education sector below 5% or unrelated to group assignment, included workforce development, education, bullying, sociodemographic characteristics, and baseline and the environment. measures of the outcomes.

8 This variable summarizes a range of conditions that included the clarity describing the size and the representativeness of the sample as well as other characteristics of the sample. 9 This refers to a range of steps in the analysis. It may refer to whether data are analyzed using the correct instrument—for example, using the correct type of regression analysis when the dependent variables are nominal, ordinal, or intervalar. It could also refer to whether the interpretations of analysis are based on the correct unit of analysis or level of such analysis. For example, if a sample was taken in a rural area alone, the statements in the analysis should not suggest the study took place in rural and urban areas. 10 This refers to the analysis conducted to determine if two groups are similar enough so that one can be used as an “intervention” group and another as “comparison” group in experimental studies. This analysis typically involves comparing these two groups during baseline.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 18 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries For purposes of organizing and presenting information, In the case of this particular review, there were the high- and low-quality experimental studies were potentially hundreds of search terms for different PYD grouped using these three main sectors. To produce the constructs; a large developmental period covered (i.e., main lessons learned and tables that guided the writing childhood, adolescence, and young adulthood); diverse of the Results section, the team conducted content types of interventions across a range of sectors; and analysis identifying the interventions’ main activities, a broad set of outcomes (i.e., education, knowledge, outcomes, designs, measures, and results, among other health, self-esteem, communication skills, self- information that can be found in the tables in the governance). Further, because of the differing levels of appendices. study quality, and given the fledgling nature of PYD programming in LMICs, the results could not necessarily Limitations be presented as in a typical systematic review or meta- Most systematic reviews start with a single outcome of analysis, nor was it possible to identify “what works” interest or a relationship between a class of interventions in a comparative fashion. The recommendations from and single outcome, for example, family-oriented this review are thus focused more on promising avenues programs designed to prevent violence. While these or possible approaches that can be useful for designing typical reviews have some diversity, (e.g., population interventions. served, age of children, and/or mode of delivery), the small number of programs and outcomes typically includes limits or defines a narrow set of search terms.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 19 1919 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 20 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Chapter 3 Study results

Among the 108 studies included in the final review, informed by a pilot with the same population. Programs 59% were from the peer-reviewed literature, while 41% intervened at four levels: individual, community, peer, were from the grey literature. Most documents (88%) and family. Almost all (99%) looked at the level of the discussed a single intervention, but five programs were individual, while 51% also considered the community the subject of multiple studies, so the review effectively level. Forty-three percent (43%) of studies considered covered a total of 97 different programs. The five programs that targeted peers, and 31% included families. programs with multiple evaluations were keepin’ it REAL Finally, 25% of studies only targeted one level, 34% (two evaluations), Positive Adolescent Training through targeted two levels, 32% targeted three levels, and 8% Holistic Social Programs (P.A.T.H.S., four evaluations), targeted the four levels. Parvitaran (two evaluations), Stepping Stones (three evaluations), and Collaborative HIV and Adolescent Key result 1: The majority of studies measured health Mental Health Project (CHAMP), also called VUKA outcomes. However, more than half of these studies also (two evaluations). All 108 studies were analyzed to addressed at least one other sector, such as Democracy and identify how PYD approaches were being implemented Governance or Economic Development and Education. in LMICs. While many of these 108 studies include The 108 studies included in the review covered 60 projects that could be potentially important PYD countries (Figure 4), of which 29 were in the middle- innovations, because they either lacked evaluations or income countries of China, South Africa, and India, these evaluations were not available during the search with an average of nine programs in each country.11 stage of this review, lessons from these projects could not Most of the other countries included in the studies had inform the second part of the review. Thus, the second only one or two programs each. Just under 80% of part of the analysis, covering what the evidence shows programs measured health outcomes (e.g., HIV/AIDS, about the effectiveness of PYD programs (section 3.2), SRH, or mental health), and less than half reported on includes a much more limited set of studies. outcomes related to Democracy and Governance or How have PYD approaches been Economic Development and Education. At least 46 out of 86 programs addressing health outcomes also focused implemented in LMICs? on achieving outcomes related to the other sectors. Most programs (66%) were informed by empirical Although the review found PYD programs in most predictors of youth development or theory, 32% sectors, it is worth noting that only one program focused were informed by an evaluated program adapted for on the environment. another setting or population, and 14% reported being

11 The study also includes Hong Kong, which technically is a high-income category.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 21 2121 Figure 4. Number of Studies by Country

Key result 2: The majority of studies targeted youth in 21% of studies. Just over three-fourths (77%) targeted schools and both males and females. both males and females, while 12% targeted only females and just 3% targeted only males. Interventions targeted Over half of the studies included in the review (54%) young people in urban settings, those not enrolled at looked at interventions that targeted youth in schools, school or unemployed, as well as those from minority while 44% assessed programs that were delivered through ethnic groups. None of the studies targeted the needs community organizations. Some settings were difficult of lesbian, gay, bisexual, transgender, and/or intersex to identify because they refer to advocacy activities at (LGBTI) youth specifically. Intervention duration varied the institutional level. Therefore, they were classified as widely. The most commonly reported duration was one “other” (see Figure 5). Approximately one-third of the academic year. The minimum reported duration was studies (31%) centered on both younger (10–14 years) five hours. Almost all the studies for which information and older (15–19 years) adolescents. Young adults on duration was available reported program intervention (20–29 years) alone were the subject of 23% of studies, periods of at least several weeks. and adolescents alone (10-19 years) were the subject of Figure 5. Settings of the Interventions

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 22 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Key result 3: NGOs were the most common type of by universities and United Nations (UN) agencies implementing organization. (Figure 6). Co-implementation arrangements, such as partnerships between universities and governments, were Non-governmental organizations (NGOs) were the most less common. common type of implementing organization, followed

Figure 6. Percentage by Type of Implementing Organizations

The goals and scope of the programs included in this the second-most common category, followed by activities review were diverse, with varying theories of change using media and youth-friendly services that were not and intentions. Overall, 31% of the reports explicitly home based. An example of the latter is the provision of mentioned the programs’ theory of change, with youth-friendly health services in which programs trained Bandura’s social cognitive theory12 the most commonly staff working at health centers to provide services that cited (six studies). engage youth and give them information and care with respect in a non-threatening atmosphere. The types of intervention activities varied widely. Educational activities led by adults were the most Opinion leader-led activities, which rely on the program common. These included workshops led by adults and participation of opinion leaders to disseminate messages, after-school classes led by teachers. Peer education was or parent/youth activities and home-based services,

12 Albert Bandura’s social cognitive theory is a theory of social diffusion and innovation that integrates modeling and social network influences and explains determinants and processes governing personal and social change. See Bandura’s 1986 Social foundations of thought and action: A social cognitive theory (Englewood Cliffs, NJ: Prentice-Hall, Inc.).

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 23 2323 such as those through which outreach program staff or services to all or some members of the households, not volunteers go to the youth’s home to provide counseling, only the youth being targeted by the program.) Figure psychosocial services, or information, were the least 7 shows the number and percentage of programs by common. (Note that these programs often provide activity type.

Figure 7. Number of Programs by Type of Activities

Activities

Educational activities not led by peers G Peer education G Use of media G Youth-friendly services, not home based CD

Activities with parents or teachers; others CD

Organization of social events e

Direct service provision, not home based

Community meetings 30

Mentoring 30

Physical activity 28

Home-based services 24

Parent–youth activities 17

Opinion leader conducted activities 0 100 Percentage of programs implementing activities.

Key result 4: Less than half of programs integrated the programs. (For this assessment, the team used a broad gender issues. interpretation of gender integration that could include something from collecting gender-disaggregated data to Overall, 43% of studies reported information that using a “gender-synchronized” approach that deliberately indicated some level of integration of gender issues in includes both males and females to transform gender

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 24 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries dynamics intentionally). Several of the studies included information and skills training (including vocational in the analysis described deliberately including girls in training), communication, interpersonal skills and the intervention, collecting gender-disaggregated data, conflict resolution skills, managing emotions, and coping aiming to transform gender norms, having separate strategies, as well as problem solving, decision making, curricula for males and females, or specifically discussing and self-reflection. gender roles, gender stereotypes, or gender equality in the intervention activities. More than three quarters of the studies (81%) included PYD outcomes under the Agency domain. Self-efficacy, Key result 5: The majority of programs do not identify as self-confidence, self-esteem, self-determination, and PYD. belief in future are some examples in this domain.

The team only explicitly identified 11% of studies as At least half of the studies included PYD outcomes being focused on PYD programs. However, a careful related to the Contribution domain. Peer leadership, assessment of the information provided in the studies mentoring and, less commonly, volunteering, civic against PYD outcomes revealed that all the 108 studies engagement and community mobilization are some covered outcomes in at least one PYD domain. Only examples. 2% of studies addressed one domain alone; 17% addressed two domains; 44%, three domains; and 36%, Many studies (86%) included PYD outcomes related four domains (Appendix 5). to the Enabling Environment domain. Examples include promoting parental involvement, bonding and Key result 6: Almost all of the studies (99%) describe communication, prosocial norms, equitable gender programs that build assets. norms, and youth-friendly services.

All but one study included at least one PYD outcome Figure 8 shows how the studies addressed the four considered part of the Assets domain. PYD outcomes in domains. this domain included health education, access to health

Figure 8. Number of studies in each PYD domain

Key result 7: The majority of programs were in the gender in varied levels of sophistication, ranging from Health sector, particularly focusing on HIV and SRH. sex disaggregation of data to more complex analysis of gender norms. As shown in Figure 9, health was the most commonly found program focus (79% of the studies), followed The most common subsectors in health were HIV/AIDS by Economic Development and Education (48%) (44%), SRH (39%), mental health (25%), smoking, and Democracy and Governance (45%) (see Figure alcohol and drug use (20%), and resilience (19%). 9). Twenty-eight percent (28%) of studies addressed

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 25 2525 Figure 9. Number of Studies by Sector

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 26 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries What does the evidence say about PYD were classified as lower quality experimental and quasi program efficacy in LMICs? experimental designs and 53% used non- experimental methods (Figure 10) Key result 8: Only around three-quarters of the studies included information about programmatic evaluation. Key result 10: All but one of the high-quality studies were Less than half of the studies included experimental or in the Health sector. quasi-experimental designs. Overall, 23% of all the studies met the criteria for Of the 108 studies, 82 included outcome- or impact- inclusion in the “high-quality study” category (Figure level evaluations but the studies had varying levels 10), scoring between 6 and 8 on the Blueprints checklist, of rigor. As described above, only those 39 studies as explained in the methods section of this report. One (Figure 10) that provide moderate or highly-rigorous was a quasi-experimental study, and the others were evaluations were analyzed to answer the question about RCTs. All but one of these studies were in the Health what the evidence tells us about the effectiveness of PYD sector, with the other falling into the Democracy and programs. Information about the 43 studies that were Governance sector. Twenty experimental studies were classified as having less rigorous evaluations can be found considered to be lower quality. Of those, four studies in Appendix 3 and Appendix 9. addressed all three sectors, four addressed Health and one other sector, and one addressed both the Democracy Key result 9: Just under one-fifth of all programs—out of and Governance and the Economic Development and 108 with and without evidence—were evaluated using a Education sectors. Nine studies fell into the Health randomized control trial (RCT). sector alone, one addressed Democracy and Governance While program evaluation results were available for alone, and one addressed Economic Development and 76% of the studies. Only 23% were classified as high Education alone (Appendix 8). quality experimental studies. Less than a quarter, 24%,

Figure 10. Number of Studies by Sector and Quality

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 27 2727 Only results produced using experimental designs and Rachel Jewkes and colleagues (2006) investigated one quasi-experimental design are discussed in this whether combining a broad economic empowerment section of the report. Less than a quarter (15%) of intervention and the original Stepping Stones these studies came from grey literature; the rest (85%) intervention package that was directed to influence came from peer-reviewed papers. More than half of the gender norms and HIV prevention could reduce the programs evaluated by these studies were conducted by incidence of gender-based violence among young men universities alone (36%), NGOs alone (31%), or both and women. The intervention, called Creating Futures, (10%). The featured programs targeted adolescents was developed as a new type of economic empowerment and youth of several age groups. Many (36%) targeted intervention that enabled livelihood strengthening by youth between 10–19; a little more than a quarter helping participants find work or set up a business; it did (28%) targeted boys and girls ages 10–14; 21% targeted not give cash or loans. Creating Futures was piloted in 15–29-year-olds; only 3% targeted 15–19-year-olds two informal settlements in South Africa with 232 out- only; and 13% of the programs targeted all three age of-school youth, mostly aged 18–30, using two baseline groups (10–14, 15–19, and 20–29). Studies were surveys and mid line and endline at 28 and 58 weeks, in conducted in countries all over the world. However, they a study using an experimental design. The study found at were concentrated in South Africa (13%), India (10%), endline: and Uganda (10%). The programs also featured several • Young men’s mean earnings increased by 247% types of activities. The most common activities were and women’s increased by 278%. educational activities not led by peers (31%); however, many used peer education (23%), media (20%), youth • There was a significant reduction in women’s friend services (17%), activities with other adults such experience of the combined measure of physical as parents and teachers (18%), organization of social or sexual interpersonal violence in the prior 3 events (14%), mentoring (12%), physical activities such months, from 30.3% to 18.9%. as sports (10%), community meetings (9%), home-based • Men and women scored significantly better services (8%), and other activities (8%). on tests of gender attitudes, and men reported significantly reduced controlling practices in their Key result 11: Of 24 studies that described interventions relationships. targeting all three sectors, 15 had evaluations. Five were experimental designs, and only one was a higher-quality • The prevalence of moderate or severe depression RCT. symptomatology and suicidal thoughts among men decreased significantly. Among studies covering all three sectors, Stepping The health-related outcomes of Stepping Stones are Stones is the only program that was evaluated using an highlighted in Box 2. RCT. This program was originally designed to address HIV infection and gender-based violence. However, it Key result 13: Using a holistic PYD approach can help was classified as a cross sectoral program because some increase self-esteem, self-confidence, and self-efficacy, as of the adaptations of this program included economic well as improve SRH and HIV knowledge and behaviors. outcomes. The RCT reviewed for in this report found • An evaluation of the Empowerment and that participants had a reduced risk of herpes simplex Livelihood for Adolescents (ELA)13 program, virus 2 acquisition over two years of follow-up after which targeted 14- to 20-year-old girls in Uganda baseline. Young men in the program also showed and focused on life skills, vocational training, improvements in self-reported intimate partner violence, and recreational activities found that the program casual sex, and problem drinking during the 12 and 24 had significantly increased self-employment, month follow-ups. pregnancy-related knowledge, HIV knowledge, Key result 12: The RCT-based study of Stepping Stones and condom usage. It also found significant suggests that a holistic PYD approach to increase decreases in the probability of having had sex women’s economic empowerment and reduce the unwillingly in the year. incidence of violence among young men and women can • Questscope, a non-formal education in Jordan, successfully increase employment and reduce violence aimed to facilitate mastery and social experiences without giving cash or loans. to improve participants’ sense of self-efficacy, social skills, positive connections and prosocial behaviors (Morton & Montgomery, 2012). No significant

13 Appendix 8 shows details about activities and outcomes of the programs.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 28 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries intervention effects were found for developmental • The Bangladeshi Association for Life Skills, assets (e.g., self-efficacy or social skills), but Income, and Knowledge for Adolescents analyses show a significant, positive intervention (BALIKA) project aimed to bring change in effect on behavioral problems, with effects mostly girls’ lives and their status in the community attributable to changes in the younger (ages so that they are perceived as assets rather than 13–15) group. as burdens and liabilities to their families and • Yes, Youth Can (YYC) is a three-year USAID- to society (Amin, Ahmed, Saha, Hossain, & funded program in Kenya with the goal of Haque, 2016). In-school participants received addressing the underlying social, economic, and tutoring in mathematics and English, whereas political factors that drive youth political and out-of-school participants received computer social marginalization. The evaluation (NORAC, or financial training. All participants received 2014) found that YYC led to improved relations training on gender rights and negotiation, critical between youth and their communities and a thinking, decision making, and livelihoods skills, statistically significant increase in the tendency of and met weekly with mentors and peers in safe, participants to express trust in their communities. girl-only locations. The evaluation results suggest The evaluation also found statistically significant a significant reduction in the likelihood of child impact on the participants’ scores on the marriage as well as increased positive health, Generalized Self-Efficacy Scale, used to measure educational, economic, and social outcomes for self-esteem and self-confidence. YYC led to some girls, including building their confidence. improvements in political engagement. The use None of the programs reviewed above identified as a of community members as “mobilizers” was an PYD program. Only P.A.T.H.S was identified as PYD important factor that positively affected youth by the authors of its multiple evaluations and has the participation and engagement. However, the holistic approach that characterized the PYD framework. economic impact was moderate. Box 1 gives more details about this unique program.

Box 1. Some Evidence on PYD Outcomes: Positive Adolescent Training through Holistic Social Programs (P.A.T.H.S.)

Positive Adolescent Training through Holistic Social Programs, or P.A.T.H.S., is the only program that the implementers identified as a PYD program. This systematic review included six peer-reviewed papers that discuss findings of complementary evaluations conducted on the P.A.T.H.S. program in Hong Kong and Macau. Most of the studies were qualitative evaluations, with only one high-quality experimental study (Ma & Shek, 2010; Luk, Leong, & Au, 2012; Luk, Chan, & Hu, 2013). In both locations, the program had two tiers. The Tier 1 program is a universal PYD program in which students in secondary school participate in 10 to 20 hours of training of the core program during an academic year. In the Tier 1 Program, 15 PYD outcomes, referred to as “constructs” in this program are included in the 40 teaching units (Ma & Shek, 2010). The Tier 2 program is geared toward students with greater needs in different psychosocial domains and is implement- ed by school social work service providers (Shek, Siu, Lee, Cheung, & Chung, 2008). This intervention targets the community, individuals, and peers and addresses most of the main PYD constructs cited in Catalano, Berglund, et al. (2002). One of the program evaluations that used pre and post experimental design in Macau (Luk et al., 2012) found that 53% of the participants had significant improvement on the total scores of the Chinese Positive Youth Development Scale and the two composite scores. The first score focused on personal development and includes ten subscales (resilience, social competence, emotional competence, cognitive competence, be- havioral competence, moral competence, self-determination, self-efficacy, beliefs in the future , and clear and positive identity.) The second scored focused on psychosocial competence, which is a combination of five subscales (social, emotional, cognitive, behavioral and moral competencies.) The post-test scores for these composite scores were significantly higher than the pretest scores on the related measures. The “happiness of the family life” was found to have significant differences in the score of the program participants, which was shown to be the factor related to youth growth. In a different evaluation, Shek et al. (2008) interviewed students and teachers about the perceptions of the program in Hong Kong and found that students and teachers perceived that it had positive outcomes for the students’ well-being.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 29 2929 Key result 14: Including objectives relevant to the An RCT study aiming to improve the mental health Democracy and Governance or Economic Development and psychosocial outcomes of war-affected young and Education sectors—such as improving food security people (age 7 to 18) in the Democratic Republic of the or income level, or employment of participants in Congo showed improvements in post-traumatic stress interventions that aim to improve health outcomes— disorder (PTSD) symptoms (O’Callaghan et al., 2014). helps achieve health-related outcomes. This study assessed symptoms of post-traumatic stress reactions, internalizing problems, conduct problems, and Some programs combined objectives related to health, prosocial behavior using blinded interviewers at pre- and such as HIV prevention, with objectives related post-intervention and at a 3-month follow-up. The study other sectors, such as Democracy and Governance or assessed a family-focused, community-based psychosocial Economic Development. The multi-component HIV intervention that integrated the intervention within local prevention program, Shaping the Health of Adolescents health, education, and social systems, creating positive in Zimbabwe (SHAZ!), for example included a family interactions and community acceptance of war- comprehensive assessment of sexual behaviors and affected young men and women suffering from PTSD. biological measures (HIV and herpes simplex virus 2 incidence), while also addressing food security. The RCT • At post-test, participants reported significantly of SHAZ! showed long-term benefits (of at least one fewer symptoms of post-traumatic stress reactions year) on food security and the number of participants compared to controls. receiving their own income, reducing the risk of • At a 3-month follow-up, participants reported engaging in sex in exchange for food, money, or other large improvements in internalizing symptoms resources (Dunbar et al., 2014). and moderate improvements in pro-social scores, Street Smart was an HIV intervention program delivered and caregivers noted a moderate to large decline in to youth over a 10-week period in Uganda. Young conduct problems among the young participants. people were monitored at recruitment, as well as The Real Fathers program implemented in Uganda by four months (85% retention), and 24 months (74% the Georgetown University Institute for Reproductive retention) after the program began. Among the findings Health aimed to improve parenting skills in young of their pilot experimental study in Kampala were that: fathers (Georgetown University Institute for Reproductive Health, 2015). This intervention, • Only 48% of participants had ever been employed which focused on young fathers (age 16–25) parenting at recruitment, while 86% were employed from toddlers (ages 1–3 years) in post-conflict northern months 21 to 24 post-recruitment. Uganda, used mentoring to build positive parenting • Over two years, participating youth had decreases practices and relationship skills among the young in the number of sexual partners, mental health fathers. The study, an RCT of the 10-month program, symptoms, delinquent acts, and drug use, and demonstrated improvements in communication skills; their condom use increased. increased amount of time parents spent with their child; • The evaluation suggested that providing and improved “positive parenting,” attitudes rejecting employment, in conjunction with HIV physical punishment, and the parents’ confidence in prevention, provides sustained support to young ability to use nonviolent discipline. people to prevent HIV infection (Rotheram- Another Uganda-based program, implemented by Save Borus, Lightfoot, Kasirye, & Desmond, 2012) the Children, aimed to improve child resilience based See appendices 10 through 16 for more information on psychosocial-structured activities addressing issues of about nonexperimental studies addressing multiple safety and control, self-esteem, thoughts and reactions sectors. during danger, resource identification, and coping skills. It involved 15 in-school educational sessions and Key result 15: Programs that involve children, youth, a community service component. Topics addressed parents, and other adults working collaboratively at included safety and control, awareness and self-esteem, different levels of intervention (individual, household, personal narratives, coping skills, and future planning community) successfully help achieve health-related (Appendix 9). The experimental evaluation of this program outcomes, especially mental health-related program reported enhancement of children’s resilience outcomes. and feelings of stability and security after trauma as they progressed emotionally and cognitively over the course

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 30 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries of the program (Ager et al., 2011). Self-reported child Among the high-quality studies, nine were primarily well-being and teacher- and parent-reported measures aimed at preventing HIV or improving other SRH of improvement of children’s well-being were both outcomes, with eight of these implemented in sub- statistically significant. Saharan Africa and the others in Malaysia, Vietnam, and China. Six were implemented primarily in Key result 16: There is insufficient evidence to determine elementary and (more often) secondary schools, and what works or what is promising for interventions that three were implemented in universities and community link Democracy and Governance outcomes and Economic organizations. Education and skills development Development and Education outcomes. were the most common program features, with a Only one lower-quality experimental study jointly small number of programs also featuring community addressed these two sectors. Based in the Dominican mobilization, adolescent-friendly health services, and Republic, Juventud y Empleo aimed to improve the provision of financial support. labor market entry of young people and included • Five studies showed significant improvements in elements focused on leadership and conflict resolution knowledge (including knowledge about HIV and/ (Ibarrarán, Ripani, Taboada, Villa, & García, 2012). or other STI prevention or management) and Juventud y Empleo trained Dominican youth between attitudes (including attitudes toward unprotected 16 and 29 years of age and inserted them in the job sex, contraceptive use, and health service use), market. Youth received 75 hours of basic or life skills lower intentions to have sex, and higher self- training and 150 hours of technical or vocational efficacy (James, Reddy, Ruiter, McCauley, & training. For the technical and vocational training, the van den Borne, 2006; Li et al., 2010; Ibrahim, program offered training courses for a wide range of jobs, Rampal, Jamil, & Zain, 2012; Pham et al., 2012; such as administrative assistant, baker, hairstylist, clerk, Heeren, Jemmott, Ngwane, Mandeya, & Tyler, auto mechanic, or bartender, among others. Training 2013). was followed by an internship in a private sector firm, facilitated by the implementer, with training programs • Five studies reported significant short-term tailored to the firm´s labor demand. Although mainly reductions in self-reported risky behaviors and/or targeting youth employment outcomes, this project also increases in health service use (James et al., 2006; targeted democracy and governance related outcomes Jemmott et al., 2010; O’Leary et al., 2012; Heeren tangentially. Training also included life skills, leadership et al., 2013; Aninanya et al., 2015). and conflict resolution. Among the positive labor • The Life Skills and HIV/AIDS Education market outcomes, the study reported positive effects for Programme (James et al., 2006) found participants, such as finding employment with a written improvements in knowledge, attitudes, and contract and with health insurance, as well as increase in perceived social support as well as reduced sexual monthly earnings for men and women. The study also activity in the past six months among program reported decreased pregnancy among female participants participants. and positive perceptions of health, better education, HIV and/or SRH was also a common focus of the and better expectations for the future among men and interventions in the studies that used lower-quality women, as well as increased leadership, self-esteem, and experimental designs, which included school-based HIV self-organization. prevention programs implemented in Vietnam (Kaljee et Of the 39 studies grouped in the Health sector, 14 were al., 2005), Panama (Aramburú et al., 2012), and India high-quality experimental studies, and nine were low- (Chhabra et al., 2010). These programs focused on quality experimental studies. Fifteen percent (15%) of provision of information and skills training and showed the studies were non-experimental. beneficial effects on knowledge, attitudes, and self- efficacy (see Appendix 4). Key result 17: Provision of information and skills training showed beneficial effects on HIV and SRH- related knowledge, attitudes, and self-efficacy.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 31 3131 Box 2. Positive Evidence on SRH Outcomes: Stepping Stones

The review included two studies reporting on evaluations of Stepping Stones, one an RCT in rural South Africa and the other a complementary qualitative study. Though Stepping Stones was first developed for Uganda (Welbourn, 1995), Tina Wallace (2006), who reviewed 27 evaluations of the program, found it had been used in more than 100 countries, with its curriculum translated into Khmer, Amharic, French, Spanish, Portuguese, Russian, and Kyrgyz. Based on several theories of behavioral change, including models of critical reflection, Stepping Stones aims to prevent HIV by improving sexual health through building stronger, more gender-equitable relations with better communication between partners (Jewkes et al., 2006). This approach targets the individual, couple, household and communities. The version of Stepping Stones applied in South Africa (Jewkes et al., 2006) used a manual with 13 core sessions that covered love; sexual health and its joys and problems; body mapping; menstruation; contraception; sexual problems; pregnancy; HIV; sexually transmitted diseases; safer sex; gender-based violence; motivations for sexual behavior; and dealing with grief and loss, including building assertive skills. Jewkes et al. (2008, 2010) found that Stepping Stones enabled the intervention participants to reduce their risk of herpes simplex virus 2 acquisition by one-third over two years of follow-up. It also reduced intimate partner violence by male participants. However, this evaluation did not find any statistically significant effects on HIV reduction. The qualitative research showed that Stepping Stones generally empowered participants to take control of different aspects of their lives and apply their cognitive skills, as well as to positively influence their peers.

Mental health Palosaari, Diab, & Punamäki, 2012). These four Key result 18: There is promising evidence about interventions involved a series of five to 20 educational school-based therapy interventions increasing pro- and skill-building sessions (typically based on cognitive social behaviors, coping skills, and life skills. However, behavior therapy or coping skills training). evidence about what works to reduce depression All five studies reported beneficial effects on various symptoms is still limited. aspects of well-being and psychological adjustment One high-quality study in the area of mental health or behaviors (e.g., conduct problems and pro-social in young people looked at a universal (aimed at all behaviors). students) school-based cognitive therapy intervention Substance use in Chile that sought to reduce depression symptoms (Araya et al., 2013). It found that the intervention did Key result 19: Interventions that conduct educational not lead to reductions in depressive symptoms and led activities and develop life and self-efficacy skills in youth to only clinically insignificant reductions in anxiety. significantly reduce substance use. Based on the conclusions of this RCT and the literature, Three high-quality studies aimed to reduce substance the authors of this study suggest that classroom-based use, including use of tobacco. One of these, the keepin’ interventions may not reach the intensity needed to it REAL program, was implemented in Mexico and achieve effects on depression outcomes or that it might involved a 10-week education and skills development not be possible to teach complex skills in large groups intervention (Marsiglia et al., 2014). Box 3 gives more and during a limited time period. The lack of evidence details about this program. in this field suggests that a note of caution must precede the introduction or continuation of school-based mental • Short-term results showed slight decreases in health interventions. frequency of alcohol use in past month. Five studies that addressed mental health promotion • Longer-term (two years later) results showed (defined broadly here to include resilience and suicide- decreases of alcohol use and smoking in the past prevention interventions) had lower-quality experimental month with the use of booster sessions (Marsiglia, designs. These include a Hong Kong-based school Kulis, Booth, Nuño-Gutierrez, & Robbins, 2015). resilience program (Wong et al., 2009) and school- A study of a school-based intervention implemented in based coping and life skills education programs in Taiwan that involved ten 45-minute sessions delivered India (Leventhal et al., 2015), Cambodia (Jegannathan, over 16 weeks and booster sessions 6 and 12 months Dahlblom, & Kullgren, 2014), and Gaza (Qouta, after completion of the program aimed to prevent

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 32 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries smoking. Another program with similar outcomes was In these three studies, evaluators found improvements a peer-led school-based smoking prevention program in attitudes, perceived behavioral control, life skills, and in Romania. A final school-based program in Costa behavioral intentions (Guo, Lee, Liao, & Huang, 2015) Rica aimed to diminish drug use among students as well as improvements in knowledge, self-efficacy, and through improvement in life skills showed changes in smoking behaviors (Bejarano, Ugalde, & Morales, 2005; knowledge, positive communication, and self-esteem. (Lotrean, Dijk, Mesters, Ionut, & De Vries, 2010 ). Box 3. Evidence Shows Promising Results to Reduce Substance Use: keepin’ it REAL

Two evaluations of keepin’ it REAL, conducted in Mexico (Marsiglia et al.,2014; Marsiglia & Booth, 2015), were included in this review. These papers discussed the results of the pilot evaluation and the 1-year follow-up of the program conducted in high schools in Guadalajara, Mexico. The developers of keepin’ it REAL based the curriculum on communication competence theory (Spitzberg & Cupach, 1984). The main goals of the program were to increase young people’s drug resistance skills and promote anti-substance-use norms and attitudes (Marsiglia et al., 2014). The intervention used a 10-week curriculum and videos that taught students four resistance strategies—Refuse, Explain, Avoid, and Leave (REAL)—that were used most commonly by youth in the United States and Mexico (Kulis et al., 2009, 2014, 2015; Marsiglia & Hecht, 2005; Marsiglia et al., 2009). The results of the initial RCT of keepin’ it REAL in 35 schools in the southwestern United States demonstrated that the program contributed to reduced alcohol and marijuana use and increased refusal confidence (Hecht et al., 2003). These findings led researchers to consider the adaptation of this intervention to Mexico. The researchers trained social studies teachers to deliver an adapted and translated curriculum and dubbed videos. In an RCT, students from two middle schools in Guadalajara, Mexico, completed surveys at baseline, immediately after completion of keepin’ it REAL, and 8 months after program completion. Desired intervention effects were seen for alcohol use, in both the short and long term, and for cigarette use in the short term and marijuana use in the long term. These desired intervention effects were generally greater for girls than for boys (Marsiglia et al., 2014; Marsiglia et al., 2015).

One high-quality study looked at a school-based some physical activity tests and in the percentage intervention in Ecuador that aimed to improve diet and of participants who met the recommendations for physical activity called ACTIVITAL (Andrade et al., appropriate levels of physical activity given by the 2014). It involved an educational package delivered in program staff. classrooms that included workshops with parents, social events at school, and school environment modifications. Democracy and Governance ACTIVITAL was developed using participatory Key result 20: Only two studies provided evidence approaches and tailored to the Ecuadorian school of effectively achieving Democracy and Governance context. The program was assessed for effectiveness outcomes that were not linked to other sectors. on one set of the primary outcomes—physical fitness, screen time, physical activity—and the effect on body Five studies (5%) addressed Democracy and Governance mass index (BMI) as a secondary outcome. Outcome alone, including one high-quality RCT, one lower- measurements were performed when students entered quality experimental study, and three nonexperimental the eighth and ninth grades, and after 28 months, at the studies. end of the academic year. Medical doctors, nutritionists, One high-quality study, of the Parivartan program, was and health professionals with field experience received identified in this sector (Miller et al., 2014). This quasi- a 40-hour training session to assess outcomes. Program experimental study, which aimed to improve adolescent activities involved students, teachers, and parents males’ gender attitudes and increase positive bystander performing physical activities, organizing social events, behaviors, is described in Box 4. and using media. Results showed improvements in

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 33 3333 Box 4. Positive Evidence About Gender Norms: Parivartan

This systematic review included two peer-reviewed papers reporting on Parivartan, an innovative program implemented in Mumbai from 2008 to 2012. The program, modeled after the Coaching Boys Into Men program implemented in the United States by Futures Without Violence (formerly Family Violence Prevention Fund), drew in young men and boys through cricket clubs. It used male coaches to train boys to challenge and question traditional notions of manhood in their society and teach them about respecting women and girls and preventing perpetration of violence against them. The Mumbai program evaluation collected baseline and midline data (at 12 months) and found that participants’ agreement with statements about traditional masculinity and manhood declined from baseline to follow- up, indicating positive effects on gender-equitable beliefs. After the adaptation to Mumbai, the International Center for Research on Women developed “Parivartan Plus” as part of the UK Department for International Development’s STRIVE effort, which aimed to address structural drivers—such as poverty and HIV-related stigma—that continued to fuel the AIDS epidemic. Parivartan Plus took place in rural Karnataka in southern India and again in Shivaji Nagar, the Mumbai slum community of about 600,000 residents. Since then, it has been adapted to several locations in India.

The one lower-quality experimental study fell under the One lower-quality experimental study assessed the Democracy and Governance sector. This was a school- Akazi Kanoze youth livelihoods program in Rwanda based violence prevention program implemented in Iran (Alcid, 2014), aimed to enable youth to be more (Ekhtiari, Shojaeizadeh, Foroushani, Ghofranipour, & capable of earning a livelihood through appropriate Ahmadi, 2012). It involved education and skills training and relevant connections to life and work readiness accompanied by information for parents, training for training, opportunities, market actors, and skills. In school counselors, and coordination with counseling addition to the core curriculum, Akazi Kanoze offered services. At baseline, both qualitative and quantitative youth access to specialized workforce development studies consistently confirmed lack of necessary skills training and resource programs. The program behavioral skills for prevention of domestic violence provided all participating youth with access to workforce among high school girls, whom this program targeted. linkage opportunities (internships and apprenticeships), The mean of preventive behaviors score immediately formal sector jobs, and entrepreneurship and other after and two months after the intervention were livelihood opportunities. Internships provided on- significantly higher in the intervention group than in the the-job experience and in some cases led to full-time control group. employment. The evaluation of Akazi Kanoze found that a higher percentage of youth were employed in the Key result 21: Only two studies provided evidence of intervention group compared to the control group. The effectiveness to achieve Economic Development and program increased the ability of youth to apply for a job Education outcomes. and the ability to develop a business plan and understand Four studies (4%) addressed Economic Development marketing techniques, attracting customers. Finally, the and Education alone: one high-quality RCT, one lower- program was found to have increased the likelihood of quality experimental study, and two non-experimental participants having savings. studies.

The Peruvian Job Youth Training Program (Projoven), implemented between 1996 and 2010, was evaluated by Díaz and Rosas (2016). The evaluation did not find a statistically significant impact of Projoven on employment but did find effects on the quality of employment (formal employment). Specifically, the probability of having a job with health insurance and the probability of having a pension increased by 3.8 and 3.3 percentage points, respectively, for the intervention group compared to the control group (Díaz & Rosas, 2016).

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 34 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Chapter 4 discussion

PYD is an appealing philosophy with applications The team was encouraged to find PYD strategies being across a very wide range of important outcomes for employed in pursuit of a wide range of outcomes, young people. Simply put, if young people have the including health, education, employment, conflict knowledge and skills they need, have the opportunity to resolution, violence prevention, gender equality, and harness these skills and leadership opportunities, and are civic engagement. Schools and job training programs are supported by key actors, systems and structures in their the environments in which many young people spend respective environments, they will more likely thrive as much of their time. PYD programs in those settings are adults. Strengthening positive development of youth in often designed to make the settings more supportive, high-income countries has been shown to contribute to safe, and productive. Safety and productivity are directly good health, productive employment, meaningful civic related to PYD efforts in pursuit of violence reduction contributions, and happy families, all of which foster the and capacity building for civic engagement. Efforts to positive development of successive generations. reduce the spread of HIV and other STIs by promoting positive development more broadly among young Our goals in this review were first to describe PYD women have not only affected SRH but also resulted in programming in LMICs and then to understand the reductions in food insecurity and increases in having an evidence regarding the efficacy of this approach in income (Dunbar et al., 2014). Programming designed these settings. After extensive search procedures, 1,075 to improve economic conditions through job training documents in the peer-reviewed and grey literature were and internships has resulted in significant improvements identified which described evaluations of PYD programs. in labor market outcomes, but also has reduced positive Of these, only 108 were from LMICs. In this chapter, attitudes toward early child-bearing among young the team first discusses the wide variety of activities these women and improved conflict resolution behaviors for programs used and then provide some thoughts on the both men and women (Ibarrarán et al., 2012). The wide quality of evidence and the impact of programs where range of targeted outcomes also emphasizes the broad high-quality evidence exists. appeal of using PYD strategies in LMICs. PYD programs are new to LMICs, but A variety of PYD outcomes were have broad appeal. targeted and a variety of activities used. As described extensively in this paper, our search yielded The team found that almost all the PYD programs almost 100 separate PYD programs in 60 low and reviewed targeted one or more PYD outcomes in the middle-income countries that had solid evaluations. Assets domain, most often some kind of knowledge (e.g., These relatively few programs were spread out across the math, science, health), combined with other transferable globe, and most of the 60 countries had only a few PYD competencies, such as social skills, emotional regulation, programs. This geographical variability affirms that PYD and problem solving. It was especially encouraging programming has broad appeal and that youth in every to see that programs were also likely to target youth part of the world, from every culture, facing a wide range outcomes in the Agency domain, such as self-awareness, of challenges, can benefit from more knowledge, stronger self-determination, leadership abilities, and positive skills, leadership opportunities, and more supportive behavior. environments. Finding so few program evaluations of PYD programs in LMICs is indicative of how very Programs focused on Assets and Agency are primarily recently PYD strategies have been introduced into youth concerned with the individual young person. At the programming in LMICs, as well as how infrequently same time, however, PYD programs can benefit from such programs are evaluated. having a supportive environment and supporting a

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 35 3535 young person’s engagement with those in the world By intentionally targeting outcomes across several around them. A large majority of the PYD programs sectors, PYD programs hold the promise of increasing included in this study addressed the Enabling the return on prevention investments. It is more efficient Environment in some way to support the positive to target factors that predict many outcomes than those development of youth. Often this was done by trying that predict only one or two. A PYD approach has the to shift social norms and societal structures away from benefit of linking theory to evidence that strengthening unhealthy practices—such as child marriage, drug use, youth development leads to a wide range of positive violence, and unsafe sex—toward healthier norms and adult outcomes in education, employment, social attitudes. Less common, but still present in half of the relationships, and reductions in substance use and other programs, was an emphasis on supporting youth to make behavioral health problems (Catalano, Berglund, et al., a Contribution through engagement in community and 2002; Gavin, Catalano, David-Ferdon, Gloppen, & leadership. Youth who have knowledge and skills, but Markham, 2010). no opportunity or experience using them, may have a harder time capitalizing on these assets. A large part of To assess the full benefits of PYD programming, future being a successful adult involves making a contribution evaluations should measure a wide range of outcomes to the well-being of not only oneself but also others in across sectors. PYD programs ideally strengthen the larger community. To achieve this goal as an adult, multiple PYD outcomes (e.g., specific and soft skills youth need opportunities to practice and fail and/or and norms), preferably with multiple targets (e.g., succeed as agents of change. About half of the programs youth, teachers, civic leaders) and in multiple ways. In the team found explicitly targeted increased youth addition to the direct costs of implementing complex engagement and/or leadership as an outcome. interventions, the developers and implementers of such interventions must have a broader range of skills and Consistent with the emphasis on imparting knowledge, resources than is necessary for more limited or highly more than 80% of the programs employed adult- focused interventions, which teach only one skill or led educational activities with youth as the direct provide only one type of support. However, the payoff beneficiaries. More than half of the programs used is that PYD programs have the potential to improve peer-led education, often in conjunction with adult- the lives of young people in a wide variety of ways. led activities. Programs designed to increase the Improvements in educational outcomes, economic well- supportiveness of the environment often included being, reductions in health risks, and environmental activities for teachers and service providers, or organized burdens all contribute to community-wide health and social events or community meetings. It was much well-being. less common for programs to organize parent–youth activities or conduct any of the activities in the home. Unfortunately, none of the program evaluations the When in-home activities were included, they often took team identified provided sufficient information on the form of “homework” assignments for the youth to do financial costs or benefits to assess whether investments with their parents as a way to engage parents in the PYD in PYD programs are cost-effective. In the absence programming goals. of cost–benefit analysis studies, the team can only speculate that benefits outweigh the costs. Furthermore, PYD programs are effective in cross assessing the return on investments of PYD programing sectoral programming, but more robust in LMICs will require measuring a much wider variety evaluation is needed. of outcomes than is typically done in development programs. Because programming is most often funded For the purposes of this review, the team organized within a single sector (such as Health) to target a single programs into three broad sectors, and found some outcome (such as HIV infection), program evaluations evidence of efficacy for PYD strategies in each of these often include indicators of the targeted outcome only, sectors. Not surprisingly, a concentration of PYD potentially failing to demonstrate important benefits that program evaluations is in the Health sector, where PYD programming may have on other outcomes. preventing the spread of HIV and improving SRH have been the focus of a great deal of international From over 1,000 initial PYD resources, the team development funding and attention in recent years. identified only one cross sectoral PYD intervention in an However, because PYD strategies focus on strengthening LMIC with a high-quality evaluation (Stepping Stones) the ability of youth to accomplish critical developmental and a few others with slightly less rigorous evaluations. tasks, these programs are expected to have positive The dearth of more high-quality evaluations, particularly impact across a range of outcomes. This makes PYD a for cross sectoral PYD programs, highlights two good choice for cross sectoral programming. problems. First, there simply are not enough PYD A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 36 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries programs designed to work across sectors. Second, variety of contexts and circumstances. Although youth those that exist have not been sufficiently evaluated with all over the world can benefit from PYD programs, just appropriate measures of outcomes across sectors. exactly what is most helpful to individual young people varies widely across contexts. PYD programming can Some PYD programs focus on be designed to address factors specific to a particular or address gender equality and context. Where cultural norms are damaging (norms empowerment for girls and women. such as gender inequality or early marriage), PYD programs may assist in helping to overcome these Less than half of the PYD programs included in this challenges, working at the community level, for example. review focused on gender equality or empowerment. In other settings where environmental conditions are Many others at least acknowledged the need to more favorable to youth development, the focus might disaggregate impacts by sex. Programs that primarily be on the development of soft skills, which are useful in target activities to males and females separately were work, family, and community involvement. The various found to be most effective in reducing gender inequality. programs included in this study help to demonstrate Stepping Stones uses gender-segregated groups followed the variety of ways in which PYD might be applied in by periodic cross-gender group meetings to discuss different contexts. issues and practice skills. This approach allows open For example, the Program to Improve Reproductive same-sex discussions to assist with changing norms and Health in Nepal (Mathur, Mehta, & Malhotra, 2004) behaviors among young men and women separately. has multiple components, including youth and adult Cross group discussions can then occur, and together the peer education, community information and education mixed-gender youth groups directly appeal to the larger campaign, youth clubs, teacher education, and supports community for help in supporting and facilitating their for employment opportunities. Trusting in Youth pursuit of healthier, safer lives. in Zimbabwe (Mercy Corps, 2015) combines job Some programs in cultures where girls have little or no training, business skills, life skills, gender awareness, and power over their own lives use female-only organizations community service (including advocacy and leadership). to focus resources on girls to reduce the resource Familias Fuertes in Bolivia, Colombia, and Ecuador gap between males and females (Amin et al., 2016; (Orpinas et al., 2014) is one of the very few programs Bandiera et al., 2015). This approach is particularly the team found that conducts workshops with parents suited to the goals of reducing child marriage and early and their children. Programa Para o Futuro – Youth pregnancy because the “women only” settings provide Women in Action in Brazil (Network-Brasil, 2012), a safe place for honest discussion of sensitive issues. combines employability training with life skills and Evaluations support the value of having young women educational skills for adolescent girls and young women mentor younger women. The mentors benefit from the and uses technology to connect young women to leadership experience in addition to making a valuable professional women who serve as mentors. Results from contribution to their communities. The recipients evaluations of these varied programs all showed evidence get skills training, which is reinforced by reflecting on of success across a number of outcomes. their own experience and practicing communication, Taken as a whole, there are examples of evaluated problem solving, and other skills with their mentors. programs addressing each of the domains of youth This facilitates forming bonds with mentors and other development, developing and strengthening assets and girls and women in their communities, and it builds self- skills, increasing youth agency, and strengthening the efficacy. supporting environment. The results have included Some promising approaches focus on changing the positive impacts across a range of outcomes, including attitudes and behaviors of young men. Male-only education, sexual risk behavior, early marriage, violence, interventions, such as Parivartan (Miller et al., 2014), and job skills and employment, among others. Several can focus on shifting the norms and behaviors of young of the approaches also demonstrate promise for PYD men away from disrespectful behavior toward girls and in increasing gender equality. As with the reviews of women though discussion and examples set by older and PYD in HICs, this review concludes that, while there is respected men in the community. promise for the PYD approach, there is still much to be learned. USAID’s significant investment in PYD and One size does not fit all. its evaluation should contribute greatly to the global knowledge base of effectiveness of the approach. One of the strengths of PYD as a framework for interventions in LMICs is that it is adaptable to a wide

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 37 3737 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 38 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Chapter 5 conclusions and Recommendations

Conclusions Enabling Environment) as well as their targeting of multiple outcomes within each of these This systematic review set out to answer two main domains. Most programs addressed more than research questions: one PYD domain, and 35% targeted all four PYD • How have PYD approaches been implemented in domains. Almost all programs helped build assets LMICs? among youth (99%), and a majority fostered an enabling environment for youth development • What does the evidence say about the effectiveness (86%) and addressed youth agency (80%). of these approaches? Approximately half of all programs addressed In the next section, conclusions are categorized by these youth political and social contributions to their two guiding research questions. communities. How have PYD approaches been implemented in • PYD programs are implemented across LMICs? sectors, across age groups, and by gender. In categorizing PYD across sectors, the USAID • Although youth-serving organizations technical bureaus and their respective sectors serve implement PYD programs across the globe, as a useful framework. A majority of the programs very few programs self-identify as PYD. Our reviewed (79%) addressed issues related to Health, analysis of 108 peer-reviewed and grey literature while others addressed Economic Development studies identified 97 PYD programs that have and Education (46%) and Democracy and been or are being implemented across 60 LMICs. Governance (44%). HIV/AIDS (44%) and There was a geographic concentration of programs SRH (39%) were the most commonly targeted in South Africa (13), India (8), and China (8), subsectors. Programs most often targeted youth three countries whose economic growth has ages 10–19. The majority of studies (76%) distinguished them from other LMICs. However, documented programs that targeted both male only 11% of programs self-identified as PYD, and female youth (12% targeting female youth indicating that although they may incorporate only and 3%, male youth only), and over 40% elements of PYD into their program design, of studies reported information indicating the program implementers are likely not aware of integration of gender issues in the programs they the existing literature and evidence relevant to evaluated. However, many of these programs PYD from HICs. Helping programs understand are not gender-transformative in that their that PYD is a validated approach can help them programming does not explicitly recognize and apply PYD theories and strategies, self-identify challenge gender norms and inequalities. as PYD, and contribute to evidence base. By not self-identifying as PYD, programs are less likely to • Programs implement a diverse array of activities contribute to the growing evidence bases of PYD across multiple domains, distinguishing PYD in LMICs. from other approaches to youth development. Adult-led educational activities were the most • Most PYD programs address multiple PYD frequently implemented activity type (81%) domains, and nearly all programs help youth among PYD programs reviewed. Fifty eight to build assets. Programs were identified as PYD percent of the programs used peer education and based on their focus on one or more of the four 49%, media engagement. As expected, this review PYD domains (Assets, Agency, Contribution,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 39 3939 did not find any PYD programs that conducted • The review found few instances of longitudinal only one type of activity; rather, most undertook studies or evaluations of PYD programs. The multiple activities with youth. Indeed, it is the vast majority of evaluations identified in this combination of activities addressing multiple review had a short-term follow-up or follow-up constructs across domains that distinguishes PYD conducted immediately after a PYD program was from other approaches. completed. As such, these evaluations do not What does the evidence say about the capture the long-term effects of PYD on a range effectiveness of PYD programs? of outcomes. Evidence from HICs shows that shifts in youth-related outcomes, which include Key findings from this assessment of evidence from PYD both individual and community-wide outcomes, programs are described in three categories: evidence can persist over time. For example, Project quality and availability, the effect of PYD on youth P.A.T.H.S and Life Skills Training programs in the development outcomes, and emerging traits of PYD United States demonstrated continued positive programs with positive results. effects on youth behavior, including improved Quality and availability of evidence related to PYD interpersonal skills and decision making (Life Skills Training), higher capacity for managing • Although evaluations were available for a one’s reactions in social and emotional situations, majority of programs included in this review, greater self-efficacy with creating new solutions to their quality varied; stronger evaluations were problems, and increased empathy, as in the case found largely in the Health sector. Evaluations of the P.A.T.H.S program (Catalano et al., 2004). were available for 74% of all identified PYD In LMICs, the lack of longitudinal evidence studies. However, only 18 studies (17%) met constitutes a significant gap in the evidence base, the criteria for inclusion in the “high-quality as impacts on PYD outcomes may most often evaluation” category, with 11 of these focused manifest over a time horizon that is longer than only on Health and 5 including Health and the duration of an intervention. another sector. Only two high-quality studies fell completely outside of the Health sector, one The limited amount of rigorous evidence related to PYD on Democracy and Governance and the other on programs in LMICs leaves major questions about “what Economic Development and Education. works” unanswered. However, some programs that have been rigorously evaluated, particularly in health, have • There is a lack of robust and consistent been found to produce significant positive effects on measurement of PYD outcomes. Despite outcomes related to health knowledge, attitudes, and the presence of PYD programming in LMICs, behaviors. Key findings related to PYD effectiveness evaluations tended to measure only sector across sectors are described next. or sector-specific outcomes (e.g., increased knowledge of HIV), rather than PYD outcomes • There is limited evidence available from cross (e.g., increased self-regulation). Evaluations sectoral programs on the impacts of PYD generally focus on a single outcome of interest programming across sectors. However, the specific to the main sector under which programs little evidence that does exist suggests that are implemented instead of accounting for the PYD has the potential for meaningful impacts impact of PYD on a wide range of outcomes as across sectors. The Stepping Stones program— has been seen in HICs. For example, evaluations which along with a complementary livelihoods of youth workforce development interventions intervention (Creating Futures) focused on have tended to focus on program impacts on outcomes related to HIV infection, gender- labor market outcomes, such as job placement based violence, and livelihood strengthening— rates, rather than on PYD outcomes, such as self- produced impressive results. However, the higher regulation, positive identity, and self-efficacy. The quality evaluations of this program did not find lack of comprehensive measurement across PYD statistically significant results of HIV. While data outcomes is a major barrier to advancing PYD from lower-quality studies demonstrate similarly as an evidence-based, cross sectoral approach to positive results, additional rigorous evidence is youth programming. needed to strengthen the evidence base regarding the added value of cross sectoral programs (Jewkes et al., 2014).

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 40 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries • Several health-focused PYD programs have outcomes of interest for the economic growth resulted in improved knowledge and attitudes sector. Only one program evaluated impacts about SRH, as well as a short-term reduction related to the environment, and none focused of risky behaviors. Nine out of 17 health specifically on LGBTI youth, suggesting a need for program evaluations (53%) that were identified more studies in these areas. as “high-quality” focus on preventing HIV or Although the available evidence does not allow for improving other SRH outcomes. Of these, five a complete understanding of the effects of PYD studies showed statistically significant changes in programming with respect to measures such as effect knowledge (including knowledge about HIV and size or direction of causality, it is possible to identify other STI management) and attitudes (including some commonalities. The following traits listed require attitudes toward unprotected sex, contraceptive more rigorous testing to fully understand their effect use, and health service use); intentions to have sex; on PYD outcomes, but these innovative and thoughtful and self-efficacy. Five studies reported statistically approaches appear to have contributed to positive significant short-term reductions in self-reported results and can inform future programming—namely, risky behaviors or increases in health service use. promising PYD programs: These studies suggest that PYD approaches can lead to improvements in youth health behaviors • Adopt a systematic approach to youth related to SRH. Evidence on outcomes in mental programming by engaging with numerous health and physical activity is less conclusive. stakeholders and working across multiple • Some PYD programs have led to shifts in settings. Many promising programs identified gender norms and attitudes. The evidence, in this review go beyond individual youth as though limited, suggests that some programs the target beneficiary, also working directly with have improved gender-related outcomes in community members to ensure a more positive LMICs. One high-quality, quasi-experimental enabling environment in which youth can thrive. study of the Parivartan program demonstrated This is particularly true of programs that tackle overall improvements in attitudes about gender issues related to gender, many of which target among male youth. Programs in Bangladesh, stakeholders other than young women (e.g., male Iran, Uganda, and beyond similarly demonstrated peers or community elders) to achieve broader positive effects related to economic and social environmental shifts in gender norms. In addition empowerment of young women, as well as to involving a diversity of stakeholders, many reductions in gender-based violence. This programs operate in different settings—such as evidence illustrates the potential of PYD to affect schools, community centers, and households— gender-based outcomes positively across diverse and through media outlets. As a result, their contexts. However, far more evidence is needed to dissemination of content to target beneficiaries is establish concrete links between specific program often far reaching. activities and shifts in gender-focused outcomes. • Teach transferable skills and knowledge to • Lower-quality evaluations have demonstrated youth to support positive outcomes across positive effects of PYD programs on sectors. While more traditional types of assets— employment, skills development, and financial such as technical, vocational, and academic behaviors. Though high-quality evaluations that skills—are featured across PYD programs, the measure outcomes related to economic growth combination of these traditional assets with were not available, a number of lesser quality transferable competencies, such as socioemotional experimental studies show promising results. An and problem-solving skills, is what differentiates experimental study of Akazi Kanoze, a youth PYD approaches. In addition, promising livelihoods program in Rwanda, demonstrated programs address constructs under the Agency improvements in employment outcomes, domain, such as self-awareness, self-determination, expectations of employment, and savings. leadership abilities, and positive behavior. These Similarly, a nonexperimental study of a Colombia- cross sectoral competencies are at the core of PYD based program involving vocational training as a holistic approach. activities and internships reported improvements • Include innovative, youth-centered, and in employability, job quality and retention, and youth-led activities. Traditional, adult-led self-esteem. More rigorous evaluation is needed educational activities remain the most widely to determine best practices for PYD as it impacts implemented activity type in PYD programming.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 41 4141 However, programs are increasingly enlisting communities of practice, as well as PYD-focused youth themselves to contribute or lead through events and gatherings. approaches such as peer mentoring. Additional • Engage youth and community stakeholders innovative, youth-centered approaches include throughout program design and community-level meetings and discussions, as implementation to garner buy-in and well as the creation of safe and youth-friendly strengthen the enabling environment. PYD spaces where youth can freely express themselves programming is most effective when it is shaped and engage in social and cultural activities. by young people’s own ambitions, desires, and Many of the programs identified as having the interests. Several effective PYD programs involve greatest impact on youth development outcomes multiple actors (including youth as well as implement a combination of these approaches. adults) from targeted communities in the design Recommendations and implementation of interventions. Program implementers should consider early contributions The Team prepared recommendations for funders, to program design by youth to foster increased implementers, and researchers engaged or interested buy-in and stronger overall youth engagement. In in PYD programming in LMICs. Recommendations addition, programs should engage key community address program design, directions for investment and stakeholders in the design and implementation of evaluation and learning. interventions. Multi-stakeholder programs can contribute to more sustainable, long-term effects Recommendations for program design by creating a stronger enabling environment. • Leverage evidence on the effectiveness of PYD This is a crucial and often overlooked aspect programs in HICs and, increasingly, LMICs, of PYD: the environment surrounding youth, to improve the design of programs that target including local community members and culture, youth. Expanded awareness about—and explicit plays a significant role in their ability to develop identification of—PYD as an approach is needed. positively. As described earlier, the low number of programs • Promote youth-led and youth-centered specifically identified as “PYD” suggests that approaches. The emergence of youth-centered the PYD approach is occurring organically, not and youth-led approaches is an encouraging necessarily intentionally or with guidance from development in youth programming. Further existing literature and practice. The program expanding activities that empower youth to play a approaches cited in this review should be leading role in their own development, as well as considered as new PYD programs are designed and that of their peers, could improve PYD outcomes, implemented. However, given the lack of solid particularly those relevant to the Contribution evidence across a sufficient number of programs domain. Mentoring activities (including peer- in LMICs, implementers should also build on the mentoring), for example, allow both the mentor established PYD literature from HICs. and mentee to develop peer relationships and Improvements in PYD implementation can be contribute to their communities. Youth centers, fostered through more effective sharing of impact such as the ones developed for the BALIKA evidence, best practices, and lessons learned. program, can lead to the development of peer Donors and researchers can play an important relationships, self-expression, and sociocultural role in increasing awareness of PYD among LMIC competencies. Furthermore, as noted in the implementers by supporting the development of YouthPower Learning technical brief14 on PYD toolkits and guidelines, as well as conducting targeting, recruitment, and retention of youth in more rigorous evaluation of PYD programs. skills building development initiatives (2016), Funders can also more explicitly adopt the PYD these approaches can also improve program framework for youth development and encourage attendance and reduce dropout rates. Funders grantees and partners to shape program design can play an important role in promoting such around PYD concepts and outcomes. Joint approaches by providing incentives and developing learning could also be encouraged through guidelines for implementing specific youth- peer learning networks, working groups, and centered and youth-led activities.

14 https://static.globalinnovationexchange.org/s3fs-public/asset/document/Brief_5_PRINT_VERSION_edited_2-17%20pdf.pdf?OLlSfoHvmvZHMGUYlKoJm po4B3SKP94g A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 42 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Recommendations for programmatic investment in LMICs. Deliberate attention to these groups • Consider expanding PYD programs working in is crucial to ensure these marginalized groups are sectors where efficacy is supported by rigorous provided with opportunities to develop alongside evidence. A number of high-quality evaluations their peers. Funders should consider providing of PYD programs working in HIV reduction incentives for programs to incorporate more and SRH have produced convincing evidence of inclusive approaches. impact on knowledge, attitudes, and behaviors, • Further gender integration in PYD particularly related to adolescent SRH and gender programming is crucial. Issues related to gender norms. Programs focused on these sectors and must also be further incorporated within PYD outcomes could be expanded to reach more youth. programing. Although research has found some • Invest in expanding the evidence base by PYD programs to have positively influenced testing promising approaches, including those gender norms and attitudes—and indeed, many working toward improved youth employability featured youth programs include some gender- and livelihoods. While some positive results based distinction in outcomes measurement— have been linked to improvements in youth PYD programming should more deliberately employability and livelihoods, further testing of attempt to understand and address the effect PYD programs focused in these areas is necessary. of gender roles, restrictions, and hindrances on Empirical evidence is also required to more desired outcomes. Ideally, programs would be robustly determine the value of cross sectoral designed with the explicit goal of transforming programming. While programs like Stepping gender norms and achieving gender equality. Stones show promising results, a wider sample of Recommendations for evaluation and learning high-quality evidence is crucial to understanding • Process and impact evaluations of PYD the impact of such programs. programs in LMICs require more strategic Funders and researchers must work together development and far greater investment. in expanding high-quality evaluations of PYD Because PYD programming in LMIC is in programs beyond health. The Partnership to the very early stages, substantial evidence gaps Strengthen Innovation and Practice in Secondary limit our understanding of the effectiveness Education15 and Research for Improving Systems of PYD approaches. Implementers, funders, of Education16 are two examples of funder-led and researchers alike can play important roles initiatives that invest in high-quality evaluations in advancing programs to ensure more robust and research in the education sector. Similar evaluations that provide evidence of programmatic initiatives could be established for PYD, within impact. Figure 11 outlines steps to produce and across sectors. stronger evidence that will help support future • Consider ways to make programs more programming. Obtaining more robust evidence inclusive of marginalized groups, including on the impacts of PYD programs does not LGBTI, indigenous and disabled youth, ethnic always require investing in experimental design minorities, youth offenders, and many others. evaluations. Instead, a stepped approach While PYD as an approach can be effectively to program design and testing should be applied to all youth, programming also can be adopted to help ensure that programs can be tailored to serve marginalized groups. This review evaluated at various stages of development and found a major gap in the inclusion of marginalized implementation. youth, including (but not limited to) LGBTI, indigenous, and disabled populations in programs

15 http://psipse.org/ 16 http://www.riseprogramme.org/

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 43 4343 Figure 11. Six Steps Toward Program Scale-up

The framework described in Figure 11 supports outcomes, which are intermediary in nature. a process of learning and adaptation, starting This implies that programs and implementers from the early stages of a program’s life, are still largely fixed on a sector- or issue-based which can help to prepare the program for framework of youth development, as opposed to an experimental evaluation and ultimately to the more holistic perspective embodied by PYD. reach more beneficiaries at scale.17 Because of As a result, little research is available on how PYD the variation in levels of development of PYD programs affect PYD outcomes, in contrast to programming documented throughout this report, sector-specific outcomes such as HIV rates or, in implementers, researchers, and funders should the case of economic growth, job placement rates. 18 consult this framework and others to effectively Work has already begun to address this issue. allocate resources to identify a program’s current YouthPower Learning curated and developed stage of development and determine the next steps PYD Illustrative Indicators and published a in refining it and building evidence of impact. Positive Youth Development Measurement Toolkit19 Significant investment in PYD evaluations is that suggestions on what and how implementers crucial, but it should carefully consider each could measure to demonstrate the impact of their program’s stage of development. programs on PYD outcomes. This is a significant • More robust and consistent measurement of first step in ensuring that implementers are PYD outcomes is necessary. To truly understand aware of the wide range of PYD outcomes and the potential of PYD as an approach, a more relevant indicators that can be measured across comprehensive measurement of PYD outcomes interventions. However, the field has yet to is required. As this study finds, many PYD agree upon measurement tools that capture these programs in LMICs primarily measure outcomes indicators, and thus there is much work to be specific to the main sectors in which they are done on the measurement of PYD outcomes. implemented, and most do not measure PYD

17 Figure 11 was adapted from a figure prepared for a presentation by Justin Milner, 2011 Annie E. Casey Foundation. 18 Linda Collins’ multiphase optimization strategy (MOST) approach for behavioral interventions also provides a useful framework for optimizing program models. https://methodology.psu.edu/ra/most 19 The PYD Measurement Toolkit, associated illustrative indicators, measurement tools and other resource and guidance can be found at http://www.youthpower. org/positive-youth-development-toolkit

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 44 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Areas for Further Research Second, this review does not address the cost- While this review provides insights on how PYD is effectiveness of implementing PYD programs, including implemented and what existing research says about the in comparison to non-PYD programs. In large part, effectiveness of PYD approaches in LMICs, two key this omission is due to a lack of cost data. As such, questions remain that need further investigation. future cost data and value-for-money analyses would be a welcome addition to inform funders, researchers, and First, the predictive validity, or the extent to which practitioners about the value of PYD approaches. This certain program attributes, such as PYD domains cost information should not be taken in isolation, but and constructs, can be determined to reliably predict rather contextualized with data on the impacts of PYD specific youth-related outcomes, of the PYD domains programs across a range of outcomes of interest. and outcomes defined in this paper for positive and negative behavioral health, education, and economic This review demonstrates the current reach and potential outcomes has yet to be demonstrated in LMICs. Future of PYD programs in LMICs, providing timely insights research into the longitudinal relationship between PYD into the breadth and quality of these programs. Though outcomes and long-term positive and negative outcomes unanswered questions remain, the team hopes that this could help inform PYD interventions to focus on the research provides an important contribution to the field domains and outcomes most protective or promotive of and that these findings and recommendations will lead PYD in LMICs. to evidence-based program improvements across the world.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 45 4545 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 46 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries References

Achyut, P., Bhatla, N., Singh., A. K., Verma, R. K., Khandekar, S., Aninanya, G. A., Debpuur, C. Y., Awine, T., Williams, J. E., Pallav, P., NiKalje, D. (2011). Building support for gender equality Hodgson, A., & Howard, N. (2015). Effects of an adolescent among young adolescents in school: Findings from Mumbai, sexual and reproductive health intervention on health service India. New Delhi, India: International Center for Research on usage by young people in northern Ghana: a community- Women. randomised trial. PLoS One, 10(4), e0125267. doi:10.1371/ journal.pone.0125267 Ager, A., Akesson, B., Stark, L., Flouri, E., Okot, B., McCollister, F., & Boothby, N. (2011). The impact of the school-based Aramburú, M. G., Estripeaut, D., Rowley, S., Smoot, S., Chamorro, Psychosocial Structured Activities (PSSA) program on conflict- F., & Bayard, V. (2012). Educational impact of peer- affected children in northern Uganda. Journal of Child Psychology intervention on the knowledge and attitudes about HIV/ and Psychiatry and Allied Disciplines, 52(11), 1124-1133. AIDS in adolescents in Panama. International Journal of doi:10.1111/j.1469-7610.2011.02407.x Adolescent Medicine and Health, 24(2), 135-141. doi:10.1515/ IJAMH.2012.020 Ajuwon, A. J., & Brieger, W. R. (2007). Evaluation of a school-based reproductive health education program in rural South Western, Araya, R., Fritsch, R., Spears, M., Rojas, G., Martinez, V., Barroilhet, Nigeria. African Journal of Reproductive Health, 11(2), 47-59. S., Montgomery, A. A. (2013). School intervention to improve mental health of students in Santiago, Chile: A Alcid, A. (2014). A Randomized Controlled Trial of Akazi Kanoze randomized clinical trial. JAMA Pediatrics, 167(11), 1004-1010. Youth in Rural Rwanda. Education Development Center. doi:10.1001/jamapediatrics.2013.2361 Retrieved from http://idd.edc.org/sites/idd.edc.org/files/ RCT%20Report.pdf Bahnassi. K. A. (2016). Mid-term evaluation report of Youth Economic Empowerment Project UNDP – Yemen. Washington, DC: United Alianza Heartland México/Heartland Alliance International. (2015). States Agency for International Development. Youth violence prevention through audiovisual media: EJEMPLAR. FOG No. AID-523-F-12-00004. Final report. Washington, DC: Bandiera, O., Buehren, N., Burgess, R., Goldstein, M., Gulesci, United States Agency for International Development. Retrieved S., Rasul, I., & Sulaiman, M. (2015). Women’s empowerment from http://pdf.usaid.gov/pdf_docs/PA00KNH7.pdf in action: Evidence from a randomized control trial in Africa. Retrieved from http://www.ucl.ac.uk/~uctpimr/research/ELA. Al-Iryani, B., Basaleem, H., Al-Sakkaf, K., Crutzen, R., Kok, G., & pdf van den Borne, B. (2011). Evaluation of a school-based HIV prevention intervention among Yemeni adolescents. BMC Public Bandura, A. (1986.) Social foundations of thought and action: A social Health, 11, 279. doi:10.1186/1471-2458-11-279 cognitive theory. Englewood Cliffs, NJ: Prentice-Hall, Inc. Amin, S., Ahmed, J., Saha, J., Hossain, I., & Haque, E. (2016). Baptiste, D. R., Bhana, A., Petersen, I., McKay, M., Voisin, D., Bell, Delaying Child Marriage Through Community-Based Skills- C., & Martinez, D. D. (2006). Community collaborative youth- Development Programs for Girls: Results from a Randomized focused HIV/AIDS prevention in South Africa and Trinidad: Controlled Study in Bangladesh. New York: Population preliminary findings.Journal of Pediatric Psychology, 31(9), Council. Retrieved from http://www.popcouncil.org/uploads/ 905-916. pdfs/2016PGY_BALIKA_EndlineReport.pdf Beattie, T. S., Bhattacharjee, P., Isac, S., Davey, C., Javalkar, P., Nair, Andrade, H. H., Mello, M. B., Sousa, M. H., Makuch, M. Y., S., Heise, L. (2015). Supporting adolescent girls to stay in Bertoni, N., & Faundes, A. (2009). Changes in sexual behavior school, reduce child marriage and reduce entry into sex work as following a sex education program in Brazilian public schools. HIV risk prevention in north Karnataka, India: Protocol for a Cadernos de Saúde Pública, 25(5), 1168-1176. cluster randomised controlled trial. BMC Public Health, 15(1), 1-12. doi: 10.1186/s12889-015-1623-7 Andrade, S., Lachat, C., Ochoa-Aviles, A., Verstraeten, R., Huybregts, L., Roberfroid, D., Kolsteren, P. (2014). A school-based Bejarano, J., Ugalde, F., & Morales, D. (2005). Evaluación de un intervention improves physical fitness in Ecuadorian adolescents: programa escolar en Costa Rica basado en habilidades para vivir. a cluster-randomized controlled trial. International Journal of Adicciones, 17(1), 71-80. Behavioral Nutrition and Physical ActivitY, 11, 153. doi:10.1186/ s12966-014-0153-5 Benson, P. L., Leffert, N., Scales, P. C., & Blyth, D. A. (1998). Beyond the “village” rhetoric: Creating healthy communities for children and adolescents. Applied Developmental Science 2(3), 138-159.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 47 4747 Betancourt, T. S., Ng, L. C., Kirk, C. M., Munyanah, M., Mushashi, de García, D., Jones, S. E., Pucilowski, M., Fraites, A. Kawall, R, C., Ingabire, C., Sezibera, V. (2014). Family-based prevention of McIntosh, E., Chuck-a-Sang, R. (2014). Evaluation of the mental health problems in children affected by HIV and AIDS: Guyana Skills and Knowledge for Youth Employment program: An open trial. AIDS, 28(Suppl 3), S359-368. doi:10.1097/ Mid-term performance evaluation. Washington, DC: United qad.0000000000000336 States Agency for International Development. Retrieved from http://pdf.usaid.gov/pdf_docs/PA00K7XX.pdf Bhana, A., Mellins, C. A., Petersen, I., Alicea, S., Myeza, N., Holst, H., McKay, M. (2014). The VUKA family program: Piloting a Díaz, J. J., & Rosas, D. (2016). Impact evaluation of the Job Youth family-based psychosocial intervention to promote health and Training Program Projoven. Inter-American Development Bank mental health among HIV infected early adolescents in South Working Paper Series IDP-WP-693. Retrieved from https:// Africa. AIDS Care, 26(1), 1-11. doi:10.1080/09540121.2013.8 publications.iadb.org/bitstream/handle/11319/7615/Impact- 06770 Evaluation-of-the-Job-Youth-Training-Program-Projoven. pdf?sequence=1 Catalano, R. F., Berglund, M. L., Ryan, J. A. M., Lonczak, H. S., & Hawkins, J. D. (2002). Positive youth development in the Dunbar, M. S., Kang Dufour, M. S., Lambdin, B., Mudekunye- United States: Research findings on evaluations of positive youth Mahaka, I., Nhamo, D., & Padian, N. S. (2014). The SHAZ! development programs. Prevention & Treatment, 5(1), 15a. project: Results from a pilot randomized trial of a structural intervention to prevent HIV among adolescent women in Catalano, R. F., Berglund, M. L., Ryan, J. A. M., Lonczak, H. S., Zimbabwe. PLoS One, 9(11), e113621. doi:10.1371/journal. & Hawkins, J. D. (2004). Positive youth development in the pone.0113621 United States: Research findings on evaluations of positive youth development programs. The Annals of the American Academy of Eccles, J., & Gootman, J. A. (2002). Community programs to promote Political and Social Science, 591(1), 98-124. youth development. Washington, DC: National Research Council Institute of Medicine: National Academy Press. Catalano, R. F., Gavin, L. E., & Markham, C. M. (2010). Future directions for positive youth development as a strategy to Edmeades, J., Hayes, R., & Gaynair, G. (2014). Improving the lives promote adolescent sexual and reproductive health. Journal of married adolescent girls in Amhara, Ethiopia: A summary of the of Adolescent Health, 46(3 Suppl), S92-S96. doi:10.1016/j. evidence. Washington, DC: International Center for Research jadohealth.2009.12.026 on Women. Retrieved from http://www.icrw.org/wp-content/ uploads/2016/10/140406_ICRW_ChildMarriage_RptRev_ Catalano, R. F., Hawkins, J. D., Berglund, M. L., Pollard, J. A., & pages4_lo.pdf Arthur, M. W. (2002). Prevention science and positive youth development: Competitive or cooperative frameworks? Journal of Education Development Center, Inc. (2009). Youth have opportunities Adolescent Health, 31(6 Suppl), 230-239. for work in East Timor (Prepara Ami ba Servisu–PAS–Program), USAID cooperative agreement no: 486-A-00-07-00010-00: Chhabra, R., Springer, C., Leu, C. S., Ghosh, S., Sharma, S. K., & Quarterly Report, April 1–June 30, 2009. Washington, DC: Rapkin, B. (2010). Adaptation of an alcohol and HIV school- United States Agency for International Development. Retrieved based prevention program for teens. AIDS and Behavior, 14(4 from http://pdf.usaid.gov/pdf_docs/pdacx355.pdf Suppl), S177-S184. doi:10.1007/s10461-010-9739-3 Educational Research Institute of Harbin Normal University Clark, L. F., Miller, K. S., Nagy, S. S., Avery, J., Roth, D. L., Liddon, & Institute of Population and Labor Economics–Chinese N., & Mukherjee, S. (2005). Adult identity mentoring: Academy of Social Sciences. (2005). Evaluation of the impact of Reducing sexual risk for African-American seventh grade life-planning skills training in the Harbin city education system. students. Journal of Adolescent Health, 37(4), 337.e331-337. Beijing, China: CFPA and PATH. Retrieved from https://www. e310. doi:10.1016/j.jadohealth.2004.09.024 path.org/publications/files/HIV_ChinaYRH_harbin_rpt.pdf Collins, T., Yusuf, Y., Tesfahun, H. M.., & Dejene, S. (2013). A Ekhtiari, Y. S., Shojaeizadeh, D., Foroushani, A. R., Ghofranipour, rights-based approach to adolescent and youth development, F., & Ahmadi, B. (2012). The effect of an intervention based on Ethiopia: End of programme evaluation 2013, final report. the PRECEDE-PROCEED model on preventive behaviors of Retrieved from https://www.unicef.org/evaldatabase/files/ domestic violence among Iranian high school girls. Iranian Red Ethiopia_2013-023_Evaluation_of_Adolescent_Programme- Crescent Medical Journal, 15(1). doi:10.5812/ircmj.3517 Final_Report_RNE.pdf Encore Employment. ( 2012). Alternative livelihoods for youth affected Curtain, R. ( 2009). A programme evaluation of ‘Palestinian adolescents: and infected by HIV & AIDS through skill development and youth Agents of positive change – towards an environment promoting volunteering: Project evaluation (Final report) UN Volunteers. peace and reconciliation’. UNICEF MENA Regional Office. Retrieved from https://www.unicef.org/evaldatabase/files/ Erulkar, A., & Tamrat, T. (2014). Evaluation of a reproductive health OPT_2009-009_-_Norwegian_report_.pdf program to support married adolescent girls in rural Ethiopia. African Journal of Reproductive Health, 18(2), 68-76. Daniels, U. (2007). Improving health, improving lives: Impact of the African Youth Alliance and new opportunities for programmes. Evans, D., Jackson, M., Rodriguez, L., & Yalley, B. (2011). An African Journal of Reproductive Health, 11(3), 18-27. evaluation of the Core Education Skills for Liberian Youth (CESLY) program and recommendations for future non-formal education Das, M., Verma, R., Ghosh, S., Ciaravino, S., Jones, K., O’Connor, programming in Liberia. Washington, DC: The Mitchell Group, B., & Miller, E. (2015). Community mentors as coaches: Inc. Retrieved from http://pdf.usaid.gov/pdf_docs/PA00JG2M. Transforming gender norms through cricket among adolescent pdf males in urban India. Gender and Development, 23(1), 61-75. do i:10.1080/13552074.2015.1013675

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 48 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Flay, B. R., Graumlich, S., Segawa, E., Burns, J. L., & Holliday, M. Y. Ibarrarán, P., Ripani, L., Taboada, B., Villa, J. M., & García, B. (2004). Effects of 2 prevention programs on high-risk behaviors (2012). Life skills, employability and training for disadvantaged among African American youth: A randomized trial. Archives of youth: Evidence from a randomized evaluation design. Inter- Pediatrics & Adolescent Medicine, 158(4), 377-384. doi:10.1001/ American Development Bank Working Paper IDB-WP-342. archpedi.158.4.377 Ibrahim, N., Rampal, L., Jamil, Z., & Zain, A. M. (2012). Gavin, L. E., Catalano, R. F., David-Ferdon, C., Gloppen, K. Effectiveness of peer-led education on knowledge, attitude M., & Markham, C. M. (2010). A review of positive youth and risk behavior practices related to HIV among students development programs that promote adolescent sexual and at a Malaysian public university – A randomized controlled reproductive health. Journal of Adolescent Health, 46(3 Suppl), trial. Preventive Medicine, 55(5), 505-510. doi:10.1016/j. S75-91. doi:10.1016/j.jadohealth.2009.11.215 ypmed.2012.09.003 Georgetown University Institute for Reproductive Health. (2015). IREX. (2014). Youth Theater for Peace Kyrgyzstan (YTP): USAID Real Fathers Initiative Endline Report. Washington, DC: United Agreement No. 116-A-00-10-00003-00, Final Program Report, States Agency for International Development. March 1, 2012–February 28, 2014. Retrieved from http://pdf. usaid.gov/pdf_docs/PA00KBMH.pdf Guillemois, D., Mohamed, M. S., & Mohamed, M. I. (2012). Final report Evaluation of the “Youth at risk project” and some security James, S., Reddy, P., Ruiter, R. A. C., McCauley, A., & van den related components. Final Report, UNDP Somalia, December Borne, B. (2006). The impact of an HIV and AIDS life skills 2012. program on secondary school students in Kwazulu-Natal, South Africa. AIDS Education and Prevention, 18(4), 281-294. Guo, J. L., Lee, T. C., Liao, J. Y., & Huang, C. M. (2015). doi:10.1521/aeap.2006.18.4.281 Prevention of illicit drug use through a school-based program: Results of a longitudinal, cluster-randomized controlled trial. Jegannathan, B., Dahlblom, K., & Kullgren, G. (2014). Outcome Journal of Adolescent Health, 56(3), 314-322. doi:10.1016/j. of a school-based intervention to promote life-skills among jadohealth.2014.12.003 young people in Cambodia. Asian Journal of Psychiatry, 9, 78-84. doi:10.1016/j.ajp.2014.01.011 Haggerty, K. P., Skinner, M. L., MacKenzie, E. P., & Catalano, R. F. (2007). A randomized trial of Parents Who Care: Effects on key Jemmott, J. B., 3rd, Jemmott, L. S., O’Leary, A., Ngwane, Z., Icard, outcomes at 24-month follow-up. Prevention Science, 8(4), 249- L. D., Bellamy, S. L., Makiwane, M. B. (2010). School-based 260. doi:10.1007/s11121-007-0077-2 randomized controlled trial of an HIV/STD risk-reduction intervention for South African adolescents. Archives of Pediatrics Hayes, R. J., Changalucha, J., Ross, D., Gavyole, A., Todd, J., Obasi, and Adolescent Medicine, 164(10), 923-929. doi:10.1001/ A. I., Grosskurth, H. (2005). The MEMA kwa Vijana Project: archpediatrics.2010.176 Design of a community randomized trial of an innovative adolescent sexual health intervention in rural Tanzania. Jewkes, R., Gibbs, A., Jama-Shai, N., Willan, S., Misselhorn, A., Contemporary Clinical Trials 26(4), 430-442. doi:10.1016/j. Mushinga, M., Skiweyiya, Y. (2014). Stepping Stones and cct.2005.04.006 Creating Futures intervention: Shortened interrupted time series evaluation of a behavioural and structural health promotion and Heard, E., Auvaa, L., & Pickering, C. (2015). Love Bugs: Promoting violence prevention intervention for young people in informal sexual health among young people in Samoa. Health Promotion settlements in Durban, South Africa. BMC Public Health, 14, Journal of Australia, 26(1), 30-32. doi: 10.1071/he14055 1325. doi:10.1186/1471-2458-14-1325 Hecht, M. L., Marsiglia, F. F., Elek, E., Wagstaff, D. A., Kulis, S., Jewkes, R., Nduna, M., Levin, J., Jama, N., Dunkle, K., Khuzwayo, Dustman, P., & Miller-day, M. (2003). Culturally grounded N., Duvvury, N. (2006). A cluster randomized-controlled trial substance use prevention: An evaluation of the keepin’ it to determine the effectiveness of Stepping Stones in preventing R.E.A.L. curriculum. Prevention Science, 4(4), 233-248. HIV infections and promoting safer sexual behaviour amongst doi:10.1023/A:1026016131401 youth in the rural Eastern Cape, South Africa: Trial design, Heeren, G. A., Jemmott, J. B., 3rd, Ngwane, Z., Mandeya, A., & methods and baseline findings.Tropical Medicine & International Tyler, J. C. (2013). A randomized controlled pilot study of Health, 11(1), 3-16. doi:10.1111/j.1365-3156.2005.01530.x an HIV risk-reduction intervention for sub-Saharan African Jewkes, R., Nduna, M., Levin, J., Jama, N., Dunkle, K., Puren, A., university students. AIDS and Behavior, 17(3), 1105-1115. & Duvvury, N. (2008). Impact of stepping stones on incidence doi:10.1007/s10461-011-0129-2 of HIV and HSV-2 and sexual behaviour in rural South Africa: Hernández Ramírez, E. M. (2010). Evaluación de un programa Cluster randomised controlled trial. BMJ, 337, a506. de prevención del consumo de sustancias psicoactivas para la Jewkes, R., Wood, K., & Duvvury, N. (2010). ‘I woke up after I infancia. Health and Addictions, 15(1), 67-78. joined Stepping Stones’: Meanings of an HIV behavioural Hinson, L., Kapungu, C., Jessee, C., Skinner, M., Bardini, M. intervention in rural South African young people’s lives. Health & Evans-Whipp, T. (2016). Measuring Positive Youth Education Research, 25(6), 1074-1084. doi:10.1093/her/cyq062 Development Toolkit: A Guide for Implementers of Youth Johnson, L. R., Johnson-Pynn, J. S., & Pynn, T. M. (2007). Youth Programs. Washington, DC: YouthPower Learning, Making civic engagement in China: Results from a program promoting Cents International. Retrieved from http://www.youthpower. environmental activism. Journal of Adolescent Research, 22(4), org/resources/how-do-youth-skills-development-initiatives- 355-386. doi:10.1177/0743558407301914 ensure-effective-targeting-recruitment-and

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 49 4949 Kaljee, L. M., Genberg, B., Riel, R., Cole, M., Tho, L. H., Thoa, Luk, A. L., Chan, W. U., & Hu, S. X. (2013). Macau, world capital L. T. K., Minh, T. T. (2005). Effectiveness of a theory-based for gambling: A longitudinal study of a youth program designed risk reduction HIV prevention program for rural Vietnamese to instill positive values. Frontiers in Public Health, 1, 58. adolescents. AIDS Education and Prevention, 17(3), 185-199. doi:10.3389/fpubh.2013.00058 doi:10.1521/aeap.17.4.185.66534 Luk, A. L., Leong, K. M., & Au, A. M. (2012). Evaluation of the Kinsler, J., Sneed, C. D., Morisky, D. E., & Ang, A. (2004). effectiveness of a positive youth development program for Evaluation of a school-based intervention for HIV/AIDS secondary students in Macau. Scientific World Journal, 2012, prevention among Belizean adolescents. Health Education 621841. doi:10.1100/2012/621841 Research, 19(6), 730-738. doi:10.1093/her/cyg091 Lundgren, R., Beckman, M., Chaurasiya, S. P., Subhedi, B., & Knox, R. (n.d.). Youth Participation in Local Governance final Kerner, B. (2013). Whose turn to do the dishes? Transforming evaluation: Final report. United Nations Development gender attitudes and behaviours among very young adolescents Programme – UNDP Jordan. Retrieved from https://erc.undp. in Nepal. Gender & Development, 20(1), 127-145. org/evaluation/evaluations/detail/6331 Ma, H. K., & Shek, D. T. (2010). Subjective outcome evaluation Kulis, S., Marsiglia, F. F., Elek, E., Dustman, P., Wagstaff, D. A., & of a positive youth development program in Hong Kong: Hecht, M. L. (2005). Mexican/Mexican American adolescents Profiles and correlates.Scientific World Journal, 10, 192-200. and keepin’it REAL: An evidence-based substance use doi:10.1100/tsw.2010.2 prevention program. Children & Schools, 27(3), 133-145. Marsiglia, F. F., & Booth, J. M. (2015). Cultural adaptation of Lasida, J., & Rodríguez, E. (2006). Entering the world of Work: Results interventions in real practice settings. Research on Social Work from six entra 21 youth employment projects. Baltimore, MD: Practice, 25(4), 423-432. International Youth Foundation. Marsiglia, F. F., Booth, J. M., Ayers, S. L., Nuño-Gutierrez, B. Lau, N. S., & Hue, M. T. (2011). Preliminary outcomes of a L., Kulis, S., & Hoffman, S. (2014). Short-term effects on mindfulness-based programme for Hong Kong adolescents substance use of the keepin’it REAL pilot prevention program: in schools: Well-being, stress and depressive symptoms. Linguistically adapted for youth in Jalisco, Mexico. Prevention International Journal of Children’s Spirituality, 16(4), 315-330. Science, 15(5), 694-704. doi:10.1007/s11121-013-0421-7 doi:10.1080/1364436X.2011.639747 Marsiglia, F. F., & Hecht, M. L. (2005.) Keepin’ it’ REAL: An evidence- Leffert, N., Benson, P. L., Scales, P. C., Sharma, A. R., Drake, D. R., based program. Santa Cruz, CA: ETR Associates. & Blyth, D. A. (1998). Developmental assets: Measurement and prediction of risk behaviors among adolescents. Applied Marsiglia, F. F., & Kulis, S. S. (2009). Diversity, oppression, and Developmental Science, 2(4), 209-230. change: Culturally grounded social work. Chicago, IL: Lyceum Books. Lerner, R. M. (2002). Concepts and theories of human development (3rd ed.). Mahwah, NJ: Lawrence Erlbaum Associates. Marsiglia, F. F., Kulis, S. S., Booth, J. M., Nuño-Gutierrez, B. L., & Robbins, D. E. (2015). Long-term effects of the keepin’ it Lerner, R. M. (2004). Liberty: Thriving and civic engagement among REAL model program in Mexico: Substance use trajectories America’s youth. Thousand Oaks, CA: Sage Publications. of Guadalajara middle school students. Journal of Primary Prevention, 36(2), 93-104. doi:10.1007/s10935-014-0380-1 Lerner, R. M., Lerner, J. V., Almerigi, J. B., Theokas, C., Phelps, E., Gestsdottir, S., von Eye, A. (2005). Positive youth development, Marsiglia, F. F., Kulis, S., Martínez-Rodríguez, G., Becerra, D., participation in community youth development programs, & Castillo. J. (2009). Cultural specific youth substance and community contributions of fifth-grade adolescents: abuse resistance skills: Applicability across the US–Mexico Findings from the first wave of the 4-H study of positive youth border. Research on Social Work Practice, 19(2):152– development. The Journal of Early Adolescence, 25(1), 17-71. 164. doi:10.1177/1049731507303886 doi:10.1177/0272431604272461 Mathur, S., Mehta, M., & Malhotra, A. Y. (2004). Youth reproductive Leventhal, K. S., Gillham, J., DeMaria, L., Andrew, G., Peabody, health in Nepal: Is participation the answer? Washington, DC: J., & Leventhal, S. (2015). Building psychosocial assets and International Center for Research on Women. Retrieved from wellbeing among adolescent girls: A randomized controlled trial. https://www.icrw.org/wp-content/uploads/2016/10/Youth- Journal of Adolescence, 45, 284-295. Reproductive-Health-in-Nepal-Is-Participation-the-Answer.pdf Li, S., Huang, H., Cai, Y., Ye, X., Shen, X., Shi, R., & Xu, G. (2010). Mercy Corps. (2012). Support for Kosovo’s Youth Leaders (SKYL), Evaluation of a school-based HIV/AIDS peer-led prevention cooperative agreement no. 167-A-00-08-00104-00: End programme: The first intervention trial for children of migrant of program evaluation, 1 October 2008–31 January 2012. workers in China. International Journal of STD & AIDS, 21(2), Washington, DC: United States Agency for International 82-86. doi:10.1258/ijsa.2009.008514 Development. Retrieved from https://www.mercycorps.org/sites/ default/files/skyl_eval_final_31_jan_2012.pdf Lippman, L., Moore, K. A. & McIntosh, H. (2009). Positive indicators of child well-being: A conceptual framework, measures Mercy Corps. (2015). Trusting in Youth in Zimbabwe Project, and methodological Issues. Innocenti Working Paper No. 2009- cooperative agreement number AID-613-A-13-00003: Final 21. Florence: UNICEF Innocenti Research Centre. report. Washington, DC: United States Agency for International Development. Retrieved from http://pdf.usaid.gov/pdf_docs/ Lotrean, L. M., Dijk, F., Mesters, I., Ionut, C., & De Vries, H. PA00KF3J.pdf (2010). Evaluation of a peer-led smoking prevention programme for Romanian adolescents. Health Education Research, 25(5), 803-814. doi:10.1093/her/cyq034

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 50 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Miller, E., Das, M., Tancredi, D. J., McCauley, H. L., Virata, M. Partners of the Americas. (2015). The A Ganar Alliance: Using sport C. D., Nettiksimmons, J., Verma, R. (2014). Evaluation of a to impact youth employment and youth engagement: Final gender-based violence prevention program for student athletes report, September 2009–September 2015. Washington, DC: in Mumbai, India. Journal of Interpersonal Violence, 29(4), 758- Author. 778. doi:10.1177/0886260513505205 Patton, G., Bond, L., Butler, H., & Glover, S. (2003). Changing Morton, M. H., & Montgomery, P. (2012). Empowerment-based schools, changing health? Design and implementation of the non-formal education for Arab youth: A pilot randomized Gatehouse Project. Journal of Adolescent Health, 33(4), 231-239. trial. Children and Youth Services Review, 34(2), 417-425. doi:10.1016/j.childyouth.2011.11.013 Patton, G. C., Bond, L., Carlin, J. B., Thomas, L., Butler, H., Glover, S., Bowes, G. (2006). Promoting social inclusion in schools: A Muhammed, N. (2001). St. John’s College and Belize Police group-randomized trial of effects on student health risk behavior Department. Evaluation of Youth at Risk pilot program. Retrieved and well-being. American Journal of Public Health, 96(9), 1582- from https://www.unicef.org/evaldatabase/files/BZE_2001_001. 1587. doi:10.2105/ajph.2004.047399 pdf Patton, G. C., Glover, S., Bond, L., Butler, H., Godfrey, C., Mukoma, W., Flisher, A. J., Ahmed, N., Jansen, S., Mathews, C., Pietro, G. D., & Bowes, G. (2000). The Gatehouse Project: A Klepp, K. I., & Schaalma, H. (2009). Process evaluation systematic approach to mental health promotion in secondary of a school-based HIV/AIDS intervention in South Africa. schools. Australian and New Zealand Journal of Psychiatry, 34(4), Scandinavian Journal of Public Health, 37(Suppl 2), 37-47. 586-593. doi:10.1046/j.1440-1614.2000.00718.x doi:10.1177/1403494808090631 Patton, G. C., Sawyer, S. M., Santelli, J. S., Ross, D. A., Afifi, R., Namy, S., Heilman, B., Stich, S., & Edmeades, J. (2014). Be a man, Allen, N. B., Viner, R. M. (2016). Our future: A Lancet change the rules! Findings and lessons from seven years of CARE commission on adolescent health and wellbeing. The Lancet, International Balkans’ Young Men Initiative. Washington, DC: 387(10036), 2423-2478. doi:http://dx.doi.org/10.1016/S0140- International Center for Research on Women. Retrieved from 6736(16)00579-1 https://www.icrw.org/publications/be-a-man-change-the-rules/ Pham, V., Nguyen, H., Tho le, H., Minh, T. T., Lerdboon, P., Riel, Network-Brasil. (2012). Programa Para o Futuro – Young Women in R., Kaljee, L. M. (2012). Evaluation of three adolescent Action: Monitoring and evaluation final report. Unpublished sexual health programs in Ha Noi and Khanh Hoa Province, report. Vietnam. AIDS Research and Treatment, 2012, 986978. doi:10.1155/2012/986978 Nicholls, M., & Hassan, A. (2014). Mid-term performance evaluation of the USAID Somali Youth Leaders Initiative (SYLI). Pittman, K., O’Brien, R., & Kimball, M. (1993). Youth development Washington, DC: United States Agency for International and resiliency research: Making connections to substance abuse Development. Retrieved from http://pdf.usaid.gov/pdf_docs/ prevention. Report prepared for The Center for Substance Abuse PA00K3XD.pdf Prevention. Washington, DC: Center for Youth Development and Policy Research. NORAC. (2014). Yes, Youth Can impact evaluation report. Washington, DC: United States Agency for International Posner, J., Kayastha, P., Davis, D., Limoges, J., O’Donnell, C., Development. Retrieved from http://pdf.usaid.gov/pdf_docs/ & Yue, K. (2009). Development of leadership self-efficacy PA00JZQX.pdf and collective efficacy: Adolescent girls across castes as peer educators in Nepal. Global Public Health, 4(3), 284-302. O’Callaghan, P., Branham, L., Shannon, C., Betancourt, T. S., doi:10.1080/17441690902783157 Dempster, M., & McMullen, J. (2014). A pilot study of a family focused, psychosocial intervention with war-exposed youth Prado, G., Pantin, H., Briones, E., Schwartz, S. J., Feaster, D., at risk of attack and abduction in north-eastern Democratic Huang, S., Szapocznik, J. (2007). A randomized controlled Republic of Congo. Child Abuse & Neglect, 38(7), 1197-1207. trial of a parent-centered intervention in preventing substance doi:10.1016/j.chiabu.2014.02.004 use and HIV risk behaviors in Hispanic adolescents. Journal of Consulting and Clinical Psychology, 75(6), 914-926. O’Leary, A., Jemmott, J. B., 3rd, Jemmott, L. S., Bellamy, S., doi:10.1037/0022-006x.75.6.914 Ngwane, Z., Icard, L., & Gueits, L. (2012). Moderation and mediation of an effective HIV risk-reduction intervention for Qouta, S. R., Palosaari, E., Diab, M., & Punamäki, R. L. (2012). South African adolescents. Annals of Behavioral Medicine, 44(2), Intervention effectiveness among war‐affected children: A cluster 181-191. doi:10.1007/s12160-012-9375-4 randomized controlled trial on improving mental health. Journal of Traumatic Stress, 25(3), 288-298. doi:10.1002/jts.21707 Orpinas, P., Ambrose, A., Maddaleno, M., Vulanovic, L., Mejia, M., Butron, B., Soriano, I. (2014). Lessons learned in evaluating the Romero, A., Pick, S., Parra-Coria, A., & Givaudan, M. (2010). Familias Fuertes program in three countries in Latin America. Evaluación del impacto de un programa de prevención de Revista Panamericana de Salud Pública, 36(6), 383-390. violencia en adolescentes. Revista Interamericana de Psicología, 44(2), 203-212. Partners of the Americas. (2003). Annual report year IX, 2003: Program for at-risk youth in northeastern Brazil. (USAID Rosas-Shady, D. (2006). Review of the Youth Worker Training Cooperative Agreement #512-A-00-94-00010-00). Washington, subbrogram in Colombia: Ex-post project evaluation report. Office DC: Author. Retrieved from http://www.popline.org/ of Evaluation and Oversight, Inter-American Development node/239640 Bank report no. OVE/EPPER-01/06. Retrieved from https:// publications.iadb.org/handle/11319/4575?locale-attribute=en

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 51 5151 Roth, J. L., & Brooks-Gunn, J. (2003). What exactly is a youth Van Zyl, L. E., & Rothmann, S. (2012). Beyond smiling: The development program? Answers from research and practice. evaluation of a positive psychological intervention aimed at Applied Developmental Science, 7(2), 94-111. doi:10.1207/ student happiness. Journal of Psychology in Africa, 22(3), 369- S1532480XADS0702_6 384. doi:10.1080/14330237.2012.10820541 Rotheram-Borus, M. J., Lightfoot, M., Kasirye, R., & Desmond, K. Villar, R. (2006). Collaborating with the private sector: A case study of (2012). Vocational training with HIV prevention for Ugandan an entra21 project in Salvador, Bahia, Brazil. Baltimore, MD: youth. AIDS and Behavior, 16(5), 1133-1137. doi:10.1007/ International Youth Foundation. Retrieved from http://www. s10461-011-0007-y iyfnet.org/library/learning-series-1-collaborating-private-sector- case-study-entra21-project-salvador-bahia Ruiz, H. R. (2011). Evaluation of adolescent and youth participation in UNICEF Cambodia. New York, NY: UNICEF. Retrieved from Visser, M., Zungu, N., & Ndala-Magoro, N. (2015). ISIBINDI, https://www.unicef.org/evaluation/files/Cambodia_FINAL_ creating circles of care for orphans and vulnerable children in REPORT_Full_Parts_1-2.pdf South Africa: Post-programme outcomes. AIDS Care, 27(8), 1014-1019. doi:10.1080/09540121.2015.1018861 Scales, P. C., Roehlkepartain, E. C., & Fraher, K. (2012). Do developmental assets make a difference in majority-world contexts? Volosevych, I. (2011). Youth social inclusion for civic engagement in A preliminary study of the relationships between developmental Ukraine 2008–2011 final project evaluation. Washington, DC: assets and international development priorities. Minneapolis: United States Agency for International Development. http:// Search Institute. Retrieved from http://www.search-institute.org/ www.youthpower.org/resources/youth-social-inclusion-civic- downloadable/DoAssetsMatter-2012-Report.pdf engagement-ukraine-2008%E2%80%932011-final-project- evaluation Shanghai Institute for Planned Parenthood Research. (2005). Impact of a comprehensive youth reproductive health intervention among Wallace, T. (2006). Evaluating Stepping Stones: A review of existing vocational school students in Shanghai. Beijing, China: CFPA and evaluations and ideas for future m&e work. Johannesburg, PATH. Retrieved from http://www.path.org/publications/files/ South Africa: ActionAid International. Retrieved from http:// HIV_ChinaYRH_shanghai_voc_rpt.pdf steppingstonesfeedback.org/wp-content/uploads/2016/10/ SS_ActionAid_EvaluatingSteppingStones_TWallace_2006.pdf Shek, D. T. L., Siu, A. M. H., Lee, T. Y., Cheung, C. K., & Chung, R. (2008). Effectiveness of the Tier 1 Program of Welbourn, A. (1995). Stepping Stones. A training package in Project P.A.T.H.S.: Objective outcome evaluation based on a HIV/AIDS, communication and relationship skills. London, randomized group trial. Scientific World Journal, ,8 4-12. England: Strategies for Hope. Retrieved from http://www. participatorymethods.org/resource/stepping-stones-training- Spitzberg, B. H., & Cupach, W. R. (1984). Interpersonal package-hivaids-communication-and-relationship-skills communication competence (Vol. 4). Thousand Oaks, CA: Sage Publications. Wong, M. C. S., Lee, A., Sun, J., Stewart, D., Cheng, F. F. K., Kan, W., & Ho, M. (2009). A comparative study on resilience level Srikala, B., & Kishore Kumar, K. V. K. (2010). Empowering between WHO health promoting schools and other schools adolescents with life skills education in schools –School mental among a Chinese population. Health Promotion International, health program: Does it work. Indian Journal of Psychiatry, 24(2), 149-155. 52(4), 344-349. doi:10.4103/0019-5545.74310 World Bank. (n.d.) World Bank country and lending groups [Data Sterland, B. (2007). UNV Support to strengthen youth volunteerism file]. Retrieved from https://datahelpdesk.worldbank.org/ in Kyrgyzstan, project no. 00038888: An end of project knowledgebase/articles/906519-world-bank-country-and- evaluation. Retrieved from http://sterland.biz/wp-content/ lending-groups uploads/2015/09/KGZ_projecteval_youth_02.pdf World Bank. (2006). Preparing youth for 21st century jobs: Entra Stine, K. (2015). Youth engagement to promote stability: Final 21 across Latin America and the Caribbean. Washington, DC: evaluation. Washington, DC: United States Agency for Author. Retrieved from http://www.iyfnet.org/sites/default/files/ International Development and Search for Common Ground. YouthDevNotesEntra21Dec06.pdf Tianjin Municipal Research Institute for Family Planning & Institute World Bank. (2007). World development report 2007: Development of Population and Labor Economics, Chinese Academy of Social and the next generation. Washington, D.C.: Author. Sciences. (2005). Evaluation of theimpact of parents’ reproductive Retrieved from http://documents.worldbank.org/curated/ health training in Tianjin City. Beijing, China: CFPA and en/556251468128407787/pdf/359990WDR0complete.pdf PATH. YUWA. (2014). YUWA annual report 2014. Washington, DC: United States Agency for International Development. (2012). Youth United States Agency for International Development. in development policy. Washington, DC: Author. Retrieved from https://www.usaid.gov/policy/youth Zuilkowski, S. S., & Alon, I. (2015). Promoting education for vulnerable children by supporting families: A holistic Valiant Consulting Group, Ltd. (2001). Youth Start Plan: Ex-post intervention in Uganda. Journal of Social Service Research, 41(4), evaluation final report. Washington, DC: Inter-American 454-465. doi:10.1080/01488376.2015.1039103 Development Bank. Retrieved from https://publications.iadb. org/bitstream/handle/11319/3784/Youth%20Start%20Plan%20 -%20%20MIF/AT-125%20-%20Ex%20Post%20Evaluation. pdf?sequence=1

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 52 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Appendices

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 53 5353 Appendix 1 Search Terms Used for the Systematic Review

The search terms are grouped in four categories; target population, intervention-related terms, type of intervention, and type of study. These four categories were linked by the connector “AND” in the search. The search terms were refined using the seminal papers listed in Appendix 2 using two search engines, Scopus and Pub Med.

• Target population: youth* OR adolescen* OR teen* OR young adult* OR early adult* • Intervention: (positive AND behavi*) OR positive OR (*social AND skills) OR social* OR (social* AND development) OR pro-social OR (moral AND development) OR self-determination OR agency OR strengthening OR self-efficacy OR (strength* AND competenc*) OR (strengths AND development) OR (social* AND competence) OR (mental health) OR psycho-social OR (life AND skills) OR resilienc* OR (problem AND solving AND skills) OR (health* AND belief*) OR coping OR (coping AND behavior) OR (coping AND strategies) OR (social AND change) OR (protective AND factor*) OR mentor* OR risk-taking OR at-risk OR crim* OR gang* or food* OR educ* OR employ* OR repro* OR hiv OR vih OR particip* OR inclusi* OR polit* OR well-being • Type of intervention: intervention* OR program* OR project* OR trial* OR (preventive AND medicine) OR (health AND services) • Type of Study: evaluation OR impact OR outcom* OR result* OR stud* OR randomiz* OR (cluster AND analysis) OR research OR controlled OR development OR logistic OR model* OR framework* OR review OR strateg* OR proj* OR prog*

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 54 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Appendix 2 Seminal Papers

The seminal papers were selected by the team of project advisers from the YouthPower Learning project. These papers were instrumental in refining the search terms described in Appendix 1. These papers are foundational in the field of PYD. They present frameworks of analysis and results of evaluations of innovative PYD programming.

1. Catalano, R. F., Gavin, L. E., & Markham, C. M. (2010). Future directions for positive youth development as a strategy to promote adolescent sexual and reproductive health. Journal of Adolescent Health, 46(3 Suppl), S92-S96. doi:10.1016/j.jadohealth.2009.12.026

2. Catalano, R. F., Hawkins, J. D., Berglund, M. L., Pollard, J. A., & Arthur, M. W. (2002). Prevention science and positive youth development: Competitive or cooperative frameworks? Journal of Adolescent Health, 31(6 Suppl), 230-239.

3. Clark, L. F., Miller, K. S., Nagy, S. S., Avery, J., Roth, D. L., Liddon, N., & Mukherjee, S. (2005). Adult identity mentoring: Reducing sexual risk for African-American seventh grade students. Journal of Adolescent Health, 37(4), 337.e331-337.e310. doi:10.1016/j.jadohealth.2004.09.024

4. Flay, B. R., Graumlich, S., Segawa, E., Burns, J. L., & Holliday, M. Y. (2004). Effects of 2 prevention programs on high-risk behaviors among African American youth: A randomized trial. Archives of Pediatrics & Adolescent Medicine, 158(4), 377-384. doi:10.1001/archpedi.158.4.377

5. Gavin, L. E., Catalano, R. F., David-Ferdon, C., Gloppen, K. M., & Markham, C. M. (2010). A review of positive youth development programs that promote adolescent sexual and reproductive health. Journal of Adolescent Health, 46(3 Suppl), S75-91. doi:10.1016/j.jadohealth.2009.11.215

6. Haggerty, K. P., Skinner, M. L., MacKenzie, E. P., & Catalano, R. F. (2007). A randomized trial of Parents Who Care: Effects on key outcomes at 24-month follow-up. Prevention Science, 8(4), 249-260. doi:10.1007/s11121- 007-0077-2

7. Patton, G., Bond, L., Butler, H., & Glover, S. (2003). Changing schools, changing health? Design and implementation of the Gatehouse Project. Journal of Adolescent Health, 33(4), 231-239.

8. Patton, G. C., Bond, L., Carlin, J. B., Thomas, L., Butler, H., Glover, S., Bowes, G. (2006). Promoting social inclusion in schools: A group-randomized trial of effects on student health risk behavior and well-being. American Journal of Public Health, 96(9), 1582-1587. doi:10.2105/ajph.2004.047399

9. Patton, G. C., Glover, S., Bond, L., Butler, H., Godfrey, C., Pietro, G. D., & Bowes, G. (2000). The Gatehouse Project: A systematic approach to mental health promotion in secondary schools. Australian and New Zealand Journal of Psychiatry, 34(4), 586-593. doi:10.1046/j.1440-1614.2000.00718.x

10. Prado, G., Pantin, H., Briones, E., Schwartz, S. J., Feaster, D., Huang, S., Szapocznik, J. (2007). A randomized controlled trial of a parent-centered intervention in preventing substance use and HIV risk behaviors in Hispanic adolescents. Journal of Consulting and Clinical Psychology, 75(6), 914-926. doi:10.1037/0022- 006x.75.6.914

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 55 5555 Appendix 3 Checklist for Blueprint Program Evaluation

The team used the checklist for the Blueprint Program Evaluation to guide the quality assessment of the evidence identified in the program reports reviewed. Studies received a score of 1 point for each criterion they met. The Blueprint checklist used assigns the same weight to all the following elements: 1. Study used an experimental design (randomized controlled trial—RCT). 2. The sample was clearly described. This variable summarizes a range of conditions, including clarity describing the size and the representativeness of the sample as well as other characteristics of the sample. 3. The reliability or validity of tests and measures was described. 4. The study used intention to treat analysis. 5. The analysis was done at the proper level. This refers to a range of steps in the analysis. It may refer to whether data were analyzed using the correct instrument—for example, using the correct type of regression analysis when the dependent variables are nominal, ordinal, or intervalar. It could also refer to whether the interpretations of analysis were based on the correct unit of analysis or level of such analysis. For example, if a sample was taken in a rural area alone, the statements in the analysis should not suggest the study took place in rural and urban areas. 6. The analysis controlled for baseline outcome measures. 7. The analysis demonstrated baseline equivalence between conditions. This refers to the analysis conducted to determine if two groups are similar enough that one can be used as an “intervention” group and another as a “comparison” group in experimental studies. This analysis typically involves comparing the two groups during baseline. 8. The study demonstrated that attrition is below 5% or unrelated to group assignment, sociodemographic characteristics, and baseline measures of the outcomes. Studies with evaluation results were divided into the following four categories, according to study design and quality score: high-quality experimental studies, high-quality quasi-experimental studies, lower-quality experimental studies and lower-quality nonexperimental studies.

Program Name ______1. Does the study have a high-quality design? A randomized trial is ideal, but two or more studies with quasi- experimental designs may be sufficient. Report on the use of randomization or the nature of the quasi- experimental design. ___2. Does the study clearly describe the sample size at each stage of data gathering? Report the number of subjects at each stage, including the N at baseline and the Ns and percentages of the baseline sample remaining at post-test and each follow-up. ___3. Are the measures reliable and valid? Report the information provided by the study (e.g., interrater reliability, Cronbachs’s alpha). ___4. Does the study use an intent-to-treat analysis? The study should attempt to follow and analyze all subjects as assigned to their original condition. ___5. Is the analysis done at the proper level? Report on whether the analysis matches the level of the intervention. (For example, if schools are randomized, the analysis should compare schools, not persons, or use multi-level statistical methods that adjust for clustering). ___6. Does the analysis control for baseline outcome measures? Report on the use of change scores, baseline outcomes as covariates, or group-by-time interactions.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 56 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries ___7. Does the analysis demonstrate baseline equivalence between conditions? Report on whether a test was performed, non-equivalent findings, and potential adjustments. ___8. Does the study demonstrate that attrition is below 5% or unrelated to group assignment, sociodemographic characteristics, and baseline measures of the outcomes? Report on whether a test was performed, evidence of significant differential attrition, and potential adjustments.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 57 5757 Appendix 4 Information About Programs Identified Through Nonexperimental Studies

All Three Sectors Ten nonexperimental studies addressed outcomes in all three sectors: Health, Democracy and Governance, and Educational Development and Education.

Four of the programs had components primarily focused on sexual and reproductive health (SRH) (Edmeades, Hayes, & Gaynair, 2014; Mathur, Mehta, & Malhotra, 2004; Jewkes, Wood, & Duvvury, 2010; Curtain, 2009), two on violence prevention (Jewkes et al., 2014; Namy, Heilman, Stich, & Edmeades, 2014), two on vocational skills (Edmeades et al., 2014; Mercy Corps, 2015), one on livelihood support and educational participation (Zuilkowski & Alon, 2015), one on reducing risky behaviors (Orpinas et al., 2014), and one on improving livelihoods for youth affected with human immunodeficiency virus (HIV) (Encore Employment, 2012).

Positive outcomes reported included changes in knowledge, attitudes, and behavioral intentions. For example, the Young Men Initiative implemented in Bosnia, Herzegovina, Croatia, Serbia, and Kosovo led to changes in attitudes toward gender roles and violence (Namy et al., 2014); the Familias Fuertes study implemented in Bolivia, Colombia, and Ecuador reported statistically significant increases in positive parenting and reductions in parental hostility (Orpinas et al., 2014); and the Stepping Stones program implemented in South Africa led to changes in work stress and depression symptoms in men (Jewkes et al., 2014). The TESFA program in Ethiopia reported changes in contraceptive use and HIV testing (Edmeades et al., 2014), and the Stepping Stones program also reported increases in earnings, receiving a grant, and decreases in theft due to lack of food or money (Jewkes et al., 2014). Other studies reported positive changes such as increase in access to health services (Mathur et al., 2004) and increased school attendance (Zuilkowski & Alon, 2015). None of the studies in this group reported on longer-term outcomes. Health AND Democracy and Governance OR Economic Development and Education Ten studies addressed Health AND either Democracy and Governance (Andrade et al. 2009; Posner et al. 2009; Al- Iryani et al. 2011; Erulkar and Tamrat 2014) OR Economic Development and Education (Ma & Shek, 2010; Luk, Leong, & Au, 2012; Network-Brasil, 2012; Luk, Chan, & Hu, 2013; Visser, Zungu, & Ndala-Magoro, 2015). Of the five that addressed Health AND Democracy and Governance, three were in SRH and involved education, skill- building, participatory activities (including peer education), and community engagement. All reported positive effects, ranging from improvements in knowledge about HIV and menstruation (Posner et al., 2009) to self-reported use of contraception (Andrade et al., 2009). Stepping Stones, already discussed, was also counted in this section because of the program’s evidence on improvements in communication skills, conflict management, and peer relations (Jewkes et al., 2014). A program in Ethiopia that involved skills training and microfinance opportunities reported beneficial effects on financial outcomes, communication, and integration with other community members (Erulkar & Tamrat, 2014).

Five programs addressed Health AND Economic Development and Education. One was a Brazil-based program targeted to females in schools, community organizations, and universities that focused on employability training, skills development, and mentoring (Network-Brasil, 2012). The evaluation demonstrated improvements in skills, professional network-building, and (in a subset of participants) secondary education completion and enrollment in continuing education, as well as increased insertion in the job market.

The ISBINDI program—which aimed to improve physical and psychosocial well-being of orphans and vulnerable children in South Africa and involved home visits, life skills training, career guidance, and access to health services— showed improvements in HIV risk, family support, and problem solving (Visser et al., 2015).

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 58 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Three studies discuss the P.A.T.H.S.: Positive Adolescent Training through Holistic Social Programs in China, Macau and Hong Kong. (Luk et al., 2013; Luk et al., 2012; Ma & Shek, 2010) Democracy and Governance AND Economic Development and Education Three nonexperimental studies met the criteria for the sectors of Democracy and Governance AND Economic Development and Education. These studies included a Youth for the Future program in Jordan (International Youth Foundation, 2014), a gender equity intervention in Indian schools (Achyut et al., 2011), and the Roots and Shoots program for environmental protection and youth political engagement (Johnson, Johnson-Pynn, & Pynn, 2007).

The Youth for the Future program involved community-level action plans, grants to community-based organizations (CBOs), and capacity-building for the Jordanian Ministry of Social Development (International Youth Foundation, 2014). The program reported improvements in participation in education, employment, and self-reported confidence, communication skills, and relationships with parents. The gender equity intervention involved role-plays and discussion and led to improvements in attitudes toward gender issues. The China-based program involved activities including caring for the natural environment and for other community members (Johnson et al., 2007). Survey results showed improvements in perceptions of civic and social responsibility. Health Alone HIV and SRH Of the nonexperimental studies under the Health sector, eleven addressed HIV and SRH, including three in China (Educational Research Institute of Harbin Normal University & Institute of Population and Labor Economics– Chinese Academy of Social Sciences, 2005; Shanghai Institute for Planned Parenthood Research, 2005; Tianjin Municipal Research Institute for Family Planning & Institute of Population and Labor Economics, Chinese Academy of Social Sciences, 2005), one in Yemen (Al-Iryani et al., 2011), one in Belize (Kinsler, Sneed, Morisky, & Ang, 2004), one in Nigeria (Ajuwon & Brieger, 2007), one in Botswana (Daniels, 2007), one in Rwanda (Betancourt et al., 2014) and three in South Africa (Baptiste et al., 2006; Bhana et al., 2014; Mukoma et al., 2009). Other than the program in Rwanda, which was implemented in healthcare facilities, all were primarily implemented in schools. These programs focused on provision of information and skills training. Most programs showed beneficial effects on knowledge, attitudes, self-efficacy, and behavioral intentions. Participants in the Nigeria program also reported decreases in risky sexual behavior. Two of the programs reported improvements in parent-child communication (Tianjin Municipal Research Institute for Family Planning & Institute of Population and Labor Economics, Chinese Academy of Social Sciences, 2005; Betancourt et al., 2014), which was the focus of the intervention. Among these, VUKA (Bhana et al., 2014) is based on the CHAMP program developed in the United States and was piloted in Trinidad and South Africa, although no strong evidence on the effects of VUKA on youth populations in low- and middle-income countries has been published. Mental Health Of the nonexperimental studies that fell under the sector of Health only, four addressed mental health, including a positive psychology intervention targeted to tertiary students in South Africa (Van Zyl & Rothmann, 2012), a school- based mindfulness program implemented in Hong Kong (Lau & Hue, 2011), and YOMI-VIDA, a school-based program implemented in Colombia (Hernández Ramírez, 2010). Outcome measures varied, but all reported some improvements in mental health and well-being. Democracy and Governance Alone Three nonexperimental studies addressed the Democracy and Governance sector alone, one of which aimed to change gender norms and involved three months of weekly two-hour educational sessions (Lundgren, Beckman, Chaurasiya, Subhedi, & Kerner, 2013). Results showed changes in rejection of traditional gender norms. Another program, a violence prevention program implemented in Mexico, involved teacher-led workshops (Romero, Pick, Parra-Coria, & Givaudan, 2010). This program led to changes in knowledge about and attitudes toward violence. The other nonexperimental study was related to the Parivartan program1 (Das et al., 2015).

1 This report reviewed more than one evaluation of the Parivartan program. These studies used different-quality designs.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 59 5959 Economic Development and Education Alone Two studies addressing Economic Development and Education alone were evaluated with nonexperimental designs. These included the Social Safety Net program implemented in Colombia (Rosas-Shady, 2006) and a risk-prevention program implemented in Belize (Muhammed, N.). The Colombia program involved vocational training activities and internships. The evaluation reported improvements in employability, job retention, job quality, and self-esteem. The Belize program involved educational activities, art classes, mentoring, and a summer program. The evaluation reported reductions in contact with police and improvements in employment and school retention.

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 60 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Appendix 5 Stua dies T bulated by Quality and PYD Domains and Constructs

High-quality Lower-quality Non-experimental No outcome experimental studies* experimental studies studies evaluation n=18, n=18, n=43, n=26, 17% of total 17% of total 41% of total 25% of total

Any Assets 18 (17%) 18 (17%) 42 (40%) 26 (25%)

Any Agency 12 (11%) 22 (21%) 37 (35%) 20 (19%)

Any Contribution 5 (5%) 10 (10%) 24 (23%) 13 (12%)

Any Enabling 17 (16%) 15 (14%) 37 (35%) 21 (20%) Environment

*including one high-quality quasi-experimental study

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 61 6161

on

after

focus of the

steps

ofessional ofessional put

first

range strong

to

a a

their

non-governmental market-driven

with interventions

chance

take engage

a and

adds to

youth

that

program

levels

e skills training, community community e skills training, in

enhancement helps

participants

government

training esponsibilities as duty bearers esponsibilities as duty bearers

of

skills give people

structural

to support skills

all

adolescent sexual and reproductive health, health, adolescent sexual and reproductive , young

capacity V ocational and lif

V of

et-driven et-driven the

ocational through Employability Internship Follow-up

V

entrepreneurial, or vocational skills. or vocational entrepreneurial, 1: 2: 3: 4:

ogram, assisting them with the challenges of job placement, assisting them with the challenges of job placement, ogram, orking Phase Phase Phase Phase Involvement Enhancing W elevant sector offices and youth-led organizations to mainstream youth-led organizations to mainstream sector offices and elevant

Activities Comprehensive package of activities. Four major program phases: phases: major program Four package of activities. Comprehensive • building mark technical, • lessons learned in phases 1 and 2 into practice a pr the pr into school. or reintegration a business, developing transferable skills. skills. transferable • sites so that Matched with local businesses or work environment. experience. gain valuable work youth • Key strategies: strategies: Key • • institutions to fulfil their r • r to HI responses capacity- through development and community gender awareness, people and communities young building activities for activities or services, and participation in community development and participation development in community activities or services, planning Main activities: Main activities: /AIDS, sexual and /AIDS, V Positively impact youth impact youth Positively and youth employment engagement using sport of adolescents and young of adolescents and young as the as well people, and promotion protection to of rights relating HI reproductive health and reproductive in Ethiopia. livelihoods with opportunities to youth conduct their own their review planning, and share activities, as as well information understanding of the of democracy process uatemala, uatemala, renadines, incent Country goals Project G V G Dominican Republic, Honduras, St. Jamaica, Kitts and St. Nevis, and the and Suriname population 10–24 Both Ethiopia development improve To ence d vi E USAID 16–24 Female Dominica, Royal Royal Norwegian Embassy UNICEF Unknown Unknown Cambodia people young provide To ithout Implementer Funder range Age target Sex Partners of the Americas UNICEF & United Nations Fund Population (UNFPA) Cooperation for Cooperation for of Development Cambodia W

s ie d anar Alliance: anar Alliance: ppendix 6 G roup Project roup A Stu Intervention name A Using Sport to Impact Youth and Employment (Partners of Youth the Americas, 2015) A Rights-Based to Approach Adolescents and Youth in Development Ethiopia Y., Yusuf, T., (Collins, & M.., H. Tesfahun, 2013). S., Dejene, G 2011) R., H. (Ruiz, Commune Youth Youth Commune

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 62 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Y L evel 3 evel L P L earning L evel 1 (equivalent to evel P-Regular serves learners L L P learners attend school in either L P-Youth programs. A programs. P-Youth L evel 2 (equivalent to grades 3 and 4); and 2 (equivalent to grades 3 and 4); evel L P) and the Nonformal Education program. A Education program. P) and the Nonformal L ormal Education program targets youth aged 15–35 years but aged 15–35 years targets youth ormal Education program P-Regular or A P-Regular or The CES servesolder (18–35) learners. significantly P-Youth L L Activities Two complementary interventions: The Accelerated The complementary interventions: Two (A Program a condensed primary grades for school curriculum represents levels: 1 – 6 and is organized into three grades 1 and 2); A (equivalent to grades 5 and 6). does not observeon the upper age. a strict cap A while than primary older (10–18 years) school age, who are A Nonf short-term training based All six implementing agencies offered of particularly in the area needs, on studies of labor market to a five- training over received Youth technology. information technology-related technical nine-month period in an information Some an internship. by followed and job-seeking skills, and life area training in basic skills and managing their remedial received youth also provided. placement services Job were microenterprise. own Created a bridge between businesses in the tourism sector and a bridge between Created Instituto had no access to these businesses. who previously youth integrated a social effort de Hospitalidade successfully into the operations of the companies and enlisted their support core the project. throughout atin America and the atin access to quality informal access to quality informal basic education the improve To of employability in disadvantaged youth L Caribbean and place them in decent jobs from public schools and to from place them in jobs the tourism sector , , iberia equitable increase To Country goals Project L Peru, Peru, Paraguay, the Panama, Dominican Republic, and Bolivia population 16– 29 Both El Salvador 16–29 Both Brazil youth train low-income To ynch L ucent USAID 10–35 Both Technologies, Technologies, Nokia, Microsoft, Merrill L Multilateral Investment USAID, Fund, Brazil Ministry of Tourism, International Youth Foundation, Multilateral Investment Fund of the Inter-American Development USAID Bank, iberian L iberia Implementer Funder range Age target Sex Education Development in Center, partnership with the Ministry of Education, Research Institute, Triangle and Young Christian Men’s Association L International Youth Foundation Instituto de Hospitalidade (Hospitality Institute / International Youth Foundation ., & ., L Y) L iberian L D., Jackson, Jackson, D., illar, R., 2006). 2006). R., illar, asida, J., & J., asida, L V Intervention name Core Education Core Skills for Youth (CES Youth (Evans, M., Rodriguez, Rodriguez, M., 2011) B., Yalley, Rodríguez, E., E., Rodríguez, 2006). Entra 21 ( Entra 21/ Tourism Entra 21/ Tourism and Social Responsibility Project (

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 63 6363

society and

effective

Karamoja civil

for in

livelihood

youth

of sustainable

UYONET

a

of

of oal initiatives and alternative and alternative oal initiatives

needs alternative G

in y (Eye on Karamoja) the y (Eye

on

capacity Os—engaging participants in

G engage survey

development

to

the

institutional such as showcasing messages on a large billboard messages on a large billboard such as showcasing

to baseline youth

a

ove Bugs engaged 100 students from the schools of arts, the schools of arts, Bugs engaged 100 students from ove L orm to act as a primary collecting and sharing the for forum oing Millennium Development oing Millennium Development Contributing Empowering Strengthening oject delivery. oject delivery. Conducting aried activities,

Activities The project strategy was focused on four thematic output areas: strategythematic output areas: on four was focused The project • and an audio-visual documentar sociocultural dimensions of the Karamojong; • platf oriented Karamoja a youth- for and advocating of youth views policy; socioeconomic development • ong pr productive activities through tailor-made skills and knowledge skills and knowledge tailor-made activities through productive as identified in the project in cluster groups provided trainings, areas; geographical • V carrying distributing lollypops the in the site of intervention; one only B-–be faithful and have ABC message (A–abstinence, and staff—including and C–condoms); partner, the university, practitioners from a range of health promotion and N sectors, government further questions and offering information. answering conversation, participants to the Samoa Family also referred The program social activities provided furtherAssociation for services; Health kits freely and made condoms contraceptive with music; available. education and carpentry in the and installation of the dispensers enhanced promotion, styling, These students also participated of the project. student ownership on STIs and information that provided in sexual health workshops brief counselling and question and offered relationships healthy time. ove Bugs was a health ove foster linkages between linkages between foster the traditional justice and system administrative and the national local system by governance supporting Karamoja to identify youth and sustainable effective interventions, development advance their concerns to local and national leaders, to and be empowered contribute to sustained socio-economic development. L promotion initiative aimed initiative promotion awareness to increase healthy promote of STIs, sexual relationships, personal develop skills and communication and condom use, effective access to sexual provide including health resources, students at for condoms, of the National University Samoa. Country goals Project population Both Samoa Unknown Unknown Uganda sought to The project College students in Samoa overnance overnance UNDP Democratic G Thematic Trust Fund The National of University Samoa ove Bugs ove Implementer Funder range Age target Sex Uganda Youth Uganda Youth Network (UYONET) L was a health promotion initiative implemented at the National of University Samoa ove Bugs ove C., & Pickering, ., Intervention name Karamoja Youth Karamoja Youth Empowerment Project Dennis, S., (Muzaki, & C., Bewayo, T., 2013). D., Kitutu, (Heard, E., Auvaa, Auvaa, E., (Heard, 2015) L L

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 64 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

of

and

Combating

forms

job

complementary of

worst

and

the

exploitation:

of

Development education

sexual

for

public eradication

/AIDS targeting youth, ages 13–24, and ages 13–24, /AIDS targeting youth,

V and ostitution”) through prevention, prevention, ostitution”) through

quality employability:

trafficking

& to

and

, targeting street vendors, commercial sexual commercial vendors, targeting street ,

/AIDS directly and/or working through their families. their families. through and/or working /AIDS directly Prevention V

training Access

violence

labor:

/AIDS: Prevention of HI Prevention /AIDS: ocational V e skills applicable to the workplace, along with specific market- to the workplace, e skills applicable Education: Child Sexual V

Activities Four components: a teacher-led, peer-assisted primary school peer-assisted a teacher-led, components: Four to encourage youth training of health workers program, and community distribution, condom promotion/ youth friendliness, mobilization. educational been central to this in arts education have Techniques activities. communication was also emphasis on information, There area. technologies and digital inclusion expansion. • lif areas. Emphasis on innovative abilities. related • urban child labor and garbage pickers. domestic servants, exploitation, • sexual violence (“child pr and networks as advocacy as well counselling and legal aid services, service coalitions. HI ages 0–12 targeting children care) assistance (community-based living with HI Program Areas: Program • other STIs, other STIs, , V HI and unwanted pregnancy and unwanted pregnancy among adolescents development of competent development citizens: and responsible who and youth children into confident, develop and productive healthy, able to meet their adults, individual needs and contribute to society Country goals Project population 12–18 Both Tanzania the incidence of reduce To /AIDS V European European Commission, Development Cooperation The Ireland, United Joint Nations Programme on HI and the UK Department for International Development USAID 7– 18 Both Brazil contribute to the To overnment of overnment ondon School Implementer Funder range Age target Sex Tanzanian Tanzanian National Institute Medical for the Research, African Medical and Research the Foundation, L of Hygiene and Tropical and Medicine, the Ministries of Health and of Education & of the Culture G Tanzania Partners of the Americas ijana V avyole, avyole, rosskurth, rosskurth, G G ) V Intervention name MEMA kwa 2005). H., (Mk (Hayes, R. J., J., R. (Hayes, J., Changalucha, D., Ross, Obasi, J., Todd, A., . . . I., A. POMMAR At-Risk Program Youth (Partners of the 2003). Americas,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 65 6565 our f

education in

settings

ork ormal w

abilities

of

non-f

variety

advanced a

emedial, in r

easingly training

incr

oom-based, velop de hands-on classr

in in

will

eadiness skills training to become competent workers. eadiness skills training to become competent workers. engage engage

ticipants y skill component areas: leadership and life skills, work readiness, readiness, work skills, leadership and life y skill component areas: Par Youth Youth

• Participants and technical skills. skills, financial and entrepreneurial learned in the have an opportunitythe skills they to apply will have site/training in a variety of work “hands-on” way in a classroom settings. Phase II: the their next steps toward participants take During this phase, livelihood person selects one of three Each young of work. world education and or formal job/internship, (small business, pathways coaching and then receives to his/her interests training) according each readiness, work improve To and mentoring along the way. Training Partner staff to identify participantworks with youth first Partners then assist participants Training goals. his/her development Training Finally, in taking the next step their development. participants youth in the second “accompany” Partners mentor or the integration of to ensure in order phase of the program, instruction and the on-the-job training components of formal the lessons can apply the youth well and determine how program into Phase II. proceed learned in Phase I as they Phase I: Phase I: • • r and work ke Activities or local

of

ork readiness capacity ticipants ticipants

ork/training par par the

er er Off Off Build institutions to support w coherent training • opportunities to learn f work/training • opportunities to learn w FROM • este L Country goals Project population USAID 16–30 Both Timor Implementer Funder range Age target Sex Education Development Center Intervention name Prepara Ami Prepara ba Servisu –PAS– Program (Education Development 2009). Inc., Center,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 66 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

of of

the ts-

very to e e to

e our f training, y spor

local

b to

tak education in

a

activities girls settings ovide

ensur

” to eplication and pr

skills

r attendance

ork meetings oject e designed

that ormal w or y lif caste) f pr

that

sensitize abilities

of members unities

to implement school the famil

non-f

e t ollow-up f ocate “Parivartan, eceive policies velopment

sessions

r and

y

and comm er

de variety

adv track schemes

and advanced a theatr

to to suppor famil velop emedial,

deliv in meet, village committee visits r

de eet to each tutoring

tribe/scheduled

to school

or educating girls and to str girls each

easingly

encourage outr home

and

in

w-caste overnment

training learnings g and members

ticularly those who have fallen behind those who have ticularly to incr staff staff lo or

special

tance of girls’ education and the f

which to staff mentors at

oups

and oom-based,

overnment (scheduled in gr

g

each

y velop

conduct plans

school school ys in ound girls’ education, early marriage, and gender marriage, early ound girls’ education,

local onment and to design implement plans de

hands-on classr meetings overning committees: committees: overning school

bo caste families

local

committee champions in in

findings spaces

will train train w ticipation of girls in school

train tan orkers e unities and leaders: unities and leaders:

attendance lo unity

w

and with equip eadiness skills training to become competent workers.

saf

individual local

and and

oject

all and

t t engage engage w-caste pr Parivar

and staff

each vulnerability lo

comm e

ticipants

velop velop p elop leadership and career counselling programs for girls for counselling programs elop leadership and career w-caste adolescent girls: w-caste adolescent girls: w-caste families of adolescent girls: y skill component areas: leadership and life skills, work readiness, work skills, leadership and life y skill component areas: y strategies Par Youth Youth Identify De Establish Encourage Outr Ma Link Recruit Form Use De Suppor Suppor Shar illage comm Advocate Train Train o o

• Participants and technical skills. skills, financial and entrepreneurial learned in the have an opportunitythe skills they to apply will have site/training in a variety of work “hands-on” way in a classroom settings. Phase II: the their next steps toward participants take During this phase, livelihood person selects one of three Each young of work. world education and or formal job/internship, (small business, pathways coaching and then receives to his/her interests training) according each readiness, work improve and mentoring along the way.To Training Partner staff to identify participantworks with youth first Partners then assist participants goals.Training his/her development Finally,Training in taking the next step their development. participants youth in the second “accompany” Partners mentor or the integration of to ensure in order phase of the program, instruction and the on-the-job training components of formal the lessons can apply the youth well and determine how program into Phase II. proceed learned in Phase I as they Phase I: • • r and work ke Activities Activities L and track their situation. year • and gain leadership skills • par meet the needs of girls, L ar sensitize parents socialization • f material and financial incentives encouraging critical program and empowerment based life-skills violence including attitudes around on gender norms, reflection and sexual harassment/abuse of girls against women • V to the impor communities girls in school action to retain School staff and g • management committee members to conduct gender analyses of the school envir “girl friendly”. schools more make • adolescent girls • dev • and par safety and policy implementers: makers Policy • regularl briefing them • ke • • their peers • • Adolescent boys: • • marriage consequences of early • or local of capacity ticipants ticipants par par the ent work readiness readiness ent work er er OM work/training Off Off Build institutions to support coher training • the quality of is to improve of adolescent girls life vulnerable and from marginalized in the Bijapur communities districts and Bagalkot of north Karnataka by supporting entry and of adolescent retention girls in secondary delaying education and by and entryage at marriage Specifically, into sex work. the intervention aims of these to bring levels outcomes among girls in line low-caste with those of all girls in Karnataka. opportunities to learn f work/training • opportunities to learn FR • Country goals Project Country goals Project population population Female India of Samata goal The overall 13 USAID 16–30 Both Timor L este Department for International Development (DFID) (UK) E V Implementer Funder range Age target Sex Implementer Funder range Age target Sex Education Development Center STRI 2015) ., L Intervention name Intervention name Prepara Ami Prepara ba Servisu –PAS– Program (Education Development 2009). Inc., Center, Samata S., T. (Beattie, P., Bhattacharjee, C., Davey, S., Isac, . . S., Nair, P., Javalkar, Heise, .

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 67 6767 to

skills

other training e-service

pr

and

umeracy lobal Citizen and Girls

n

dization,

G education ooms and

and

offices committees and standar

t networks through through t networks

materials

teachers

classr grants

clubs

of

literacy

work t-up in outh

y

learning existing ocational

star education education businesses

v

eform

training to Frame r ering:

and

and

off training unity

vice ehabilitation r egional

r

technical riculum

of water tanks, girl-friendly spaces) girl-friendly water tanks, school-based

comm teaching orums training in-ser

of

velopment F outh-owned

cur

and implementation

y of of of and/or

de

Qualification education in

or skills f

riculum, sports for change, community action events, action events, community sports change, for riculum, training:

werment orkforce ocational velopment engthening pacity-building centers certification, nonformal rehabilitation support volvement • w • •V • business • • Construction De Ca In Str Establishment Teacher inkages with private-sector and suppor

Activities Two primary elements which work to aid this population: Most primary to aid this population: elements which work Two skills and training in work provides the program prominently, with a mentorship component, The training is paired skills. life to educational and/or employment to link youth which works on the component focuses The second program opportunities. and their criminal offenders youth institutional system surrounding the program the judicial system, through Working reintegration. nonviolent sentencing as a legal option for advances alternative youth. • (latrines, structures • gain teaching qualifications • • • • • • Empo L internship or apprenticeships. Corps’ Mercy Civic education training through Corps cur and leaders, among youth task forces creating training, advocacy decision-making participation youth in local government promoting also provided were outh outh y y

oved for at for oved equitable Somali 15,000

e economically ered to participate ered and

least

Fair 100,000 At

To reduce crime by crime by reduce To enhancing skills and opportunities increasing at-risk youth for • secondary education services impr mor are empow least 50,000 Somali youth, least 50,000 Somali youth, and members, community education officials • with supportive self-reliant systems • in and contribute and productively positively to society uyana Country goals Project G population USAID 15–24 Both USAID 15–24 Female Somalia Implementer Funder range Age target Sex Education Development Center Mercy Mercy CARE Corps, International, the Save Children International; local partners Somaliland are National Youth Organization (SONYO) and Mudug Development Association Network ogram cía, cía, ar G eaders Pr Intervention name Skills and for Knowledge Employment Youth (SKYE) (De D., Jones, S. E., E., S. Jones, D., M., Pucilowski, A. Kawall, Fraites, E., McIntosh, R, R., Chuck-a-Sang, 2014). L & M., (Nicholls, A., Hassan, 2014 ) Somali Youth Somali Youth

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 68 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

self-

then

leaders

skills,

young

life

Serb

basic

and

learned

Albanian

Kosovo participants

in-service to existing teachers and pre-service to young

all emerging

1, 2,

Phase Phase centers and implementation certification,

training • workforce development • nonformal skills education training in literacy and numeracy • rehabilitation and education training of technical vocational standardization, Qualification Framework • Vocational • business skills training and start-up grants • support businesses youth-owned for In In training: Teacher eceived advanced training, planned joint projects, and sought planned joint projects, advanced training, eceived

Activities Activities Two primary elements which work to aid this population: Most primary to aid this population: elements which work Two skills and training in work provides the program prominently, with a mentorship component, The training is paired skills. life to educational and/or employment to link youth which works on the component focuses The second program opportunities. and their criminal offenders youth institutional system surrounding the program the judicial system, through Working reintegration. nonviolent sentencing as a legal option for advances alternative youth. r supportcommunity their implementation. for Phased approach. Phased approach. • jobs/entrepreneurship activity streams: selected into one of two participantsskills, built work In each track, or civic engagement. and the a commitment to participate lives in their own developed and confidence, raised community of their communities, well-being the tangible benefits of their efforts. realized • and other of classrooms • Construction and/or rehabilitation spaces) girl-friendly water tanks, (latrines, structures • gain teaching qualifications of teaching and learning materials • Development education offices of regional • Capacity-building reform in curriculum • Involvement education committees of community • Strengthening clubs and Girls • Establishment of school-based youth • Empowerment offering: Forums inkages with private-sector and support networks through L inkages with private-sector and supportthrough networks internship or apprenticeships. Corps’ G lobal Citizen Mercy Civic education training through action events, community sports change, for Corps curriculum, and leaders, among youth task forces creating training, advocacy decision-making participation youth in local government promoting also provided were

job

inter-

the the

gain gain build

youth youth youth

experience, and experience, y need to play a more a more y need to play Help Help Help Fair and equitable 100,000 Somali youth At least 15,000 youth

help young people help young diverse Kosovo’s from become communities participants active in building a viable shared and themselves for future through their communities of three the realization objectives: • support needed to find employment. future • enhancing skills and opportunities increasing at-risk youth for skills, confidence and skills the in leadership role active and public community on issues that directly life them. affect • ethnic reconciliation/ tolerance and work together on concrete that advance projects interests. shared • secondary education at for services improved least 50,000 Somali youth, and members, community education officials • economically more are with supportive self-reliant systems • to participate empowered in and contribute and productively positively to society Country goals Project Country goals Project G uyana crime by reduce To population population USAID 15–24 Both USAID 15– 26 Unknown Kosovo is to goal The overall USAID 15–24 Female Somalia O partners: O partners: G Implementer Funder range Age target Sex Implementer Funder range Age target Sex Education Development Center Corps Mercy local and three N Centar za Razvoj Zajednica, Center Kosovo International for Cooperation, and Mundësia Mercy Mercy CARE Corps, International, the Save Children International; local partners Somaliland are National Youth Organization (SONYO) and Mudug Development Association Network ) L eaders (SKY Intervention name Intervention name Skills and for Knowledge Employment Youth (SKYE) (De G arcía, E., S. Jones, D., M., Pucilowski, A. Kawall, Fraites, E., McIntosh, R, R., Chuck-a-Sang, 2014). Support for Young Kosovo’s Corps, (Mercy 2012). L Somali Youth Somali Youth L eaders Program & M., (Nicholls, A., Hassan, 2014 )

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 69 6969

on of

in

in

from

social, youth sports on

at

ages of

using on through

ocusing provide f

youth use

community

workers

public

based

youth to

through

responsibility safe

individual

enrolled and

other

of

a community

process consequences

14

radio social

violence universities, tools

to role activities

together 6–

each

to

approved youth

and/or and

one

the parents of of

interventions.

ages

with promote

bring community

access

6–14

professionals

on

least

domestic

group to with

faculty

assessment and at and communication. hours

psychological leadership

in

measurement

ages

youth

and

vices. vices. parents

in

better health 20

12–18

ouths, including a comparison of ouths,

the to for

and

outh school youth gang

y of

networking

youth psychosocial

platform with

meetings

ages

in of produces for

mental for

and

participate

nonviolence study

participate middle psychological of services

12–18

activities illas. illas. completes

youth 18

screening

V parents 12–18 visits

and weekend 6– learn

health

for program

w media in a participatory society. w media in a participatory society. ages platform

vices. vices. networking

and

youth

ages actively

validate

capacity

ages and radio sets. and radio sets. qualitative baseline

6–14 consequences

V youth monthly youth a a

online social and mental the

ormed services to teenagers and parents. ormed services to teenagers and parents. outh

after-school monthly training youth psychosocial

es to gang membership. es to gang membership.

y olled at the e study. e study. the

ages parents youth

engthen academic skills. engthen academic skills. elementary enrolled velop specific interventions and psychosocial processes to specific interventions and psychosocial processes velop Villa

recreational, literary, computer and art education modules literary, recreational, oject’s Web venues for learning, communication, and communication, learning, for venues Web oject’s and T and illas. illas. V vice work. vice work. on community focusing vice announcement per quarter, V rain vironment for their children and delegitimize organized criminal their children for vironment outh oup psychosocial interventions. oup psychosocial interventions. Provide Facilitate Help Provide Provide Each Each Facilitate Develop Develop Conduct Develop Conduct Develop Improve Provide Help Provide Engage Assess T Y

Activities • • and girls. boys • • • and str • moral, change. that supportand proactive positive • clubs, • en violence. • 6–14 enr alternativ • traditional and ne ser • ser and nonviolence. responsibility • the pr collaboration. • all and de them. address • gang and domestic violence on y qualitativ • validated tools. • • trauma-inf gr • psychological ser • mental health and psychosocial ser the • • •

of

gang

by

families

develop

affected

eenagers outh e-adolescent children e-adolescent children oductive alternatives to alternatives oductive Low-income T Y eceive context-specific, context-specific, eceive

• pr school desertion prevent healthy and promote lifestyles. • pr and domestic violence r and effective replicable, psychosocial community services. gang membership. gang membership. • Country goals Project population USAID 6–18 Both Mexico Illas V A) V Implementer Funder range Age target Sex Alianza Heartland Mexico (AHM) and Asistenciales ( AR L Intervention name The EJEMP Project (Alianza Heartland Mexico/ Heartland Alliance 2015). International,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 70 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries on

sports focusing through

finance

scheme lobal Youth Service Youth lobal activities

to community approved G

access

placement leadership

and

job

a in school faculty and social workers

youth entrepreneurship in youth

through

employment illas. V illas.

of 12–18

to ages culture

youth

a

youth employment

pproach. This approach uses three phases (inclusiveness, phases (inclusiveness, uses three This approach pproach. at least one radio public produces program Villa youth Introduce Secure Promote Engage Assess the consequences of gang and domestic violence on youth elementary and middle Train responsibility and community ages 6–14 learn nonviolence Youth

Activities Activities • academic skills. and strengthen social, ages 6– 14 through youth activities for after-school • Provide psychosocial interventions. group with better access to community and parents youth • Provide psychological services. and/or individual ages 6– 18 participate • Help youth in group mental health and psychosocial services. at in enrolled psychosocial services of youth to parents • Provide the V illas. elections project; youth service community volunteer camps; Day; training in students; university for program summer volunteer technologies and communication information moral, recreational, literary, computer and art education modules literary, recreational, moral, change. that supportand proactive positive ages 6–14 to universities, youth visits for • Facilitate monthly T V and radio sets. and clubs, a safe participate in and promote actively • Help parents and delegitimize organized criminal their children for environment violence. ages of youth meetings with parents weekend monthly • Provide at the 6–14 enrolled • service work. • Each on community focusing service announcement per quarter, and nonviolence. responsibility with each other through ages 12–18 networking • Facilitate youth and communication, learning, for venues Web the project’s collaboration. communication. youth for online platform • Develop from to bring together youth platform social networking • Develop all V illas. • to specific interventions and psychosocial processes and develop them. address study of the psychological consequences • Conduct a qualitative including a comparison of gang and domestic violence on youths, and girls. boys and validate psychological assessment tools based on • Develop study. qualitative using process and measurement • Conduct a baseline screening validated tools. mental health and psychosocial interventions. • Develop to provide of mental health professionals the capacity • Improve servicestrauma-informed to teenagers and parents. • support for groups; initiative of youth Capacity-building of capacity-building public policy; of youth-related development national activities to mark centers; volunteer alternatives to gang membership. to gang membership. alternatives and use of ages 12–18 on the role youth training for • Provide media in a participatorytraditional and new society. completes 20 hours of youth • Each enrolled • a 3x6 6 components (engaging, and sustainability) that achieve ownership and investing business venturing, savings, generating income, accessing markets) • •

of

outh roups roups number number

effective G

capacity the the

an

the

tunities for tunities for ective youth youth ective increase build develop increase

o o o o develop Teenagers T T T T gang by affected Youth outh Initiative outh Initiative

families of • Low-income children pre-adolescent school desertion prevent healthy and promote lifestyles. • to alternatives productive gang membership. • and domestic violence context-specific, receive and effective replicable, psychosocial community services. 14–25) in all oblasts to contribute (regions) to community-based and development alleviation poverty volunteerism through at the local level. During implementation, specific the following defined were objectives as the project and refined evolved: • centers volunteer • of eff Y and vibrant national y network • of oppor to implement community to implement community in projects development rural areas • to participate youth in discussions of policy issues them which affect is to see youth earning is to see youth a sustainable income that can significantly contribute to improving (health, their livelihoods etc.). education, Country goals Project Country goals Project population population 14–25 Both Kyrgyzstan (aged mobilize youth To 18–30 Both Yemen ultimate goal The project’s overnment, overnment, USAID 6–18 Both Mexico G UNDP Embassy of and Japan Embassy of South Korea Kyrgyzstan Japanese Os V A) G Implementer Funder range Age target Sex Implementer Funder range Age target Sex Alianza Heartland Mexico (AHM) and V Illas Asistenciales ( V UN UNDP and national several bodies and N Support to V yrgyzstan olunteerism in Intervention name Intervention name The EJEMP L AR Project (Alianza Heartland Mexico/ Heartland Alliance 2015). International, UN Strengthen Youth Youth Strengthen 2007). B., (Sterland, V K Youth Economic Youth in Empowerment (YEEP) Yemen A., (Bahnassi. K. 2016)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 71 7171

education

station

Babadok

forums.

Cultural

civic

radio show

Moris

on

the three te

Ar for

peace-building.

and

regional-youth by

training

and a

round in the field. in the field. round

led

four shows G

and trainings

and

shows magazine governance exhibition

forums

talk leadership and

good radio

ecruits youth reporters to produce stories reporters to produce ecruits youth youth 24

civic for class

radio

or a network of youth radio reporters. This was radio reporters. of youth or a network of outh-relevant issues at five separate universities. separate universities. issues at five outh-relevant

art on

our regions. books

national

regional

ee training five-day

Eight Production Comic A A Thr

Activities seminars in y • management f radio staff and substantial mentoring of community by followed Common for Search managers by • Rebenta! which r • Center in f A youth mapping exercise to identify target youth organizations to identify target youth exercise mapping A youth and individuals. • • reporting as reporting subject, youth offering issues, on youth Radio drama and participants in finding solutions. participants, Karau Dikur ba the show episodes for of 25 new production Dame. all across A large publicity campaign and a series of listening groups 13 districts. • Unknown Setting up a new youth portal to provide access to information on access to information portal youth to provide Setting up a new to participate. and how why content for to provide initiatives study of existing youth A mapping the portal and identify partnerships. of a two-way development Within the portal, Second phase: a white paper with a game launched, channel, communication towards apathy people’s young for written on the reasons and a meaningful participation and engagement in local governance, risk management plan. internship opportunities at offices of local council phase: Third skills-building local councils, in youth volunteerism members, etc. partners, opportunities with project in which youth engage in which youth and with government leaders to community peace and promote and prevent reconciliation violence election-related as a pilot phase to address as a pilot phase to address insecurity in Somalia, actors linking numerous together at the community and aid organization levels. objectives One of the key at risk youth was to reach of violence at community level. increase youth political youth increase participation and civic engagement in local governance. este the way transform To L Country goals Project population 15–30 Both Jordan is to The objective s overnance overnance USAID Unknown Unknown Timor DFID 18– 35 Both Somalia was designed The project UNDP’ Democratic G Thematic Trust Fund V Os G round Timor round este abour Implementer Funder range Age target Sex Search for for Search Common G L UNDP, UNDP, International L Organization, UNICEF & local N UNDP, UN UNDP, ocal uillemois, D., D., uillemois, L overnance G Intervention name Youth Engagement Youth to Promote Stability (YEPS) 2015). K., (Stine, Youth for Change for Youth (also Project at “Youth as known Risk” project) ( Mohamed, M. S., S., M. Mohamed, I., M. & Mohamed, 2012). G n.d.) R., (Knox, Youth Participation Youth in

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 72 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

skills,

new

and

social

iving (every L management,

works

visits

trainings, project

pupil’s

in

and of Arte Moris Cultural

http://molodistua.org

monitoring

es place immediately after es place immediately Portal

schools analysis by (trainings

by

activities;

activities evaluated

(volunteer Knowledge

and

activities. unications skills, ICT skills); unications skills, evaluated

activities;

teachers, pupils, leisure launched direction

education

PR management, team building etc); PR management, development for for

and

orientation ojects prepared within the course, monitoring visits (the within the course, ojects prepared

activities;

Project

rainings rainings Capacity Educational Ecological Sport Health Culture and a training on radio station A training on radio talk shows art class and exhibition led by A five-day forums. regional-youth and four forums national youth Three T T The

Activities Activities Heritage is aimed at the creation of a collection of oral stories by of a collection oral stories by Heritage is aimed at the creation of older generations. the lives people from young A youth mapping exercise to identify target youth organizations to identify target youth exercise mapping A youth and individuals. civic education civic leadership trainings and three • Eight regional separate universities. issues at five seminars in youth-relevant • • This was radio reporters. of youth a network management for radio staff and substantial mentoring of community by followed in the field. Common G round for Search managers by Babadok the show for of 24 radio magazine shows • Production stories reporters to produce youth Rebenta! which recruits reporting as reporting subject, youth offering issues, on youth Radio drama and participants in finding solutions. participants, Karau Dikur ba the show episodes for of 25 new production Dame. all across A large publicity campaign and a series of listening groups 13 districts. and peace-building. governance good • Comic books for organizational management and gender Increased Output 1: organizations. involving centers and volunteer of youth capacity supported. were report 595 events to the evaluation According were: The main types of events • fundraising, • leadership and comm • • • trainer was visited at least 1 time) and polling of the teachers who passed the trainings (the polling tak The trainers passing the training and after finishing first course). of the monitoring visits and polling; about the results informed are • social pr teachers and the with unsatisfactory of new results visited in the first turn) and polling of are work of pupil’s analysis informed The teachers are teachers at the end of each course. The pupils were of the monitoring visits. about the results Technologies once within Computer only surveyed experimentally course. Profession and Future • The social solidarity among generations. Strengthened Output 3. named historical and social component of the Project • regions. Center in four • social competencies and skills of youth. Developed Output 2. Activities included: • Unknown Setting up a new youth portal to provide access to information on access to information portal youth to provide Setting up a new to participate. and how why content for to provide initiatives study of existing youth A mapping the portal and identify partnerships. of a two-way development Within the portal, Second phase: a white paper with a game launched, channel, communication towards apathy people’s young for written on the reasons and a meaningful participation and engagement in local governance, risk management plan. internship opportunities at offices of local council phase: Third skills-building local councils, in youth volunteerism members, etc. partners, opportunities with project

use

, , peer” to to become with

y young y young

pacity-

youth

for

to

-to- collection

a local youth youth youth

youth esources for for esources

efforts

youth “peer

velop critical velop orks; easing sustainability of ptable to rapidly ptable to rapidly velop cooperation velop Support Build Focus Provide Support Support Instruct Help Develop in which youth engage in which youth and with government leaders to community peace and promote and prevent reconciliation violence election-related • of basic office knowledge and the ability applications, to use them develop and implement social mini- projects; • on finding information career guidance, career choice of observation, career; and future studies, • activities and ca building events; • netw • incr computer literacy to de the ability thinking, and to independently a problem; solve gradually • de skills and ability to work together; effectively • Internet r ada changing conditions of of their development life, educational and life own trajectories. • of oral stories b of the lives people from older generations. youth centers youth • as a pilot phase to address as a pilot phase to address insecurity in Somalia, actors linking numerous together at the community and aid organization levels. objectives One of the key at risk youth was to reach of violence at community level. increase youth political youth increase participation and civic engagement in local governance. Country goals Project Country goals Project population population 8–35 Both Ukraine 15–30 Both Jordan is to The objective UNDP, UNDP, , V USAID Unknown Unknown Timor L este the way transform To UN Intel DFID 18– 35 Both Somalia was designed The project UNDP’s UNDP’s Democratic G overnance Thematic Trust Fund Implementer Funder range Age target Sex Implementer Funder range Age target Sex Search for for Search Common Timor G round L este Ministry of Ukraine Youth and Sport UNDP, UNDP, International L abour Organization, UNICEF & local N G Os UNDP, UN V UNDP, vych, I., I., vych, olose V Intervention name Intervention name Youth Engagement Youth to Promote Stability (YEPS) 2015). K., (Stine, Social Youth Civic Inclusion for Engagement in Ukraine ( 2011). 2011). Youth for Change for Youth (also Project at “Youth as known Risk” project) D., ( G uillemois, S., M. Mohamed, I., M. & Mohamed, 2012). Youth Participation Youth in L ocal G overnance n.d.) R., (Knox,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 73 7373 oung y ormation

in

transf

among

vestments conflict change

in

or f

ough vioral thr

drama

ormat with discussion of issues beha ogramme which usually runs for runs for ogramme which usually

in

pr ersarial groups. Activities under this ersarial groups. and V

unity Activities under this objective included Activities under this objective magazine f sustainability

V ecorder repair, computer networking, and computer networking, repair, ecorder comm

attitudinal

oduction teams on various issues on children and oduction teams on various issues children ormation of 22 school-based drama clubs and a wider

pr long-term lasting V

the

omote /video cassette r Facilitate Engage Pr V Activities Training courses on skills for audio technicians, barbers, auto barbers, audio technicians, courses on skills for Training culinary people, monitor and personal computer repair mechanics, and skills in survival, diesel mechanics, hospitality managers, artists, broadcasting, daycare, construction, small business management, T entrepreneurship. • adv people and mentors from the f activities, competition and a theater tour grant drama club microgrant competition. • institutions. community that and sustainability grants program a sustainability workshop drama helped existing clubs to supportof 15 new the creation and a cross-border clubs in neighbouring schools and communities Tajikistan. exchange with drama clubs in objective included a participatory program assessment, training of included a participatoryobjective assessment, program and theater camps. trainers, • Execute the “Youth Today” T Today” “Youth the Execute T using a 30 minutes documentary of a 10- to 15-minute and presentation prepared T young by youth.

ecute efficient okerage

ex

an

and

Implement Evaluate • to and procedures people help young life, enter productive them with the providing specialization and skill that the private levels sector demands. labor market br labor market system that could be within the replicated training system vocational in the country • methodologies, strategies, conflict prevention and conflict prevention of peace at the a culture and regional, community, national levels for children and youth to and youth children for their participation exercise right and to engage them in media advocacy Country goals Project population 16– 29 Both Belize vernment vernment o G Inter- of Belize, American Development Bank USAID Unknown Both Kyrgyzstan sustainable Promote UNICEF Unknown Both Cambodia opportunities provide To imited (an L ecuting agency Implementer Funder range Age target Sex ex the set up for project) Youth Start Youth Plan International and Research Exchange Board (IREX) Support and Children People Young 2001). 2001). Bureau

td., V L oup, oup, aliant Consulting r V Intervention name Youth Start Plan Youth (YSP) ( G Youth Theater for Youth (YTP) Peace 2014). (IREX, (Ruiz, H. R., n.d.). R., H. (Ruiz, Youth T Youth

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 74 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries e and

e to

irls ar G tunity orkshops w interactiv

e ar oppor

the ovides assistance ovides

dynamic e been an inspector

ve ha y for each team of 10–20 y for

orkshops w

includes girls

skills

olunteers hav This

e

V Lif YUWA

team ogram:

pr Older

ogram:

velopment: pr

de soccer ograms: ograms:

Bridge

training:

unity e training to become tutors for their peers, younger students, students, younger their peers, e training to become tutors for ofessional Comm Skills-building Pr Academic Teacher eadership pr

Activities • • designed individuall discussion-based, YUWA. in of years girls based on their age and number stories. encouraged to ask questions and share • about the importance of education and pr math and science classes, remedial to a better school, transferring personal tutoring, summer school, an intensive English classes, daily and computer classes. L players) YUWA senior coaches (who are YUWA Coaches training. coach football multiday participate intensive, in at least three licensed or professional led by Clinics are training clinics each year. India and abroad. coaches from • experiences their work to share YUWA visit women Professional and lead soft skills training. and a human resources a midwife, an editor, general of police, specialist. • receiv and write. to read in the village who want to learn how and women as tutors girls can earn money Once teacher training is completed, and Hindi. English, in math, girls can learn about their their their health, bodies, and their community, rights. Country goals Project population Female India space where a safe Create seems to be 8–16 Self-funded Unspecified: Implementer Funder range Age target Sex YUWA, Sparking YUWA, led Youth Change in India Intervention name YUWA 2014). (YUWA,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 75 7575 Appendix 7 Studies Tabulated by Quality and Topics and Subtopics

High-quality Lower-quality Non-experimental No outcome experimental experimental studies evaluation studies* studies (n=43, 41% of total) (n=26, 25% of total) (n=18, 17% of total) (n=18, 17% of total) Health 17 (16%) 13 (12%) 34 (32%) 17 (16%) HIV/acquired 11 (10%) 5 (5%) 23 (22%) 8 (8%) immunodeficiency syndrome (AIDS) Sexual and 8 (8%) 2 (2%) 23 (22%) 7 (7%) reproductive health Mental health 2 (2%) 7 (7%) 15 (14%) 2 (2%) Smoking and alcohol 5 (5%) 2 (2%) 8 (8%) 5 (5%) and drug use Suicide 0 (0%) 1 (1%) 1 (1%) 1 (1%) Obesity 1 (1%) 0 (0%) 0 (0%) 0 (0%) Resilience 1 (1%) 5 (5%) 9 (9%) 2 (2%) Breastfeeding 0 (0%) 0 (0%) 0 (0%) 0 (0%) Hepatitis 0 (0%) 0 (0%) 0 (0%) 1 (1%) Nutrition 1 (1%) 0 (0%) 1 (1%) 0 (0%) Asthma 0 (0%) 0 (0%) 0 (0%) 0 (0%) Physical fitness 1 (1%) 0 (0%) 0 (0%) 1 (1%) Child maltreatment 1 (1%) 2 (2%) 3 (3%) 3 (3%)

Democracy and 2 (2%) 7 (7%) 21 (20%) 16 (15%) Governance Violence 1 (1%) 5 (5%) 11 (10%) 11 (10%) Youth capacity- 1 (1%) 3 (3%) 11 (10%) 13 (12%) building and civic engagement Child marriage 0 (0%) 1 (1%) 4 (4%) 4 (4%)

Economic 2 (2%) 6 (6%) 20 (19%) 20 (19%) Development and Education Education 1 (1%) 3 (3%) 10 (10%) 11 (10%) Workforce readiness 1 (1%) 4 (4%) 10 (10%) 15 (14%) and employability Bullying 0 (0%) 0 (0%) 2 (2%) 3 (3%) Environment 0 (0%) 0 (0%) 1 (1%) 0 (0%)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 76 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Longer-term impact Longer-term reported were All effects at 12 and 24 months follow-up. None described Statistically significant Statistically outcomes Participants risk of herpes simplex 2 acquisition was lower by one-third after over two years of intervention for Men both men and women. showed improvements in self- reported intimate partner and casual sex, violence, No such problem drinking. effects for women. in knowledge, Improvements and substance risk attitudes, behaviors activities Facilitators training (3 a weeks), single 3-hour education session, community mobilization, access and consent processes and skills development sessions lasting hours each five Community Community organization Africa s ie d Sex Sex Country Setting Intervention l Stu a Age Age range 16–23 Both South 17–24 Unknown Malaysia University Eight education iment r e uggen-heim G oundation National Institute of Mental Health the South (NIMH), African Medical Council, Research and Funder F and the Malaysia Health Malaysian Board Promotion Exp lity a Planned Parenthood Association of South Africa Implementing organization University PutraUniversity Putra University

igh-Qu ppendix 8 / AIDS A H V All three sectors All three Stepping Stones: adolescent sexual and reproductive health (ASRH) et al., (Jewkes 2006) Health only HIV and ASRH Peer-led education for program HI Intervention name/ description (Citation) (Ibrahim, Jamil, Rampal, 2012) & Zain,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 77 7777 Longer-term impact Longer-term None described None described None described None described services, perinatal and services, V Increases in utilization of STI/ Increases HI antenatal services in self-efficacy, Improvements and attitudes, knowledge, methods protection Statistically significant Statistically outcomes in self-efficacy Improvements and self-reported risky behaviors Reduction in school dropouts stronger marriage, and early better future school bonding, equitable more expectations, and more gender attitude, concerns about consequences of sex School-based SRH education and out-of- school peer outreach, community mobilization, health workers’ training in youth-friendly health services sessions integrated within regular school health education schedule (one session every weeks). two activities and skills development supplies (food, uniform, fees, school- etc.), based helpers, and support solving girls’ problems to enhance attendance. Educational support. healthcare healthcare facility School Education hana School G Africa Sex Sex Country Setting Intervention 10–17 Both 13–15 Both China School Education Age Age range 9–18 Both South 10–16 Female Zimbabwe School of Provision aboratory of The Rockefeller The Rockefeller Foundation Children’s Environ- Children’s mental Health Funder Shanghai Key L NIMH National Institute of Child Health and Human Development aboratory Navrongo Navrongo Health Research Centre of Children’s of Children’s Environmental Health Pacific Institute Research for and Evaluation. Implementing organization Shanghai Jiaotong and University Shanghai Key L of University Pennsylvania

V irls G eary et al., eary et al., /AIDS risk L V V i et al., 2010) i et al., et Us Protect et Us Protect L Community- based ASRH intervention et (Aninanya 2015) al., School-based, peer-led HI Supporting Adolescent Orphan Our Future: Our Future: HI in to Stay School as HI risk prevention et al., (Hallfors 2011) Intervention name/ description (Citation) L 2012) prevention prevention program children for of migrant workers ( reduction (O’

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 78 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries ong-term impacts on Longer-term impact Longer-term in Improvements sustained at knowledge 12 months was The result sustainable after one-year follow-up. None described L and attitudes, knowledge, social support perceived up) and (10-month follow (less on sexual behavior sexual activities and more condom use at six-month the full for follow-up) implementation group

V Improvements in knowledge, in knowledge, Improvements and self-reported attitudes, at 12 months risky behaviors Statistically significant Statistically outcomes Changes in knowledge, and self-efficacy, attitudes, vulnerability to HI perceived Reductions in self-reported risky behaviors in knowledge Improvements Students who received scores. also showed full program of in perceptions improvement and perceived sexual behavior social support. and skills development activities Adolescent, and parental health provider education. Intervention included 10 two-hour sessions for adolescents, six two-hour sessions for and parents, training two-day for workshop providers education and skills development sessions led by trained teachers (one session per week) interventions based on behavior-change theories University Education organization School 20-week School six-session Two ietnam Community Africa V Africa Africa Sex Sex Country Setting Intervention Both South rade 6 15-20 Both 18–24 Both South Age Age range G (~12 years old) 12–21 Both South National Institutes of Health (NIH) NIMH Funder NIMH United States Agency for International Development (USAID) Khanh Hoa Provincial Health Services and Ha Noi Medical School of University Pennsylvania, USA Implementing organization University of University Pennsylvania, USA KwaZulu-Natal Department of Education /AIDS V ife Skills ife L /STD risk V Exploring the World of Adolescents: ASRH (Pham et al., 2012) HI Up: Wake Sexual risk behavior reduction (Heeren, Jemmott, Ngwane, & Mandeya, 2013) Tyler, The Intervention name/ description (Citation) and HI reduction reduction intervention et (Jemmott 2010) al., Education Program (James, Ruiter, Reddy, & McCauley, van den Borne, 2006)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 79 7979 Longer-term impact Longer-term at No significant effects and 12-month three- follow-up None described in this paper. Reductions in anxiety at three Reductions in anxiety at three months (not considered difference) relevant clinically Statistically significant Statistically outcomes significant (p < .05) Statistically in alcohol frequency difference ( β = −0.22) and cigarette and amounts ( β = −0.18), significant differences marginally frequency cigarette (p < .10) for ( β = −0.15) in the treatment to when compared group Pretest group. the control and the amount frequency post-test of use predicted and amount of use frequency In addition, each substance. for of alcohol or cigarettes offers a significant increase predicted in the use of these substances. education and gender Parent not significant predictors were of changes in substance use to Compared at posttest. group, in the control females group in the treatment females reduction reported a relative of alcohol ( β in the frequency use ( β = −0.28) and cigarette = −0.25) and in the number in the smoked of cigarettes ( β = −0.22). 30 days previous hour weekly hour weekly sessions and booster two classroom sessions of a cognitive behavioral therapy-based intervention activities education and skills development Sex Sex Country Setting Intervention Both Mexico School 10-week 13–15 Both Chile School one- Eleven Age Age range Early Early adolescence Welcome Trust Welcome Funder Arizona State and NIH University uadalajara, uadalajara, uadalajara, University of University and UK, Bristol, de Universidad Chile and Mexican Social Security Institute, Mexico Implementing organization G G Arizona State University, of University : : L Mental health Think I (Yo) Feel (Pienso), and (Siento), Act (Actuo): mental health intervention to depres- reduce sion symptoms et al., (Araya 2013) (including tobacco) Substance use prevention Keepin’ it REA Intervention name/ description (Citation) substance use prevention (Marsiglia et 2014) al.,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 80 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Longer-term impact Longer-term None described None described None described Improvements in attitudes, in attitudes, Improvements control, behavioral perceived and behavioral skills, life Intentions Statistically significant Statistically outcomes in knowledge, Improvements and smoking self-efficacy, behaviors in some Improvements activity tests and physical of students the percentage activity who met the physical recommendation ideo, peer-led peer-led ideo, sessions over delivered and 16 weeks homework to be exercises completed in the following eight to 10 during weeks the summer The vacation. booster two interventions performed were at six and 12 months after completion of the main program. activities V strategy package organized at level, classroom with workshops social parents, at school, events and school environment modifications Sex Sex Country Setting Intervention 12–14 Both Taiwan School 45-minute Ten Age Age range 13–14 Both Romania School 12–15 Both Ecuador School Educational IR-UOS and ov’t ov’t of Taiwan Funder G Netherlands Royal Embassy in Romania/ Union Against Cancer VL Nutrition Third World National Normal Taiwan University Aer Pur Romania Implementing organization Universidad Universidad Cuenca, Ecuador : : L ee, ee, ries, ries, ITA L V V uo, uo, otrean, Dijk, Dijk, otrean, iao, & Huang, & Huang, iao, G L Substance use prevention program ( Romanian peer-led smoking prevention program ( activity Diet and physical ACTI 2015) 2010) Intervention name/ description (Citation) L Ionut, Mesters, & De School-based intervention diet and for physical activity. Andrade (S. et 2015) al.,

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 81 8181 Longer-term impact Longer-term in food Decreases insecurity and number of participants receiving income (two- their own follow-up) year None described Decreases in food insecurity in food Decreases of participantsand number income, their own receiving risk of transactional lower of using higher likelihood sex, of fewer evidence a condom, unintended pregnancies Statistically significant Statistically outcomes in post- Improvements disorder traumatic stress symptoms

t

+ skills V

vention, vention, e training eening and Life Health Livelihoods ee upon

• or HI treatment treatment sexually for transmitted (STIs) infections and minor ailments •Contraceptives activities • scr fr request •Referral f participants education and home-based car • inter micro-grants •Integrated social suppor Thrice-weekly, two-hour, group-based sessions. Eight total on manualized, psychosocial intervention care facility, facility, care community organization, homes Faith-based organization Republic of Congo Sex Sex Country Setting Intervention Age Age range 17–19 Female Zimbabwe Health Funder National Institute of Child Development donorAnonymous 7–18 Both Democratic a

O) G lobal AIDS Pangaea Solidarity and Integral As - sistance to Des- titute People (SAIPED) Foundation, Foundation, CA Oakland, Implementing organization G nongovernmen- tal organization (N Health AND Economic Development and Education AND Economic Development Health the Shaping Health of Adolescents in Zimbabwe (SHAZ!) (Dunbar et al., 2014) AND Democracy and Governance Health Program to improve the mental health and psychosocial outcomes of war affecting young people (O’Callaghan 2014) et al., Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 82 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Longer-term impact Longer-term None described Improvement in gender-related in gender-related Improvement attitudes Statistically significant Statistically outcomes workshop, workshop, a male led by instructor, and biweekly for workshops coaches cricket to learn how the to deliver to program male young players cricket activities Sex Sex Country Setting Intervention Age Age range Nike FoundationNike 10– 16 Male India School Three-day Funder University of University Pittsburgh Implementing organization Democracy and Governance only Democracy and Governance Parivartan: program to improve adolescent males’ gender attitudes and increase positive bystander behaviors (Miller et al., 2014) Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 83 8383 /AIDS knowledge /AIDS knowledge V : 18% increased 18% increased : serological status serological V V : 40% increase* : V knowledge test scores: ES = .63 test scores: knowledge teenagers said that 15% increase; : V V in private school, .52 in public school in private school, comparisons***; unprotected to having risk related attitude towards 11% increase*; sex: the HI knowing possibility of being acceptance*; with friends with a person who lives HI by not be embarrassed would they # 12% increase; a condom: purchasing in open-ended of students who said, to abstinence was a way question, HI prevent HI 8% increase; of their sexual partner: people discrimination toward with HI who live Improvement in HI Improvement and vulnerability, of severity response of self-efficacy, perceptions significant for condom use, efficacy cost of condom in response difference and six months post- use (immediately in to increase in addition intervention), intention to use condoms in possible sexual encounters future

V into four different modules: modules: different into four theatrical representations, lectures, dynamics, group which were and videos, of a group dictated by adolescents who were trained previously sessions for community community sessions for and development project with activities delivery, scenarios, including stories, and games plays, role on HI factual information and STIs ietnam School plus two Eight sessions, V Country Setting Intervention activities significant outcomes Statistically s ie d Both Panama School divided 12 interventions, Sex l Stu a High school (on average 15 years old) 15–20 Both iment r e Secretaria Secretaria Nacional de Ciencia y Tecnología Fogarty Inter- national Funder range Age Exp lity a Fundación Amaneceres, Panama The University The University of Maryland at School Baltimore of Medicine and Khanh Hoa Health Provincial Service Implementing organization -Qu

r V /AIDS in V ppendix 9 owe ietnamese V A L adolescents (Aramburú et al., 2012) Impact of peer intervention on the knowledge and attitudes about HI Focus on Kids Focus HI for Program Health only HIV and ASRH The and STI prevention 2005) (Kaljee et al., Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 84 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Better self-esteem, perceived adequate perceived Better self-esteem, better adjustment generally coping, in with teachers, (and specifically pro-social and regarding school, selected 100 life Randomly behavior). also perceived skill educator-teachers changes in the students’ positive and interaction. behavior classroom The control primaryThe control school changes in had positive parents and after eight dimensions before but none were the intervention, The intervention significant. statistically primary showed school parents changes in all dimensions, positive “school with the exceptions being as community “view and pressure” of support and dimension.” a source “School goals changes in Positive to be found were and objectives” All control significant. statistically secondary school teachers showed changes in all the constructs negative (except ‘‘physical environment’’) whereas and after intervention, before all intervention secondary school changes positive teachers showed with the magnitude in all dimensions with 0.20 to 0.60, ranging from “work for statistical significance except connection” (p =0.023 to 0.001). Improvement in girls’ communication in girls’ communication Improvement reductions in skills and self-efficacy risky behavior /AIDS and alcohol abuse; /AIDS and alcohol abuse; V train-the-trainer workshops, train-the-trainer workshops, and teacher training, implementation of the life in secondaryskills program an for schools once a week hour (12–20 sessions per academic year) discussion with each interactive teacher-in-charge; and with parents workshops teachers. ‘‘Capability-Building Promoting for Framework Resiliency’’ to address the challenges of poor underachievement, social-emotional well-being, in the and capability-building home, school, community, and student contexts. 10 weeks; information about information 10 weeks; HI skill building (social skills, and assertiveness training, negotiating coping skills for environments) safer community community organization Country Setting Intervention activities significant outcomes Statistically Sex 14–16 Both India School Educational materials, 8–12 Both China School in-depth Two-hour 13–16 Both India School and overnment Department of State Educational Research and Training, Bangalore G Hong Kong Hong Kong Special Admin- Region istrative National Institute of Alcohol Abuse and Alcoholism (NIH)–India Funder range Age Os G Department of Public Instruction and National Institute of Mental Health & Neuro Sciences Faculty of Medicine, Faculty of Medicine, Chinese University of Hong Kong / University of Australia/ Education and Health Promotion Foundation Albert Einstein College of Medicine and local N Implementing organization and alcohol V ife Skills Education ife L in Schools for mental health promotion (Srikala & Kishore 2010) Kumar, Mental health The Hong King Health School resilience Award program 2009) et al., (Wong School-based teenage education (STEP) II program HI for use prevention (Chhabra et al., 2010) Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 85 8585 irls showed improvement in human improvement irls showed The intervention reduced both the The intervention reduced of and proportion symptom level syndrome clinical post-traumatic stress of level among girls who had a low The results peritraumatic dissociation. risk-specific implications for have tailoring of psychosocial interventions in war conditions. the intervention significantly boys, For of clinical the proportion reduced syndrome. post-traumatic stress There was a small, statistically statistically was a small, There on anxiety effect significant negative significant); clinically (though not likely self- 0.46**; emotional resilience: social-emotional assets: 0.58**; efficacy: 0.18**; psychological wellbeing: 0.45**; 0.15* anxiety: 0.17**; social well-being: anxiety vs. (intervention increased controls) G and health maintenance, relationship, Boys skills dimensions. the total life on improved with high-risk behavior and purpose in life, human relationship, Among high- skills dimensions. total life had a small to boys risk individuals, intervention size from moderate effect attention on withdrawn/depressed, behavior, rule-breaking problems, and externalizing behavior, aggressive syndrome. The Teaching Recovery The Teaching intervention Techniques safety aims at creating It of mastery. and feelings incorporates trauma-related psychoeducation, behavioral cognitive coping methods, therapy and creative- skills training, such elements, expressive and drawing. work as dream in involved Families are through recovery children’s such as their homework, and training in sleep hygiene and emotion writing dream diaries. over five days to deliver to deliver days five over educational sessions integrating methods like social- psychology, positive and life emotional learning, skills. Six weekly sessions of 90 Six weekly minutes. University University and school aza, aza, G Palestine Country Setting Intervention activities significant outcomes Statistically Female India School facilitators trained Peer Both Cambodia School Education and skill-building. Sex 10–13 Both Mean age 12.99 sd=1.17 Students in secondary school ucile Packard ucile Packard The Finnish of Academy Science Foundation L Swedish Swedish International Department Cooperation Agency– Department Research for Cooperation Funder range Age aza, Palestine aza, G Islamic University Islamic University CorStone & David Center for Child Center for and Adolescent Mental Health, Chumneas Chey Takhmau, Hospital, Kandal Province, Cambodia Implementing organization eventhal, et al., et al., eventhal, irls First ife ife Skills Training L Teaching Recovery Teaching for Techniques mental health promotion Palosaari, (Qouta, & Punamäki, Diab, 2012) 2015) G Resilience Curriculum ( L (suicide prevention) (suicide prevention) (Jegannathan, & Dahlblom, 2014) Kullgren, Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 86 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries knowledge: knowledge: V ong-term desired intervention effects ong-term desired Impact on reduction of child marriage of child marriage Impact on reduction intervention types, all three across increase 0.69 to 0.767***; ranging from all three across in out-of-school status: in increase 0.86*; intervention types: in gender awareness marriages love in increase 0.623**; intervention: to marry girls’ desire among gender 0.664*; intervention: awareness in private tutors among all increase ranging intervention types, three in youth increase 0.84 to 0.86*; from among pay for experience in working and livelihoods gender awareness 1.48*** and 1.43**, interventions: in social visits increase respectively; in with friends among those treated 1.27*** the education intervention: Statistical significant change in self- pregnancy .056***; employment: HI 0.48**; knowledge: always active, if sexually 0.471***; or married 0.132***; uses condom: -68*** cohabitating: change significant negative Statistically in sex unwillingly in reporting having has children: -0,58**, the past year: -0.29*** L alcohol and marijuana for found were cigarettes. use but not for but gender -0.19*, Alcohol frequency: for significance interaction shows Marijuana amount: only. females but gender interaction shows 0.04ns, females only. for significant irls received irls received G Education: Education: tutoring in mathematics and English (in-school girls), and computing or financial training (out-of-school girls); awareness gender-rights skills livelihoods training; and community training; engagement. Community clubs for young young clubs for Community vocational where women skills trainings are and life Clubs also conducted. host popular recreational such as reading, activities, singing, staging dramas, games. and playing dancing, Clubs serve as a protected adolescent local space for girls. community community organization organization Country Setting Intervention activities significant outcomes Statistically Both Mexico School Education and skills training Sex 12–18 Both Bangladesh School and Early Early adolescence Kingdom of the Netherlands unknown 14–20 Female Uganda Community Arizona State University, Instituto Mexicano de Social, Seguro and NIH Funder range Age The Population The Population Council BRAC Arizona State University Implementing organization

L ivelihood ivelihood IKA) project IKA) project L L utierrez, & utierrez, ife Skills, Income, Income, Skills, ife (Amin, Ahemd, Ahemd, (Amin, & Hossain, Saha, 2016) Haque, L and Knowledge Adolescents for (BA The Bangladeshi Association for for Adolescents for program 2012) (Bandiera, All three sectors All three The Empowerment and (substance use prevention) Kulis, (Marsiglia, Nuño- Booth, G Substance use prevention it REA Keepin’ 2015) Robbins, Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 87 8787 Improvement in communication in communication Improvement 2.6***; skills at endline and follow-up: time with the child: spending more 2.1***; parenting: positive 2.2*; punishment: physical attitudes rejecting confidence in ability to use 1.6*; 2.2*** discipline: nonviolent Higher level of empowerment of empowerment Higher level positive to more related appeared a did show Analyses outcomes. intervention effect positive significant, were effects problems; on behavioral attributable to changes in the mostly (13–15) age group. younger 1O0B73. V ) Fathers L oving (REA oving L roup-based intervention, intervention, roup-based isit Protocol for home visits for isit Protocol V Mentoring and a community activity A core poster series. Engaged of the Responsible, and Mentors is mentoring. Project fathers men whom young are admire identify as those they with and work to, and relate fathers in a non-judg - young open and proactive mental, individual con - Through way. with each young versations six father once a month for discus - months and group young Mentors offer sions, fathers the opportunity- to re flect on and practice positive and conflict- communication as as well skills, resolution to be specific ways provide supportive Young partners. engaged are fathers’ wives mentoring visits two through Men - meeting. and one group Mentor tors use a structured The Men - meetings. and group aims Curriculum Training tor Mentors through to prepare - Retrieved training. a five-day http://irh.org/resource- from: library/real-fathers-mentor- curricula/#sthash.D dpuf G with learning activities (e.g., with learning activities (e.g., to literacy, related and religion, science, math, English) oriented around an educational curriculum. All sessions include recre- ational or cultural activities, and some sessions include activities. vocational organization and homes community community organization Country Setting Intervention activities significant outcomes Statistically Male Uganda Community Sex aged 16–25 13–21 Both Jordan School and USAID Fathers Foundation Foundation Open Society Institute (Zug.) Funder range Age eorgetown eorgetown G the Save University; Children Institute for Sexual Institute for and Reproductive Health, Questscope Social for in Development East, the Middle and the Jordan Ministry of Education Implementing organization ) L eorgetown eorgetown oving (REA oving G Fathers Initiative Fathers Initiative Intervention ( Institute University Reproductive for 2015) Health, L Health AND either Democracy and Governance OR Economic Development and Education OR Economic Development AND either Democracy and Governance Health Responsible, and Engaged, Questscope nonformal education for skill-building and reduction of psychosocial difficulties (Morton & Montgomery, 2012) Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 88 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Chinese P CPYDS F=8.23** CPYDS-11 F=64.06*** KEY15 F=14.94*** Scale (CPYDS) - 15 F=6.66* Development Youth ositive

Improvement in communication in communication Improvement 2.6***; skills at endline and follow-up: time with the child: spending more 2.1***; parenting: positive 2.2*; punishment: physical attitudes rejecting confidence in ability to use 1.6*; 2.2*** discipline: nonviolent Statistical significant of: Higher level of empowerment of empowerment Higher level positive to more related appeared a did show Analyses outcomes. intervention effect positive significant, were effects problems; on behavioral attributable to changes in the mostly (13–15) age group. younger Child well-being: Self-reported (b= Child well-being: (b= teacher-reported se = .07), 1.7*, (b= parent-reported se = .08), 3.0**, The interaction term se = 1.1). 4.4**, and time in the models group between of evidence the clearest provides the influence of intervention in This term this context of recovery. for both self-reported was significant child well-being, and parent-reported on these increases indicating greater children time for over measures se the intervention (b = 5.4, receiving p se = 1.5, and b = 4.0, p < .001; = 1.1, respectively). = .01, • • • • V 1O0B73. programs in this project. The in this project. programs is a Tier 1 Program youth positive universal (PYD) development designed for program Secondary 1 to 3 students. 10 and 20 hours are There the core of training for in and full program program each for each school year The Tier grade, respectively. is specifically 2 Program students who designed for psychosocial greater display needs at each grade (i.e., The selective prevention). can design of the program be seen in the publications reports. of the project hour sessions delivered over over hour sessions delivered weeks, the course of five issues of safety addressing self-esteem, and control, thoughts and reactions resource during danger, and coping identification, The skills. community service component included helping the sick and elderly, and digging boreholes, The parental planting trees. engagement component implemented was principally periodic discussion through meetings with parents the Save facilitated by in Uganda. Children Mentoring and a community activity A core poster series. Engaged of the Responsible, (REA L ) Fathers and L oving Mentors is mentoring. Project fathers men whom young are admire identify as those they with and work to, and relate fathers in a non-judg - young open and proactive mental, individual con - Through way. with each young versations six father once a month for discus - months and group young Mentors offer sions, fathers the opportunity- to re flect on and practice positive and conflict- communication as as well skills, resolution to be specific ways provide supportive Young partners. engaged are fathers’ wives mentoring visits two through Men - meeting. and one group Mentor tors use a structured home visits for V isit Protocol The Men - meetings. and group aims Curriculum Training tor Mentors through to prepare - Retrieved training. a five-day http://irh.org/resource- from: library/real-fathers-mentor- curricula/#sthash.D dpuf roup-based intervention, intervention, G roup-based with learning activities (e.g., to literacy, related and religion, science, math, English) oriented around an educational curriculum. All sessions include recre- ational or cultural activities, and some sessions include activities. vocational organization and homes community community organization Country Setting Intervention activities significant outcomes Statistically Country Setting Intervention activities significant outcomes Statistically Male Uganda Community Both Uganda School one- structured 15 highly Sex Sex aged 16–25 12–14 Both China School tiers of two are There 13–21 Both Jordan School and mean age of 10.23 (sd = 1.61) USAID Fathers Hong Kong Hong Kong Club Jockey Charities trust Foundation Foundation Open Society Institute (Zug.) Funder range Age Funder range Age Institute for Sexual Institute for and Reproductive Health, G eorgetown the Save University; Children Department of Applied Social The Sciences, Hong Polytechnic Kong University Questscope Social for in Development East, the Middle and the Jordan Ministry of Education the ChildrenSave Oak Foundation with a 7–12, Implementing organization Implementing organization ee, Sun, & Sun, ee, L ung, 2008; Shek & 2008; ung, Health AND either Democracy and Governance OR Economic Development and Education OR Economic Development AND either Democracy and Governance Health Responsible, and Engaged, (REA L ) L oving Fathers Initiative Intervention ( G eorgetown Institute University Reproductive for 2015) Health, L 2012) Ma, P.A.T.H.S.: Positive Positive P.A.T.H.S.: Adolescent through Training Holistic Social Programs (Shek, Questscope nonformal education for skill-building and reduction of psychosocial difficulties (Morton & Montgomery, 2012) Child Resilience project curriculum 2011) (Ager et al., Intervention name/ description (Citation) Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 89 8989 iving in a better neigh- n monthly earnings, earnings, n monthly L L n monthly earnings (women), earnings (women), n monthly 0.0866** Employed with written contract, with written contract, Employed 0.0183* with written contract Employed 0.0430** (men), with health insurance Employed 0.0423* (men), (natural log) L 0.1425** (weeks), Duration of unemployment 2.6994** (weeks) Duration of unemployment 3.4542** (men), Hours job seeking in last working 0.0620** day, Hours job seeking in last working 0.0901** day, Pregnancy (all women), -0.0226** (all women), Pregnancy ages 16–19), (women Pregnancy -0.0492* veryhealth good Considers having 0.0386** (%) (all), veryhealth good Considers having 0.0382** (%) (women), veryhealth good Considers having 0.0533* (%) (men), a better educa- Having Expectations: 0.0577* (all), tion level a better educa- Having Expectations: 0.1021*** (women), tion level Expectations: 0.1077** borhood (women), Owning a business Expectations: 0.0968** (women), Completing profes- Expectations: 0.0684** sional aspirations (all), abor market outcomes of statistical abor market L significance: behavior to youth Outcomes related and expecta- perceptions, style, and life tions: internships Workplace training courses and Job Republic Country Setting Intervention activities significant outcomes Statistically Sex 16– 29 Both Dominican Inter-American Inter-American Development Bank Funder range Age abor L Outsourced to Outsourced private training institutions by Ministry of Implementing organization arcía, arcía, G illa, & illa, V 2012) Democracy and Governance AND Economic Development and Education AND Economic Development Democracy and Governance y Empleo Juventud to program the labor improve entry market of between youth 16 and 29 years of age who did not complete high school (Ibarrarán, Taboada, Ripani, Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 90 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries rit Scale, (all) 0.0750**, (all) 0.0750**, rit Scale, eadership, (all) 0.0862**, (all) 0.0862**, eadership, G L rit: Persistency of effort, (all) of effort, Persistency rit: (all) 0.0686*, Ambition, rit: Expectations: Completing Expectations: aspirations (women), professional 0.0911*** in a better life Having Expectations: 0.0543** (all), 20 years in a better life Having Expectations: 0.0590* (women), 20 years position in 10 Wealth Expectations: 0.0677** (all), years position in 10 Wealth Expectations: 0.1057*** (women), years Performance Cognitive Total (all) 0.1025***, Scale (CPS) Score, (men) 0.1364** 0.0888**, (women) CPS: (men) 0.1425** in situations of Behavior CPS: (women) (all) 0.1049***, conflict, (men) 0.1128* 0.1017**, (all) 0.0719**, Self-esteem, CPS: (men) 0.1265** and self-organization, Order CPS: 0.0875**, (women) (all) 0.0966***, (men) 0.1124* (men) 0.1087* Scale, Rosenberg’s Total 0.1019** (women) G (men) 0.0996**, (Women) 0.0757**, 0.0209 G (men) 0.0241 0.0791*, (women) Measurements of socioemotional/life of socioemotional/life Measurements skills: Country Setting Intervention activities significant outcomes Statistically Sex Funder range Age Implementing organization Democracy and Governance AND Economic Development and Education (continued) AND Economic Development Democracy and Governance Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 91 9191

in

a

for

(55.1%,

having

apply employed

plan of

to

were

ability business

a likelihood youth

the

of

in the

compared to 48.9%) compared %

ed to 38.9%) and understand develop eatment group—62%, compared compared eatment group—62%,

vings (59%, compared to 44%) compared vings (59%, Higher Increase Can Increase

the tr significant at group, to 49% in control the p<.01 • job (70%, • compar techniques and attracting marketing to compared customers (76.1%, 58.8%) • sa 42) p<.001 (p. • Mean preventive behavior score score behavior Mean preventive months after and two immediately after the intervention was higher in the intervention group: 18.27 ± 2.97 the intervention: Before after intervention: Immediately 21.02a± 3.31 months after intervention: Two 23.03b± 3.77 P < 0.001 100-hour work readiness readiness 100-hour work that included curriculum topics such as personal communication, awareness, conduct, professional personal financial literacy, and rights health, responsibilities and skill-building for and skill-building for for information students, school training for parents, and coordination counselors, with counseling services organization Country Setting Intervention activities significant outcomes Statistically Female Iran School discussion, Education, Sex senior, third third senior, grade high school USAID 14–35 Unknown Rwanda Community unknown 12th grade Funder range Age Education Development Centre Tehran University University Tehran of Medical Sciences Implementing organization 15. 15. x i d en pp hofranipour, & hofranipour, iolence A Economic Development and Education only Economic Development Akazi Kanoze livelihoods youth (Alcid, program 2014) V prevention (Ekhtiari, Shojaeizadeh, Foroushani, G Democracy and Governance only Democracy and Governance 2012) Ahmadi, Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 92 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

girls

and for

schooling

information D D

for

AN secondary

demand e social spaces for young men and, men and, young e social spaces for

vices and better, more specific, in-depth specific, more vices and better, Increased Higher

• Availability of and access to servicesAvailability and study sites. at both the control increased qualitative Findings indicate some additional the participatorybenefits at the sites where Both the system was implemented. approach function and young in which the providers to best use understanding of how people’s to them improved the options available The at the study sites. substantially more participatory was substantially approach reproductive in improving effective more health antecedents and outcomes that are in the Nepali context, relevant especially initiation of including age at marriage, institutional care, prenatal childbearing, of the male awareness and increased delivery, From health needs of women. reproductive of fundamental a number baseline to endline, at the evident contextual changes were These included: study sites. and mor women. young in particular, • ser health issues understanding of reproductive and adults at the study among both youth sites. at the study youth By the end of project, their abilities to for recognized sites were and lead social organize, coordinate, of and a number activities, development initiative, of community indicative structures and commitment with regard mobilization, in place. YRH were to Governance Governance d Adolescent-friendly Adolescent-friendly peer education services, an and counselling, and information adult education campaign, youth peer education, theater on street clubs, efforts social norms, livelihood to improve and opportunities, teacher education healthcare healthcare and facility, community organization Democracy an D Democracy N Country Setting Intervention activities Significant outcomes lth A lth a Sex ucation e H Ed

d in s 14–21 Both Nepal School, ie d l Stu Andrew Andrew Mellon W. Foundation Funder range Age a iment r International Center for on Research (ICRW) Women and Engender Health Implementing organization e xp one ppendix 10 conomic Development an Development conomic A N E Program to Program youth improve health reproductive (YRH) (Mathur et al., 2004) Intervention Name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 93 9393

of

statement, statement,

the the

number

with with

verage A

disagreeing disagreeing

y to hit or kick a gay person if he y to hit or kick a gay knowledge:

rect responses (out of six questions): (out of six questions): responses rect Participants SRH A women’s most important role is to take is to take most important role A women’s

None reported Decrease in measures of “recent binge “recent of in measures Decrease drinking” (six drinks) or risky behavior, and drug abuse, such as alcohol drinking, transactional sex The program positively contributed to positively The program on attitudes about gender critical reflection in society as follows: •Participants “ “It is oka Sarajevo= Prishtina = +17%*, flirts with me”: +13%* • cor care of her home and cook for her family”: her family”: of her home and cook for care Zagreb = +5%*, Sarajevo Prishtina = +15%*, = +6%* • Zagreb = +0.6%*, Sarajevo Prishtina = +0.9*, +13%* SRH = +0.4%*Sarajevo= ife skills training ife L ASRH information Business skills training; e.g., training, vocational organic making, fence horticultural farming, livestock training, and production management; skills training in life and psychosocial on awareness support; violence gender-based community workshop; participation in service; and leadership advocacy organizations community sessions, led by trained led by sessions, facilitators integrated into class schedule the regular the academic year, over key on four with a focus gender areas: program sex, violence; attitudes; and well-being; health, and alcohol drug use. includes The program an optional residential “Be a Man” and a retreat campaign. lifestyle Refugee camps locations School Eight- to 10-hour-long ebanon L Herzegovina, Herzegovina, Croatia, Serbia, Kosovo Country Setting Intervention activities Significant outcomes Sex 10–18 Both Syria, Jordan, 14-18 Male Bosnia and Ministry of Affairs Foreign Norwegian Norwegian Ministry of Foreign CARE Affairs, Norway Funder range Age UNICEF Norway Mercy CorpsMercy USAID 18– 35 Both Zimbabwe Multiple CARE International local Balkans, implementing organizations Implementing organization Palestinian Adolescents: Agents of Positive Change (Curtain, 2009) Trusting in Youth in Youth in Trusting (TYZ) Zimbabwe Corps, (Mercy 2015) Young Men Young to Initiative help male youth a culture overcome of violence and to align themselves peaceful, a more and equitable, masculinity healthy 2014) et al., (Namy Intervention Name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 94 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

completed high-risk

adults/

enrolment

needs (**

with

socioeconomic against

basic school

grade

in

the

current highest

connections increase

functioning

hardship

discipline*** in meeting the the

in

in in in hostility** hostility** appreciation*** warmth*** hostility*** involvement*** monitoring*** communication parenting** parenting**

change

viors* vel until graduating vel Comparative Increase Decrease Psychosocial No Increase Increase Positive Parental Positive Parental Parental Parental Parental Parental Consistent Parental Parental

• status • • • • le caregivers caregivers • • (Statistical significance reported using “*”) reported (Statistical significance using Bolivia: • • Colombia: • • Ecuador: • • • • • • • beha sessions for parents/ sessions for and children caregivers aged 10–14 in the family years Participating families program three received livelihood components: psychosocial support, and support services, services. child protection Schools two-hour weekly Seven organizations and homes Colombia, Colombia, Ecuador Country Setting Intervention activities Significant outcomes Both Uganda Community Sex 10–14 Both Bolivia, (under 18) The European The European Union and the Royal Norwegian Embassy helped fund this evaluation. Unknown Children Funder range Age Pan American Health Organization (PAHO) World Education, Education, World Inc. Implementing organization Familias Fuertes positive to increase and parenting parental reduce hostility (Orpinas et al., 2014 Bantwana program Bantwana program to improve socioeconomic psychosocial status, and functioning, educational participation (Zuilkowski & Alon, 2015) Intervention Name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 95 9595

girls

the

the in

scored month of

of This was family

past 78%

70%

women 0.037).

the

reduction =

modern

in

and former,

of

project, y 27% in the SRH group y 27% in the SRH group 0.01).

oup and 60% 65% of the =

use men

the

in compared to around 50% at to around compared significant

, earnings

of V the a

both

in y better on gender attitudes, y better on gender attitudes,

end 0.0001). 0.0001). was

mean

< e

instance,

the 0.0001 and p

eased by 247%, from R411 (~$40) to from 247%, eased by

<

omen’s experience of the combined omen’s ere using family planning by the end of planning by using family ere Men’s However, For By Increase Ther

• incr w men. not seen for • significantl reduced their and men significantly practices in their relationships. controlling of moderate or severe The prevalence symptomatology depression among men significantly and suicidal thoughts decreased (p R1015 (~$102), and women’s by 278%, from from 278%, by and women’s R1015 (~$102), R174 (~$17) to R 484 (about $48) (trend test, p • and/or sexual intimate of physical measure partner months, violence in the prior three 30.3% to 18.9% (p from The greatest change was in the sexual and The greatest health and combined groups. reproductive • w girls in the SRH gr planning methods b program, an increase of 27%. an increase program, • and those in the economic empowerment had been respectively, combined groups, HI tested for the onset of project. • far and 15% among girls the combined group, modest 5% gain in outstripping the relatively the comparison arm (p<0.001).

V

11 en

T

Futures: Stones:

ee-hour sessions, HI ee-hour sessions, ee-hour sessions with Stepping Creating

• thr and violence prevention that aims to program gender- build more equitable relationships • thr participatory learning activities that enable participants on to reflect their analyse and critically and develop livelihoods strengthening skills for them Education on economic and SRH, empowerment, significant community engagement (village leaders, religious elders, and health workers) Out-of- school settings facility South Africa Country Setting Intervention activities Significant outcomes Both Sex 18–34, with 18–34, most under 30 10-19 Female Ethiopia Healthcare ender G Joint Joint Fund, Norwegian Agency for Development Cooperation, Swedish International Department Cooperation and Agency, the South Africa Medical Research Council Foundation Foundation and Packard Foundation Funder range Age O) G Project Empower Empower Project (N CARE Ethiopia Nike Implementing organization and violence V prevention 2014) et al., (Jewkes Stepping Stones and Creating programs Futures and behavioral for structural health and promotion HI TESFA program program TESFA to empower participating girls encouraging by them to take part in income- generating provide activities, health information and and services, and early reduce marriage forced (Edmeades et al., 2004) Intervention Name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 96 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Income improved after enrollment in after enrollment Income improved 52% program: 74% of financial security: feeling Improved to eat better: ability of family Improved; 65% better housing: ability to afford Improved 30% medical costs: to afford capacity Improved 44% 52% capacity: saving family Improved and integration communication Improved 93% of the community: with the rest • • • • • • • Skills training, provision provision Skills training, of training materials and allowances, linkages with arranging institutions, microfinance experience sharing visits, of as provision as well start-up capital organization Country Setting Intervention activities Significant outcomes Sex Unknown 15–29 Both Ethiopia Community Funder range Age Mary Joy Mary Joy Development Association Implementing organization & V olunteering e V ivelihoods for for ivelihoods L (Encor 2012) Employment, Alternative Alternative Affected and Youth HI by Infected Skill AIDS through and Development Youth Intervention Name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 97 9797

surveyed

who dimensions

skills

participants employed

life

D D participants 352 167 17 e skills training, 94% e skills training,

N the the 321 the

ticipants surveyed, 38% are 38% are ticipants surveyed, Among Among Among Among y phone, 47% are currently employed. employed. currently 47% are y phone, outh were asked to identify as asked outh were

having a positive impact on their a positive having 90% cite 11 dimensions, over lives, an increased including self-confidence, assertiveness, sense of responsibility, conflict motivation, commitment, communication management skills, with skills and better relationships parents. Twenty-seven youth (8%) stated that youth Twenty-seven in an enrolled currently are they 14 in universities, education program: vocational four in in schools, five one in an in college, two trainings, Of the 27 “other.” and one internship, pursuing their currently who are youth education (less than 10% of those been enrolled 78% have sampled), and the months, than three more for less than a month or six for remaining this school year. • b • par in in hospitality and 25%, employed retail. • completed lif and benefited, reported that they 86% claim that it has been useful/very useful. • y nce A a n r ove G

Os; capacity-building capacity-building Os; d G n Community-level action Community-level plans; grants to three year two- national “Coordination” N from International Youth grants to Foundation 22 smaller CBOs within targeted communities; for capacity-building the Ministry of Social Development a cy organization ra Country Setting Intervention activities Significant outcomes tion a ing Democ ss Sex uc e Ed

d ddr n A s a ie d ment p USAID 15–24 Both Jordan Community Funder range Age l Stu a iment overnment of overnment G r International Foundation Youth & Jordan Implementing organization e xp one ppendix 11 conomic Develo A N E Youth for the for Youth (formerly Future known as Youth: Jordan) Work (International Youth 2014) Foundation, Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 98 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries Percentage change of girls who oppose Percentage gender discrimination after complete change percentage 42*; intervention: better of girls who understand boys 49*; after complete interventions: with more of girls who play percentage 28*; after complete intervention: boys ratio of students who oppose odds violence after complete intervention: 2.4* such as role plays, games, games, plays, such as role and discussions, debates, to engage students in meaningful and relevant interactions and reflection issues about key Country Setting Intervention activities Significant outcomes Sex 12–14 Both India School Participatory methodologies, MacArthur Foundation, Foundation Nike Funder range Age iteracy & the Tata Tata iteracy & the ICRW, in ICRW, partnership with the Committee of Resource Organizations for L Social Institute for Sciences Implementing organization ender Equity G Movement in Movement Schools & Singh, (Achyut 2011) Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 99 9999 nce a n r ove G

d Copied from paper: “There was a “There paper: Copied from of the community- effect clear positive based peer education intervention on skills of peer educators and the life Community points. focal community in mobilizing points’ roles focal was crucial in this communities peer education.” community-based n

a

with

with

cy sessions. counselling

Os vices G ra educator Os, CBOs, CBOs, Os,

sessions G

community

partnerships

peer

educator voluntary

ocacy outh Building Creating Peer HIV Adv Y eligious leaders, local eligious leaders, of local epresentatives

• r district directors, councils, and traditional leaders • CBOs and N • committees consisting of r N councils, training • • and testing ser and the National AIDS and the National Programme • D Democ N organization lth A lth a e Country Setting Intervention activities Significant outcomes H ing ss Sex e ddr A s ie d Funder range Age l Stu a iment r Unknown UNICEF Youth Both Yemen Community Implementing organization e xp

V one ppendix 12 A N information and information skills-building (Al-Iryani et al., 2010) Not stated. HI Not stated. Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 100 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries /AIDS and V Men reported being better able to deal with conflict at home. in participants’ Improvements in evident skills were communication the interviews. Participants reported changes in the sharing of their peer relations, new and attitudes, knowledge new confidence in their ideas and ability and improved these, to communicate about HI knowledge condom use. Program coordinators, teachers, and teachers, coordinators, Program members praised the educational, and service experiences. social, (self-reported) results Survey indicating a supported these findings, most impact across moderate program impact in with a large program areas, some areas. the highest ratings for Overall, of in the area impact were program civic and social responsibility. 53.8% indicated large Self-efficacy: 41% success in carrying out projects, 5% and only medium success, showed 41% showed small change; showed large success in their belief that they 46.2% showed a difference, can make small 10.3% showed medium results, no 2.6% showed and only results, results. Thirteen three-hour sessions complemented by meetings of male and three and a peer groups female final community There meeting. 50 hours of were held over intervention, six to eight weeks. Activities included critical and other drama, reflection, participatory learning to equip approaches participants to build better, equitable gender more safer, relationships. Program activities of Program Chinese Roots & Shoots and care clubs expressed the natural concern for animal welfare, environment, and the human community. Common activities in the schools included waste such as management, electronic rubbish, recycling Activities and paper. parts, on the human focusing included taking community to the disabled children in visiting sick children zoo, and sending them hospitals, recycled made from cards Animal materials. welfare consisted of animal projects birdhouse conservation, and public construction, education about the humane of pets and zoo treatment animals. Community Community organization school South Africa Country Setting Intervention activities Significant outcomes Sex 15–21 Both National Institute for Mental Health unknown 15–24 Both China University, Funder range Age oodall G ender and Health G Unit, Research Medical Council Jane Institute Implementing organization Stepping Stones to equip participants to build better, more safer, equitable gender relationships 2010) et al., (Jewkes Roots and Shoots to program resilience promote and facilitate engagement in and community civic life et al., (Johnson 2007) Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 101 101101

V SE,.06**; CE, .04***; HI .04***; CE, SE,.06**; L From baseline to endline, there was there baseline to endline, From a change in and menstrual .15***; knowledge, .99***. restrictions, Improvement in the consistent Improvement condom use with casual partner and the Ratio (OR) 2.19*; Odds at last use of modern contraceptive OR 1.68* intercourse /AIDS V Peer educators led weekly educators led weekly Peer of groups sessions for eight to 20 participants. also involved The program wide-ranging community activities awareness group (household visits, and public events talks, to raise community about HI awareness transmission as it relates to male migration and sex and to confront trafficking, and menstrual prohibitions superstitions). Systematic training of education and health Following professionals. teachers helped the training, adolescents to elaborate to related projects several the themes of sexuality and health through reproductive and participatory, educative, Following actions. preventive of the projects, presentation a each school received kit containing specific information. organization community community organization Country Setting Intervention activities Significant outcomes Sex 11–24 Female Nepal Community 10–19 Both Brazil School, erais & G USAID Nepal and USAID ACCESS the Odebrecht the Odebrecht Foundation of Education and Health of the State of Minas Funder range Age The Center for The Center for Development and Population Activities and Education World Belgo FoundationBelgo Departments Implementing organization earning L Putting Into Action to program strengthen leadership, self-efficacy and efficacy collective among girls/ASRH Action et al., (Posner 2009) Programa de Programa Educación Afectivo Sexual Belgo, an ASRH program Andrade et H. (H. 2009) al., Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 102 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

d n a ment p The strongest quantitative gains were gains were quantitative The strongest demonstrated in outcome measures and communications of information technol ogy skills and professional modest improvement More networks. in terms of employment was shown However, completion. upon program a subset of from surveys follow-up rates of graduates indicate positive secondary education completion and education, in continuing enrollment job insertion as increased as well of quality and a tendency in favor of profound Testimonies employment. by shared impact on others were members and mentors. family Employability training Employability that integrated curriculum broad four the following of learning and areas basic skills development: information education skills; and communications technology technical skills; social and life skills; skills; and employability as eMentoring — as well women connecting young who professionals to active them with could provide and at guidance, advice, times support in securing opportunities employment mentees. for conomic Develo E D N school, school, community organization lth A lth a e H Country Setting Intervention activities Sgnificant outcomes ing ss Sex e ddr A s ie d Nike FoundationNike 15–24 Female Brazil University, Funder range Age l Stu a iment r e Academia para o Desenvolvimento da Educacão Brasil Implementing organization tion xp a uc one ppendix 13 A N Ed Programa Para o Programa Futuro – Young in Women Action program to improve employability and knowledge gender skills, life awareness, skills and voice, girl-friendly environment, and professional networks (Network-Brasil, 2012) Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 103 103103 risk* V Significant improvement in problem- Significant improvement and support*, family solving skills**, of HI reduction

and

skills

and

and

care family park

study

life address

in

to and safe

their further a health

training

guidance

to to visits visits

young men and young t with with

ysical, educational, educational, ysical, skills

eer guidance ogram/tuition/homework ogram/tuition/homework eatment Home Life Home Personal Help Help Participation Access Access

and psychosocial needs of orphans and vulnerable than younger children of age and to 18 years bonding family strengthen supportand community • • job empowerment women’s program • the ph car suppor counselling • pr • education and training, training, tr • • • scholarship career job skills, application, guidance • Homes, Homes, community organization South Africa Country Setting Intervention activities Sgnificant outcomes Sex Under 18 Female United States Presidents’ Emergency Plan AIDS for Relief and Department of Social Development Funder range Age National Association of Child Care Workers Implementing organization isser et al., 2015) isser et al., V ISIBINDI (“strong ISIBINDI (“strong to heart”) program physical promote and psychosocial of well-being orphans and vulnerable children in South Africa. ( Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 104 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

cognitive

moral

resilience***

behavioral intentions** behavioral positive identity*, identity*, positive competence**,

competence*,

CPYDS***,

inear changes from Year 1 to Year Year 1 to Year inear changes from 2 to Year 3 were significant for total significant 3 were Year 2 to satisfaction, CPYDS life for score and behavioral school adjustment, but examination of means intentions, not linear and were trends shows in the wrong sometimes changes were direction. Year 3 from in Significant improvement to after intervention paired before variables: t-test no control •Total self-determination*, norms*, prosocial satisfaction* life L •Emotional competence**, •Social competence*, universal PYD program PYD program universal in which students in Secondary 1 to 3 participate in normally or at least 10 20 hours, of training the hours, during each program core academic year. universal PYD program PYD program universal in which students Secondary 1–3 participate, with 20 hours of normally training in the full program or at least 10 hours of training in the core in each grade. program School is a Tier 1 program Administrative Administrative Region of the People’s Republic of China Country Setting Intervention activities Sgnificant outcomes Both Macau Special Sex 12 to >16 : 12 to >16 : Secondary 2 students in Macau 13–19 Both China School is a Tier 1 Program The overnment overnment Education and Affair Youth of Bureau the Macau G Education and Affairs Youth of Bureau the Macau G Funder range Age overnment Kiang Wu Kiang Wu Nursing College of Macau, Macau and Education and Affair Bureau Youth of the Macau G Kiang Wu Kiang Wu Nursing College of Macau Implementing organization uk et al., 2012) uk et al., uk et al., 2013) uk et al., L L P.A.T.H.S. ( P.A.T.H.S.: Positive Positive P.A.T.H.S.: Adolescent Training Holistic through Social Programs ( Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 105 105105

e were e were one- the are

of

the

e evaluation e evaluation of

several

findings

on

two-thirds independent-samples

based of

proportion

than

quantitative

high

esented in this paper. There are are There esented in this paper. Results Results More A The espondents perceived the program the program espondents perceived

way between-subjects analysis of analysis between-subjects way were variance indicated that there in the views no significant differences and of workers, views of program, effectiveness program perceived school bandings three across of levels (students with different academic achievement). • 89.74% of the of the instructors; indicated that the respondents very involved; instructors were perceived 89.13% of the respondents that the instructors encouraged students to participate. • t-test also indicated that ther in these no significant differences schools variables between three program adopting the 10-hour core mode and schools adopting the 20- None of mode. hour full program significant statistically are the results because of the methods limitations. • pr observations that can be several the findings: highlighted from • r example, For manner. in a positive 84.97% of the students indicated that very were objectives the program that the activities 82.78% felt clear; planned. carefully were • students had a positiv universal PYD program PYD program universal in which students in Secondary 1 to 3 participate in normally or at least 10 20 hours, of training the hours, during each program core academic year. Country Setting Intervention activities Sgnificant outcomes Sex Unknown Both Hong Kong School is a Tier 1 program The Hong Kong The Hong Kong Club Jockey Charities Trust Funder range Age The Hong Kong The Hong Kong Polytechnic University, Department of Education Studies, Hong Kong University; Baptist Department of Applied Social Sciences; Department of East Sociology, China Normal Shanghai; University, Kiang Wu Nursing College of Macau Implementing organization P.A.T.H.S. 2010) (Ma & Shek, Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 106 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

the

of

the

of

the

of

four-fifths

than four-fifths

four-fifths

more about

ticipants would recommend the recommend ticipants would Roughly Finally, While espondents perceived that espondents perceived were espondents indicated that they

program to their friends if they have have to their friends if they program a simple majority only similar needs, join similar of them (69.02%) would in the future. programs • • r their promoted the program including social development, emotional competence (83.18%), ability to resist competence (82.45%), ability to harmful influences (83.84%), and the the good distinguish between competence in making bad (85.35%), sensible and wise choices (84.02%), (84.36%). development and overall • par r Regarding satisfied with the program. adherence of program the degree the mean the workers, estimated by with a was 86.91%, of adherence level 50% to 100%. range from Country Setting Intervention activities Sgnificant outcomes Sex Funder range Age Implementing organization P.A.T.H.S. (Ma & Shek, 2010) continued (Ma & Shek, P.A.T.H.S. Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 107 107107

in

V

scale

change

gender

roles

significant gender

traditional

no to

of

eased from 0.493 to 0.858. 0.493 to 0.858. eased from was ding

e ol. om 0 to 1), acceptance of gender om 0 to 1), Rejection Accor Ther

Topics discussed with child in the past Topics pregnancy 1.26*, relationships year: HI contraception 3.5***, 1.93***, prevention*** 1.41 prevention*** • (fr by 0.330 to 0.824. from increased roles participant group. • norms incr • contr nce a n r ove G

d n building of the organizations identification and involved, training of coaches/mentors, periods of and four-month sessions with weekly regular in 2010. athletes occurred a public education In 2011, campaign and tournaments the messages reinforced the program. from Weekly two-hour sessions two-hour Weekly a three-month over Implementation period. a team of by was overseen trained 18- to 20-year-old child club graduates from one male the community, The per club. and one female was designed curriculum discussions to stimulate and girls in boys between on could reflect which they and to power topics relating gender. a cy organization ra Country Setting Intervention activities Significant outcomes ing Democ ss Sex e ddr A s ie d Nike FoundationNike 13–14 Both India Home and capacity- Training Funder range Age l Stu a iment r Parivartan was developed in ICRW, by collaboration with People’s Apnalaya, Associate for and Health, Training Mumbai School Sport Association, and Breakthrough. Save the ChildrenSave Not stated 1–14 Both Nepal Community Implementing organization e xp one ppendix 14 A N undgren et al., et al., undgren L Parivartan program Parivartan program to improve adolescent males’ gender attitudes and increase bystander positive behaviors 2015) (Das et al., 2013) Choices program Choices program to enable very adolescents young their to transform thinking about gender norms ( Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 108 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

pre-

and

violence, discrimination

significant difference significant difference children

about about of

ejection, pre-post and control and control pre-post ejection, Knowledge Knowledge Knowledge

versus intervention: F(1,1639)=15.544, F(1,1639)=15.544, intervention: versus pre-post intervention group p<.000; p=.000 t(956)=5.15, • Students’ results: Students’ results: • intervention: versus post and control p<.013 F(1,1636)=6.17, • and r adolescent rights, and experimental control between F (1,1356)=6.85, and post: pre group, psychosocial skills p<.010; p<.003 F(1,1649)=9.109, Stage 1: Teachers Stage Teachers 1: participated in workshops. replicated Teachers Stage 2: with their the workshops students. Country Setting Intervention activities Significant outcomes Both Mexico School Sex in the last grade of primary and the first three grades of secondary school Unknown Children Funder range Age Instituto Mexicano de de Investigación Familia y Población Implementing organization Yo Quiero, Yo Yo Yo Quiero, Puedo (I want to, to I can) program violence prevent et al., (Romero 2010) Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 109 109109

in

that

were were

increased

obabilities participants that

interned

mentions the tion

reported jobs

who of enthusiasm a

also

the beneficiaries

and of

yability, especially males, males, especially yability, (80%) uc

training,

participants quality evaluation vable changes in their youth vable changes in their youth Ed

enes en Acción increased the self- Acción increased enes en ered to the beneficiaries after ered o most noted attitude changes, o most noted attitude changes, ve had no contact with the police ve Parents/guardians Excitement Fourteen After The The The d

obser phases. during these two • tw a sense of displaying but the child’s discipline was also mentioned. • ha had and 20% have since the program, such as being minor contact, only stopped and cautioned during routine are Forty percent police surveillance. to school. or going employed • those with higher levels of education, of education, those with higher levels and those who interned in small medium private firms. • their jobs than those who to keep interned in public institutions. • • their emplo private firms had higher pr off training was also higher. • Jóv esteem of the beneficiaries. n a ment p ork habits and a module ocational training activities involved in karate classes, in karate classes, involved individual computer art classes, creative lessons, discussion groups, puppetry, and educational trips. sports, Pairing with a Phase 2: a one-year mentor for period follow- A two-week Phase 3: with up summer session, the activities during this phase including steel band computer classes, lessons, and an educational visits, environmental overnight camp V (basic social skills and w in work on remedial mathematics and literacy internship in a private skills); months firm lasting three training institute conomic Develo Country Setting Intervention activities Significant outcomes E ing ss Sex e ddr 18–25 Both Colombia State-owned A s ie d unknown 6–14 Both Belize University Participants were Phase 1: Inter-American Inter-American Development Bank and World Bank Funder range Age l Stu a iment r overnment of overnment St. John’s College John’s St. and Belize Police Department G National Colombia; Coordination Unit under the Administrative Department of the Presidency Implementing organization e xp one ppendix 15 A N Youth at Risk Youth to program enhance self- increase esteem, and self-discipline, expand awareness 2001) (Mohammed, Social Safety Social Safety Net Program/ Worker Youth Jóvenes Training: en Acción program job to improve opportunities 2006) (Rosas-Shady, Intervention name/ description (Citation)

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 110 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries beneficiaries increased After training, The participants who interned in The quality of the jobs that were also mentions that The evaluation reported • Parents/guardians observable changes in their youth phases. during these two • Excitement and enthusiasm were most noted attitude changes, two a sense of displaying but the child’s discipline was also mentioned. • Fourteen (80%) of the participants had no contact with the police have had and 20% have since the program, such as being minor contact, only stopped and cautioned during routine are Forty percent police surveillance. to school. or going employed their employability, especially males, males, especially their employability, of education, those with higher levels and those who interned in small medium private firms. • private firms had higher probabilities their jobs than those who to keep interned in public institutions. • to the beneficiaries after offered training was also higher. • the self- Acción increased en Jóvenes esteem of the beneficiaries. • transmission and hats and T-shirts with a T-shirts transmission and hats V Os in these communities; creating community community creating Os in these communities; G Os, CBOs, and the National AIDS Programme; and a AIDS Programme; and the National CBOs, Os, G Participants were presented with the first self-administered with the first self-administered presented Participants were was then workshop A three-day intentional activity. A post-test Saturdays. consecutive three scheduled for one month after the self and group was administered six by was followed The workshop workshop. development each candidate. sessions for individual coaching/development 10-day training workshop on life skills and peer education, skills and peer education, on life training workshop 10-day After the end of training. of pre-field days two by followed key leaflets with participants received the second session, messages about HI To create an enabling environment through advocacy advocacy through an enabling environment create To district local councils, leaders, sessions with religious building partnerships with and traditional leaders; directors, CBOs and N of local councils, committees consisting of representatives N Abstinence and Knowledge.” with yourself “Protect message: home people and families through mobilized young Workers especially people, young visits to encourage families allow to participate. adolescent girls, conducted in peer education activities were The outreach in sessions, during Qat (or Khat) chewing especially homes, and Qat markets. bus stops, beauty parlors, hotels, motels, with amphetamine-like (Qat is a plant that mild stimulant properties.). Main Activities ocational training activities involved in karate classes, in karate classes, involved individual computer art classes, creative lessons, discussion groups, puppetry, and educational trips. sports, Pairing with a Phase 2: a one-year mentor for period follow- A two-week Phase 3: with up summer session, the activities during this phase including steel band computer classes, lessons, and an educational visits, environmental overnight camp V (basic social skills and habits and a module work in work on remedial mathematics and literacy internship in a private skills); months firm lasting three information information V training institute To nurture the nurture To of positive development cognitions, emotions, and behaviors and skills residing in four poor in four residing targeted communities with HI lth a e Country Setting Intervention activities Significant outcomes H South Africa ing ss Sex e Sex Sex Country Intervention Goal ddr 18–25 Both Colombia State-owned A s Youth Both Yemen people equip young To Age ie d unknown 6–14 Both Belize University Participants were Phase 1: Inter-American Inter-American Development Bank and World Bank Funder range Age unknown 19–25 Both Yemen Yemen Country Office Funder l Stu a

TC), TC), V iment r anderbijlpark, Optentia Research Programme, Faculty of Humanities, North-West ( University V South Africa No information UNICEF Implementing agency St. John’s College John’s St. and Belize Police Department overnment of G overnment National Colombia; Coordination Unit under the Administrative Department of the Presidency Implementing organization e xp . E., & E., . L

one ppendix 16 prevention prevention A N V an Zyl, ., & van den ., V Rothmann, S., 2012) S., Rothmann, Youth at Risk Youth to program enhance self- increase esteem, and self-discipline, expand awareness 2001) (Mohammed, A Positive A Positive Psychological Intervention (PPI) ( Community-based Community-based peer education intervention for HI among Yemeni among Yemeni people young B., (Al-Iryani, K., Al-Sakkaf, Kok, H., Basaleem, G Social Safety Social Safety Net Program/ Worker Youth Jóvenes Training: en Acción program job to improve opportunities 2006) (Rosas-Shady, 2010) B., Borne, Intervention name/ description (Citation) Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 111 111111 ife-planning skills training to youth. skills training to youth. ife-planning The project includes three main components. The first main components. includes three The project skills training and youth-friendly life-planning is providing and for The second is advocating services to adolescents. teachers, such as parents, training courses to adults, providing providers, health care planning staff, family peer educators, who can provide who sell contraceptives, and shopkeepers The third SRH education and servicespeople. young for such services for is advocating among decision- approach as as well levels leaders at different and government makers education, such as health, departments, leaders of relevant planning. and family Additional components of the project’s strategy include components of the project’s Additional monitoring and services, youth-friendly policy and advocacy, materials. and informational media involvement, evaluation, L Main Activities

and

safe the adolescents’ adolescents’

awareness awareness

a vel response response vel

tive environment environment tive Increasing Increasing Creating Improving

sexual and reproductive sexual and reproductive health knowledge of positive gender and of positive human rights sexual and safer values, practices. • sexual and reproductive sexual and reproductive including: health, • self-esteem, access to and utilization of high-quality sexual and reproductive health services and counselling (youth- friendly services) • suppor national-le to building ASRH issues by of the capacity and other CFPA for, agencies to advocate and implement, plan, innovative evaluate health interventions for adolescents. for programming at the programming for community, national, and school levels. • Sex Sex Country Intervention Goal 15–24 Both China respondents’ Increase 10-24 Both China adolescent improve To Age ates ates G G Melinda Foundation Foundation Bill and Melinda Funder CFPA and PATHCFPA Bill and Educational Institute Research of Harbin Normal University Implementing agency abor Economics– China Youth China Youth Reproductive - Health Project Shanghai (Shanghai Institute Planned for Parenthood June, Research 2005) China Youth China Youth Reproductive Health (YRH) Project implementation in Harbin City (Educational Institute Research of Harbin Normal & University Institute of and Population L Chinese Academy Chinese Academy of Social Sciences, 2005) Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 112 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries ogram inking collaborators from outside and within a setting to inking collaborators from L program advisory to oversee a stakeholder group Creating and indigenous that integrate scholarly Designing programs connected such as those already messengers, Using credible

The six-week mindfulness program, which was modified and mindfulness program, The six-week the Kabat-Zinn from adapted was presented program, reduction mindfulness-based stress to students as a short course to enhance concentration and by stress reduce was This program cultivating moment-to-moment awareness. using a secular delivered The instructor terminology. religious without any approach reduction was experienced with mindfulness-based stress gentle major activities: included four The program training. which enhances the cultivation of exercise, stretching mindfulness and sensation; of body movement awareness through standing, activities —including sitting, practice with daily the and eating — which involves down, lying walking , body thoughts and emotions; of body sensations, awareness of attention which consists of a guided movement scan, the head to toes while sitting the body from throughout which involves practice, and loving-kindness down; or lying wishes and blessings to oneself all other sending well people in the world. aimed at were activities The practices in the first three cultivating moment-to-moment awareness. practice was to boost positive The aim of the loving-kindness oneself and others. cultivating friendship toward mindsets by all the sessions (12 hours), the six two-hour Apart from A (7 hours). retreat to join a full day invited participants were and outdoor mindful walking a mindful lunch, tea meditation, the students were Moreover, retreat. in the day offered were home practice on a voluntary encouraged to do daily basis (15 minutes). Main Activities • • • • design a pr activities to a setting shape relevant and perspectives knowledge messages and activities prevention to implement interventions in their own to a setting, neighborhoods To adapt and pilot adapt To Africa CHAMP in South and Trinidad and in Tobago psychosocial condition of adolescents in In this school settings. psychosocial study, condition was mainly conceptualized as well-being, promoting and reduction, stress reduction. depression Hong Designed for adolescents, Kong aimed the program the to improve psychosocial effects people by of young cultivating a state of mindful awareness. South Africa and Trinidad and Tobago Both Sex Sex Country Intervention Goal 9–13- old year- adolescents and parents at least 19 old. years 14–16 Unknown Hong Kong the Improve Age National Institute of Mental Health (U.S.) Institute of Education Funder University of University the Chicago, Human Sciences Council Research and the University of KwaZulu- Natal (South the Africa) and, Planning Family Association of and Trinidad Tobago Not reported Hong Kong Implementing agency / V D., Bell, C., C., Bell, D., au, N. S., & Hue, & Hue, S., N. au, oisin, L Collaborative HI Collaborative AIDS Prevention AIDS Prevention and Adolescent Mental Health (CHAMP) Project R., D. (Baptiste, A., Petersen, Bhana, M., McKay, I., V & Martinez, D. D., D., D. & Martinez, 2006) M. T., 2011) T., M. Mindfulness program ( Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 113 113113 prevention, prevention, V prevention. School coordinators planned School coordinators prevention. V The parent training was designed as three sessions that training was designed as three The parent discussion about ASRH, of included content on knowledge and ASRH, surrounding and communication attitudes toward skills. communication life skills, and peer education, and the training package was and peer education, skills, life skills and peer education package life based on a Jordanian Africa supported East and North the UNICEF Middle by Regional Office. on a recruited 27 high schools were educators from Peer basis. voluntarily of selected peer visited parents The school coordinators and to obtain a signed educators to explain the program their daughters/sons to participate. allowing consent form (8 trained in a 10-day The selected peer educators were workshop. hours/day) school support peer educators at school level, ensure for To which consisted of school principals management teams, (7 hours/ trained during a five-day were and vice-principals, on peer education methodologies, training workshop day) and HI skills, life with peer educators and management teams the a pre-field, implementation, Before activities at their schools. educators conducted Peer training was conducted. two-day activity once a educational sessions as an extracurricular setting. in a classroom 90 minutes for week The education office in Aden selected a team of school The education office in of school supervision, consisting of the director coordinators of school social director of school health, director the school curriculum a teacher representing services, and an expert supervisory on training of trainers committee, workshop The team was trained in a nine-day methodologies. HI health, reproductive on youth (8 hours/day) Main Activities

V transmission and V prevention which prevention V from parents about parents from ASRH education and to parent-child promote about communication ASRH education program for for education program HI the and on increasing about modes knowledge of HI focused on decreasing on decreasing focused of stigma and the level discrimination toward people living with HI prevention Sex Sex Country Intervention Goal 13-14 Both China support increase To Age ates Foundation G unknown 15–17 Both Yemen A school-based peer Funder CFPA and PATHCFPA Bill & Melinda Education authorities in Yemen Aden, Implementing agency ., & van ., G prevention prevention V abor Economics, abor Economics, Parents’ Parents’ in the Involvement Tianjin Project (Tianjin Municipal Institute Research Planning Family for & Institute of and Population L Chinese Academy of Social Sciences, 2005) A school-based HI intervention among adolescents Yemeni B., (Al-Iryani, Al- Basaleem, H., Crutzen, K., Sakkaf, Kok, R., den Borne, B., B., den Borne, 2011) Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 114 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

role- group or

activity,

small

activity single-sex small

small

role-play group individual, mixed-group activity,

sexuality:

individual

lecture, demonstration

small small activity, individual

group

intercourse:

people:

discussion

relationships:

adolescent intercourse: small

safety: activity

condom

sexual young

to

role-play, group

individual of

of

sexual

sexual reproductively: decision-making: romantic

activity soft!:

risk small

of

regard

decision-making: in

Single-sex future: role-play, individual

for

health

are

the

sexual with the group

this?: function

now!: sexual

Girls

sexuality: sexual carry and and

violence

small decisions not condoms: of

transmission and prevention, reviewed barriers barriers reviewed transmission and prevention, and

cry! the V use

that handle and

bodies

consequences

veloped questionnaire for parents/guardians, parents/guardians, for questionnaire veloped I

AIDS

use me,

clarification oup activity, homework homework oup activity, and whole class discussion oup, role-play oup activity,

our do to don’t

for

and

alues oup and whole class discussion, role-play role-play oup and whole class discussion, oup discussion Self-esteem How Dimensions Boys Responsible Promoting How Situations Coercion Not How Negative HIV Substance V

• • • • • • • student-de whole class discussion role-plays, homework, • individual activity • small gr • discussion • • small gr • plays • gr gr discussion • small gr •–Self-esteem: and solutions, and assisted youth in resisting peer pressure peer pressure in resisting and assisted youth and solutions, skills- exercises, role-playing The interactive sex. to have and other model testimonials, peer role building activities, to the specific concerns of adapted strategies were population in Belize. youth Weekly educational sessions were held in a classroom held in a classroom educational sessions were Weekly schools during a designated time period at each of three school established by basic information educators provided Peer administrators. HI regarding Main Activities /AIDS- V /AIDS prevention topics and activities: Training V HI related knowledge, knowledge, related attitudes toward condoms (Theory of Reasoned Action), self-efficacy (Social Theory), Cognitive peer norms regarding sex and condoms (Theory of Reasoned communication Action), intention to use skills, condoms (Theory of Reasoned Action), and condom use South Africa and Tanzania Unknown Sex Sex Country Intervention Goal 14 (average, 14 (average, no standard dev) 13–17 Both Belize impact HI To Age A L European European Union NIH-Fogarty and UC AIDS Research Center Funder os L ocal teams in 3 L cities Angeles University of University California, Implementing agency / V ight L School-based HI AIDS prevention in AIDS prevention Sub-Saharan Africa: project The SATZ = South (SATZ Africa and Tanzania) Flisher, W., Mukoma, N., Ahmed, J., A. Mathews, S., Jansen, I., K. Klepp, C., H., & Schaalma, (2009) Project Project (Kinsler, J., Sneed, C. C. Sneed, J., (Kinsler, & A., D. Morisky, D., A., 2004) Ang, Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 115 115115 /AIDS, /AIDS, V anlate). In El students nominated eight teachers; two were were two In El students nominated eight teachers; anlate). L Schools were randomized into four treatment arms as treatment randomized into four Schools were peer teacher instructions alone (El) (Eruwa), follows: combination of teacher education alone (E2) (Igangan), and control instruction and peer education (E3) (Igbo ), ( nominated from E2 and seven from E3. These teachers were These teachers were E3. from E2 and seven nominated from communication, on adolescent sexuality, days five trained for STD/HI prevention, pregnancy human reproduction, condom promotion and distribution, drug abuse, malaria, malaria, drug abuse, and distribution, condom promotion training methods including role-play, Relevant guinea worm. Upon and film. demonstrations, discussions, work, group with provided teachers were completion of the training, and forms condoms, educational materials, course materials, assigned to various and were to document their activities, However, classes based on existing teaching arrangements. peer education strategy where alone was E2, teachers from they Instead, class. not assigned to any were implemented, served as supervisors the peer educators in that school. for for each organized were training programs Similar five-day set of the 22 peer educators in E2 and E3 who were the trained In addition, their colleagues. also nominated by educational with condoms, provided peer educators were contained The form forms. and evaluation materials, of interventionout carried about the nature information with and described the gender of students reached intervention. Main Activities reproductive health reproductive attitude, knowledge, self-efficacy perceived and sexual practices among secondary schools students in district of the Ibarapa Nigeria southwestern Sex Sex Country Intervention Goal Age Funder unknown unknown 10–25 Both Nigeria the Improve Implementing agency School-based reproductive health education in rural program southwestern Nigeria & J., A. (Ajuwon, 2007) R., W. Brieger, Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 116 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries

to

imple - youth-

or improve

to aimed

Supported

effective services

technical

overnment structures structures overnment designed

G made

component

Ensured was

programs:

Provided

component engthen one or more elements of engthen one or more y behavior adoption by building the adoption by y behavior

livelihood

olicy in Tanzania. Tanzania. olicy in component vironment by assuring implementation by vironment

Dissemination: into

Communication

ASRH activities into existing livelihood ASRH activities into existing livelihood Services ocacy

and

Capacity-Building:

Os, and faith-based organizations to improve and faith-based organizations to improve Os, ASRH

Adv

Change G

and

outh-Friendly Policy Behavior Integrating Institutional Coordination ocational Education P Y

quality of services for young people through both static clinic quality of servicespeople through young for determined Component evaluations facilities and outreach. the services of youth-friendly increased, that the availability and quality of and client satisfaction with services improved, Alliance Youth African In all utilization of services increased. Services was integrated in ASRH/Youth-Friendly countries, pre-service training. • rec- increased for and advocated people, young for programs Importantly, programming. livelihood ognition and funding for skills training was mandated in the Zanzibar life-planning sustain- with the aim of overall organizational effectiveness, implementing by improvements showed The evaluation ability. funding to secured have and several partners in each country, sustain ASRH programming. • • the legal and policy en carry to successfully ASRH policies in order of supportive was to objective The longer-term interventions. out program work ongoing for enabling environment a sustainable, create im- found Advocacy and of Policy An evaluation ASRH. in and supportive attitudes of stakeholders, knowledge proved ASRH in commitments and actions supportive of an increase ASRH. allocation for resource and increased stakeholders, by • enable and sustain health The implementation of life- necessary people. skills of young planning skills training with both in- and out-of-school young Evaluations and people was a cornerstone of the component. this component demonstrated improve- data from process and behav- attitudes, perceptions, ASRH knowledge, ments in skills training. life-planning iors among students who received • people and set the stage for to young and available friendly with public health Alliance worked Youth African scaling up. N facilities, the integration of V • material assistance to str supported assume this coordination. to ultimately were mentation and integration of program components within mentation and integration of program within govern- as externally as well Alliance, Youth African ment and other important programs. Main Activities /AIDS, among /AIDS, V young people aged young 10–24. To improve ASRH, ASRH, improve To including the prevention of HI hana, Tanzania Tanzania hana, G and Uganda Sex Sex Country Intervention Goal 10–24 Both Botswana, Age ates G Bill and Melinda Foundation Funder United Nations Population PATH Fund, and Pathfinder International Implementing agency The African Alliance Youth partnership program 2007) U., (Daniels, Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 117 117117 /AIDS and V Supplementary psychoeducation on genocide-related trauma, Supplementary trauma, psychoeducation on genocide-related and attention to integration of past experiences present The number via six main modules. delivered are resilience, vary to complete these modules may of sessions required (Separate size. needs and family to a family’s according in and older children be held with younger sessions may and caregivers as needed.) In initial sessions, small groups leading up with a counsellor, meet separately children with support from caregivers meeting led by to a family through Intervention content is presented counselors. vignettes, the intervention, for books developed picture HI and Rwandan proverbs. activities, interactive trauma psychoeducation content were developed with input developed trauma psychoeducation content were from advisory drawing a community and also by board from collaborating organization counseling materials used by Partners the In Health/Inshuti Mu Buzima (PIH/IMB) and by Rwandan Ministry of Health (MOH). Counselors training and supervision: Counselor selection, training in the delivery of the extensive underwent and local study investigators, intervention its developers, by training period A two-week and international clinicians. learning of the central theory role-play-based involved and practices of the intervention using a comprehensive as discussion of techniques for as well intervention manual, facilitating engagement and strategies for ensuring parent practice and discussion. via group conversations family first met with in pairs when they Counselors worked comfortable with the were and once they their families, individually. worked they intervention, and Boston-based investigators After initial training, phone supervision weekly that included supervisors provided solving and problem discussion, group case presentation, Counselors met with the Rwanda-based program support. successes and challenges to review manager at least weekly An experienced clinical psychologist in intervention delivery. local additional of Rwanda provided the University from supervision. Main Activities ected children -aff V functioning and caregiver-child connect relationships, vulnerable families to and formal available and services, informal emotional and promote health among behavioral HI Both Rwanda family improve To Sex Sex Country Intervention Goal 7–17 and caregivers 30–70 years old Age National Institute of Health Funder Rwandan Ministry of Health and Partners in Health Implementing agency 2014) ., V . C., Kirk, Kirk, C., . L The Family The Family Strengthening Intervention (FSI) T. (Betancourt, Ng, S., C. M., Munyanah, Munyanah, M., C. C., Mushashi, M., . . . C., Ingabire, Sezibera Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 118 A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries ; puberty; identifying puberty; ; V et’s wake up’’ in isiZulu). up’’ in isiZulu). wake et’s L UKA (‘‘ V /AIDS Prevention and Adolescent Mental and /AIDS Prevention V ected youth and their primary caregiver and their primaryected youth caregiver -inf V ; adherence to medical treatment; stigma and to medical treatment; adherence ; V infection. Patient and provider community advisors community Patient and provider infection. of disclosure knowledge; transmission and treatment and coping acceptance, identity, youth status to others; V V V Workshops with teachers, sessions with students and with teachers, Workshops activities with parents. accompanying Supplementary psychoeducation on genocide-related trauma, Supplementary trauma, psychoeducation on genocide-related and attention to integration of past experiences present The number via six main modules. delivered are resilience, vary to complete these modules may of sessions required (Separate size. needs and family to a family’s according in and older children be held with younger sessions may and caregivers as needed.) In initial sessions, small groups leading up with a counsellor, meet separately children with support from caregivers meeting led by to a family through Intervention content is presented counselors. vignettes, the intervention, for books developed picture HI V /AIDS and and Rwandan proverbs. activities, interactive with input developed trauma psychoeducation content were from advisory drawing a community and also by board from collaborating organization counseling materials used by Partners the In Health/Inshuti Mu Buzima (PIH/IMB) and by Rwandan Ministry of Health (MOH). Counselors training and supervision: Counselor selection, training in the delivery of the extensive underwent and local study investigators, intervention its developers, by training period A two-week and international clinicians. learning of the central theory role-play-based involved and practices of the intervention using a comprehensive as discussion of techniques for as well intervention manual, facilitating engagement and strategies for ensuring parent practice and discussion. via group conversations family first met with in pairs when they Counselors worked comfortable with the were and once they their families, individually. worked they intervention, and Boston-based investigators After initial training, phone supervision weekly that included supervisors provided solving and problem discussion, group case presentation, Counselors met with the Rwanda-based program support. successes and challenges to review manager at least weekly An experienced clinical psychologist in intervention delivery. local additional of Rwanda provided the University from supervision. of structure the overall intervention retained The revised HI Collaborative pairs, child-caregiver multiple (CHAMP), Health Project and the use of a cartoon-based story CHAMPSA line from to curriculum with an altered Africa), South (CHAMP, living with perinatal accommodate the unique needs of youth HI the intervention renamed cartoon tailored storyline culturally A new and curriculum counselors supervised a psychologist to by enabled lay the intervention in an engaging and structured deliver guidance for step-by-step provides The curriculum way. to facilitate critical information counselors to deliver families within and between discussions and problem-solving groups. in multifamily loss and bereavement; AIDS-related Session topics include HI HI with HI particularly on communication, caregiver-child discrimination; topics such as puberty sensitive and HI in high-risk safe children strategies to keep and developing possible; and drug use are sexual behavior situations where As with the original CHAMP intervention and social support. HI program, sessions, families for come together with other affected activities and group family which include both multiple activities. and child group separate parent Main Activities Main Activities positive V -affected children -affected adoption of healthy adoption of healthy as a lifestyles strategy for protective against their children vulnerability to an early start using psychoactive substances functioning and caregiver-child connect relationships, vulnerable families to and formal available and services, informal emotional and promote health among behavioral HI V To support families in To the health promoting and psychosocial well- being of and adolescents children HI who are South Africa Both Rwanda family improve To Both Sex Sex Country Intervention Goal Sex Country Intervention Goal 5–13 Both Colombia the promote To 7–17 and caregivers 30–70 years old years old years and their families Age Age Universidad Universidad de Antioquia National Institute of Health Funder Funder Corporación Surgir Rwandan Ministry of Health and Partners in Health Not explicit Not known 10–13 Implementing agency Implementing agency ., ., 2014) et’s Wake Wake et’s L IDA V UKA: “ UKA: YOMI- (Hernández M., E. Ramírez, 2010) The Family The Family Strengthening Intervention (FSI) T. (Betancourt, Kirk, C., L . Ng, S., Munyanah, M., C. C., Mushashi, M., . . . C., Ingabire, Sezibera V V Up” in isiZulu A., Mellins, (Bhana, I., Petersen, A., C. N., Myeza, S., Alicea, McKay, . . . H., Holst, 2014) M., Intervention name Citation Intervention name Citation

A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries 119 119119

Making Cents International Attn: YouthPower Learning 1350 Connecticut Ave, NW, Suite 410 Washington DC 20036 1 (202) 783-4090 www.youthpower.org