The Adolescent Girls Vulnerability Index Guiding Strategic Investment in Uganda the Republic of Uganda
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THE ADOLESCENT GIRLS VULNERABILITY INDEX GUIDING STRATEGIC INVESTMENT IN UGANDA THE REPUBLIC OF UGANDA The Ministry of Gender, Labour and Social Development is the Government of Uganda’s leading and coordinating agency for the Social Development Sector. The Ministry is responsible for community empowerment, protection and promotion of the rights of vulnerable groups in society and gender responsive development. The Ministry’s mandate is to empower communities to harness their potential through cultural growth, skills development and labour productivity for sustainable and gender responsive development. UNICEF is mandated by the United Nations General Assembly to advocate for the protection of children’s rights, to help meet their basic needs and to expand their opportunities to reach their full potential. We are guided by the Convention on the Rights of the Child and strive to establish children’s rights as enduring ethical principles and international standards of behaviour towards children. Through our country programmes, we work to promote the equal rights of women and girls and to support their full participation in the political, social, and economic development of their communities. The Population Council confronts critical health and development issues—from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees. Suggested citation: Amin, S., Austrian, K., Chau, M., Glazer, K., Green, E., Stewart, D., and Stoner, M. (2013). Adolescent Girls Vulnerability Index: Guiding Strategic Investment in Uganda. New York: Population Council. © 2013 The Population Council, Inc. Population Council One Dag Hammarskjold Plaza New York, NY 10017 USA http://www.popcouncil.org Cover photo: BRAC/Jake Lyell. Any part of this publication may be copied or adapted to meet local needs without permission, provided that the parts copied are distributed free or at cost (not for profit) and that the source is identified. We would appreciate receiving a copy of any materials in which the text is used. Contents List of tables iv List of figures v List of acronyms vi Acknowledgements vii Foreword ix Executive summary xi 1. Introduction 1 1.1. Demographics: Adolescents, population projections, and benefiting from the youth bulge 3 1.2 Why adolescent girls? 7 1.3. The vulnerabilities of adolescent girls in East and Southern Africa 8 1.4. Conclusion 33 2. Developing an Adolescent Girls Index 35 2.1 Putting the AGI in context 36 2.2 Creating the index 39 3. Index results 53 3.1 Uganda 54 3.2 Regional index results 62 3.3 Limitations 62 3.4 Conclusions 64 4. Program analysis 65 4.1 What is a coverage exercise? 66 4.2 Results 69 4.3 Discussion 74 5. Policy analysis 75 5.1 Introduction 76 5.2 Methods 76 5.3 Policy review 76 5.4 Policy areas in the context of the Adolescent Girls Multilevel Vulnerability Index 81 5.5 Review of policy areas not covered by the AGI 87 5.6 Barriers to policy implementation 91 5.7 Policy analysis: Regional assessment 94 5.8 A note on national youth policies 98 6. Conclusions 103 6.1 Program and policy recommendations in the context of the AGI 104 6.2 Investing in girls and the role of the AGI 112 7. References 113 8. Appendices 121 Appendix I. Participatory assessment 122 Appendix II. Suggestions for additional survey topics 128 Appendix III. Forms 129 LIST OF TABLES 1 Percentage of adolescents aged 10-19 living in the two 26 Adolescent Girls Multilevel Vulnerability Index: poorest wealth quintiles, East and Southern Africa 13 Levels and indicators 45 2 Ratio of girls to boys who report attending school at 27 Comparisons of AGI rankings to other wealth and any time during current year, by age group, in East and development indices, by country 50 Southern Africa 17 28 Percentage of adolescent girls aged 10-19 with multilevel 3 Percentage of adolescent girls who attended school at vulnerability and percentage who are vulnerable at each any time during current year, in Uganda, by age and level, East and Southern Africa 55 region, 2006 and 2011 17 29 Percentage of adolescent girls aged 10-19 with multilevel 4 Percentage of adolescent girls, by school categories and vulnerability and percentage who are vulnerable at each age groups, East and Southern Africa 17 level, by region, Uganda 56 5 Percentage of adolescent girls aged 10-14, by schooling 30 Percentage of adolescent girls aged 10-14 and 15-19 with categories and region, Uganda, 2006 and 2011 19 multilevel vulnerability and percentage who are vulnerable at each level, by region, Uganda 56 6 Percentage of adolescent girls aged 15-19, by schooling categories and region, Uganda, 2006 and 2011 19 31 Household-level results for girls aged 10-19 by wealth quintile within Kampala, Uganda 57 7 Distribution of characteristics within school categories of adolescent girls, Uganda, 2011 20 32 AGI community-level results for adolescent girls aged 10-19, Uganda 60 8 Literacy rates among adolescents aged 15-19 and ratio of literate girls to boys, East and Southern Africa 21 33 AGI results for East and Southern Africa, by age group 61 9 Literacy rates of adolescent girls aged 15-19 by 34 AGI community-level results for adolescent girls educational categories, Uganda, 2011 23 aged 10-19, East and Southern Africa 64 10 Percentage of adolescent boys and girls aged 15-19 by 35 Sample size 68 school and employment status, East and Southern Africa 23 36 First-stage selection district allocation 68 11 Percentage of adolescent boys and girls aged 15-19 by Ladder questions asked of subcounty officials 69 school and employment status, Uganda, 2011 23 37 38 Average number of eligible programs for adolescents 12 Percentage of adolescents aged 15-19 who have ever per subcounty, by region, Uganda 71 had sex, East and Southern Africa 25 39 Total number of adolescent programs, by region, Uganda 71 13 Percentage of adolescent girls in Uganda aged 15-19 who have ever had sex, are sexually active, and have 40 Subcounty officials’ comparisons of program quality to had high-risk sex, by characteristics, 2011 25 other subcounties in the district and nation, Uganda 71 14 Sexual behaviors among adolescents in Uganda, by 41 Distribution of program type and content 71 percent and region, 2011 27 42 Average percentage of program participants, by sex and 15 Contraceptive use among adolescents aged 15-19 region, Uganda 71 who have ever had sex, Uganda 27 43 Average percentage of program participants, by age 16 Percentage of female and male adolescents in Uganda group and region, Uganda 71 aged 15-24 who are HIV-positive, 2005 and 2011 29 44 Percentage of programs that are co-ed, girls-only, or 17 Percentage of female and male adolescents in Uganda boys-only, by region 72 aged 15-24 who are HIV-positive, by region 29 45 Descriptive statistics and comparisons to Uganda 18 Percentage of adolescents aged 15-19 who know the DHS 2011 72 following HIV prevention methods, East and Southern Africa 29 46 Weighted and unweighted participants and encounters, 19 Percentage of adolescents aged 15-24 with comprehensive by age and sex 73 knowledge of HIV/AIDS in Uganda 31 47 Predictors of days attended (encounters) and 20 Percentage of adolescent girls in Uganda aged 15-19 who attendance rate 73 are currently married, by region, educational attainment, and wealth quintile, 2006 and 2011 32 48 Persons consulted 77 21 Percentage of adolescent girls in Uganda aged 15-19 who 49 Reported definitions of adolescent, youth, and child 79 are currently pregnant or have ever given birth, by region, 50 List of policies by AGI indicators 81 marital status, and educational attainment, 2006 and 2011 32 51 Additional policies reviewed: Gender-based violence Vulnerability indices 39 22 and sexual exploitation, participation, employment and 23 Indicator topics available for inclusion in the Adolescent entrepreneurship, and property rights 88 Girls Multilevel Vulnerability Index 42 52 List of policies by country 96 24 Complete list of individual indicators considered for A1 Location, number and type of each discussion group 122 inclusion in the AGI 43 A2 Frequency of the top nine issues, by age group, all groups 125 25 Complete list of household indicators considered for inclusion in the AGI 45 iv LIST OF FIGURES 1 The changing context of development—The second 23 Percentage of adults 15-49 who are HIV-positive, East decade of life is becoming more important 3 and Southern Africa 27 2 Percentage of population who are adolescents (aged 24 Percentage of female and male adolescents in Uganda 10-19), East and Southern Africa 4 aged 15-24 who are HIV-positive, by age group 29 3 Uganda: Alternative population projections for 25 Percentage of females and males aged 20-24 who were 2005-2050 and population growth components 4 married by age 18, East and Southern Africa 31 4 Percentage of population who are working age (15-64): 26 Percentage of adolescent girls aged 10-14 and 15-19 living Estimates and projections in Uganda, sub-Saharan in communities where rates of child marriage among Africa, less developed world, and the world, 1950-2100 4 women aged 20-49 exceed the national average, Uganda 31 5 Multilevel model for