Pre-pandemic Influences on Kenyan Girls’ Transitions to Adulthood during COVID-19

in Girlhood Studies
View More View Less
  • 1 Dept. of Population and Family Health, Mailman School of Public Health, Columbia University, USA meb2308@cumc.columbia.edu
  • 2 Dept. of Population and Family Health, Mailman School of Public Health, Columbia University, USA md3848@cumc.columbia.edu
  • 3 Population Council USA jpinchoff@popcouncil.org
  • 4 Population Council Kenya bkangwana@popcouncil.org
  • 5 Population Council Kenya kaustrian@popcouncil.org

Abstract

COVID-19 containment measures have left adolescent girls in Nairobi, Kenya vulnerable to negative educational, economic, and secondary health outcomes that threaten their safe transitions into adulthood. In June 2020, the Population Council conducted phone-based surveys with 856 girls aged between 10 and 19 in 5 informal settlements who had been surveyed prior to COVID-19 as part of five longitudinal studies. We performed bivariate and multivariable logistic regression analyses to assess the relationship between COVID-19 outcomes and potential protective or risk factors. We found that younger girls are experiencing high levels of food insecurity and difficulty learning from home during school closures, while many older girls face the immediate risk of dropping out of school permanently and have been forgoing needed health services.

Introduction

From March to July 2020, the Kenyan government implemented mitigation measures to curb the spread of COVID-19. These included closing schools on 15 March, banning large social gatherings, and enacting a national dusk to dawn curfew. On 6 April, the Nairobi Metropolitan Area was placed on lockdown, which was lifted on 6 July, as Nasibo Kabale (2020) notes. These mitigation policies appeared to have slowed the transmission of COVID-19 in Kenya effectively, but they threatened the wellbeing of the urban poor, including the roughly 2.9 million residents of informal settlements in Nairobi (Quaife et al. 2020).

Compared to the rest of Nairobi's population, informal settlement residents have higher mortality and poverty rates and less access to health services (Mutisya et al. 2016). Adolescent girls living in informal settlements are particularly vulnerable, with significantly higher rates of food insecurity, unprotected sex, and gender-based violence (GBV) than girls in non-slum parts of the city as Donatien Beguy et al. (2013) point out. Therefore, it is important to understand how COVID-19 mitigation efforts have had unintended adverse effects on adolescent girls.

The analytic approach for this study is centered on the Adolescent Girls Initiative Kenya (AGI-K) Theory of Change (see Figure 1) which posits that adolescent girls who acquire certain educational, economic, health, and social assets in early and mid-adolescence are better equipped to transitions safely into adulthood (Population Council 2005). When combined, these assets may provide girls with the tools and resources needed to make positive life decisions and avoid early pregnancy (Austrian, Pinchoff, et al. 2020). Early evidence suggests that COVID-19 has disrupted adolescent girls’ access to these assets in Kenya.

fig1

Original source: Austrian et al. 2016.

Citation: Girlhood Studies 13, 3; 10.3167/ghs.2020.130310

Educational Assets

During COVID-19-related school closures, adolescents in Nairobi were believed to be experiencing barriers to learning from home and increased economic pressure to drop out of school permanently (Corburn et al. 2020). Higher educational attainment increases girls’ lifelong earnings and substantially reduces their risk of child marriage and early pregnancy as Wodon et al. (2017) point out. Educational attainment is also associated with lower rates of food insecurity in adulthood; one study of Nairobi informal settlements found that each additional year of parents’ school enrollment produced a significant decline in household food insecurity (Mutisya et al. 2016). Following the Ebola epidemic in Sierra Leone, school attendance fell 16 percent among adolescent girls and teenage pregnancy rose by 65 percent in some areas (Risso-Gill 2015). Therefore, extrapolating from these findings, much is at stake if girls are unable to complete their educational plans because of COVID-19.

Economic Assets

COVID-19 mitigation efforts have resulted in economic losses that threaten families’ ability to pay for girls’ education, food, and health services. Prior to the pandemic, most residents of Nairobi urban settlements relied on income from informal sectors (Salon and Gulyani 2010), leaving them more vulnerable to the economic shocks produced by distancing policies and closures following the outbreak of COVID-19. In addition, 73 percent of Nairobi slum residents (three times the national average) were categorized as food insecure in 2013, so income loss during the pandemic could dramatically increase the number of adolescent girls going hungry (Mutisya et al. 2016).

Health Assets

Access to sexual and reproductive health (SRH) services is also likely to be disrupted by COVID-19. Prior to the pandemic, access to SRH services was low in urban informal settlements in Kenya; a 2012 survey of over 3,000 sexually active women aged 12 to 49 in Nairobi slums found that only 53 percent were using a modern contraception method (Beguy et al. 2017).COVID-19 is likely to reduce access further since early evidence indicates that the pandemic is interfering with the contraceptive supply chain in low-income countries (Purdy 2020). According to the AGI-K Theory of Change, girls who are already sexually active, as well as those who have ever experienced GBV, are further along the pathway toward negative outcomes and may be particularly vulnerable.

Social Assets

Strong social support and high self-efficacy, or confidence in one's ability to influence the events that affect one's life, have been found to be protective against poor health outcomes following traumatic events and natural disasters (Benight and Bandura 2004). However, it is unclear whether strong pre-pandemic support will protect girls from negative outcomes during the COVID-19 pandemic since social distancing measures are likely to reduce the size of their social support networks in Kenya as has happened in other global contexts (Loades et al. 2020).

Study Overview

Guided by the AGI-K Theory of Change, this study explored pre-pandemic characteristics that may either protect girls from negative outcomes during the pandemic response or put them at higher risk. The potential protective factors assessed were being in school prior to closures, a high self-efficacy score, and strong social support. The possible risk factors were having a parent who had lost complete income during the COVID-19 response, being sexually active prior to the pandemic, and ever experiencing GBV. While we do not predict a direct causal pathway between each of the factors tested—for instance being sexually active and employment seeking during COVID-19—understanding the associations between them may help to make sense of the constellation of factors that shape girls’ transitions to adulthood. These findings can inform policy recommendations to support girls in informal settlements during the prolonged COVID-19 pandemic and identify the girls who are most at risk.

Methods

Data Collection

Since April 2020, the Population Council has worked in collaboration with the Kenyan Ministry of Health COVID-19 Taskforce to conduct mobile phone-based longitudinal cohort surveys with adults residing in five informal settlements in Nairobi: Kibera; Huruma; Kariobangi; Dandora; and Mathare (Austrian et al. 2020a). In June 2020, this was expanded to include a survey with adolescents from the same households.

Respondents for the COVID-19 cohort were recruited from two existing longitudinal cohort studies: Adolescent Girls Initiative-Kenya (AGI-K) and NISITU (Nisikilize Tujengane: Listen to Me, Let's Grow Together). The AGI-K cohort was part of a randomized controlled trial involving 2,565 randomly selected households in which at least one adolescent resided (Austrian et al. 2016), while the NISITU cohort took part in a quasi-experimental study that included 4,519 households at endline 2019. Adolescent girls in the intervention groups in both studies received programming to improve their wellbeing by building educational, economic, health, and social assets while promoting positive community norms around the value of girls; controls did not experience any interventions.

The adult COVID-19 survey sample was drawn from the phone number pool of AGI-K and NISITU household contacts, stratified by the five locations. All households that reported having an adolescent member during the adult COVID-19 data collection were eligible for inclusion in the survey of adolescents.

The ongoing COVID-19 survey cohort was approved by the Population Council IRB1 and Amref Health Africa Ethics and Scientific Review Committee.2 Participants 18 years and over provided verbal informed consent, and those under 18 provided verbal assent and had a parent or guardian provide consent.

Data collection for the adolescent survey took place from 13 to 16 June 2020. Consenting adolescents spent approximately 45 minutes completing a COVID-19 questionnaire on topics that referred to changes to educational plans, social interactions, sexual relationships, ability to access healthcare, mental health, and experiences of violence since COVID-19 began. The survey instrument was designed by Population Council with input from local Kenyan researchers, piloted with 154 participants, and conducted in Swahili and English by a team of local interviewers.

Data was collected using Open Data Kit and exported to STATA version 16.1 for analysis with personally identifiable information removed to ensure confidentiality. Participants received KES 100 (USD $1) for their participation in the survey and were told that they could withdraw from the study at any time. Adolescents’ responses to the COVID-19 survey were merged with their responses to the AGI-K or NISITU endline surveys and with their parents’ responses to the June round of the adult COVID-19 survey. For this analysis, the sample was restricted to girls aged 10 to 19 with matched parent and AGI-K or NISITU endline data.

Statistical Analyses

Characteristics of our sample were tabulated by age category, and differences in the impact of COVID-19 mitigation on education, economic status, health, and agency by age category were assessed for statistical significance using chi-square tests with a significance level of 0.05. Further bivariate tests were performed to assess the relationship between negative outcomes during COVID-19 and characteristics we hypothesized to be protective or risk factors based on the AGI-K Theory of Change. Bivariate logistic regression models were run followed by multivariable logistic regression models adjusted for age, wealth tercile, and informal settlement location (a proxy for being in an AGI-K or NISITU control or intervention group). Outcomes and measures are defined in Table 1.

Table 1  

Definitions of COVID-19 Outcomes, Protective Factors, and Risk Factors Explored in this Analysis

article image

Results

Our final sample included 856 girls, categorized as younger (10 to 14 years) or older (15 to 19 years) adolescents. Characteristics of the sample are summarized in Table 2. At the time of the COVID-19 survey, over half of the respondents were living with both parents (54.8 percent) and most were enrolled in school (86.5 percent). About a third (32.0 percent) of the girls owned a personal mobile phone. Compared to younger girls, a larger percentage of older girls reported being sexually active (9.6 percent of older girls as opposed to 1.4 percent of younger girls), ever having been married or cohabitating (1.4 percent as opposed to 0 percent), and ever experiencing GBV (22.7 percent as opposed to 19.2 percent). Girls’ likelihood of leaving school and becoming sexually active rose linearly with age.

Table 2  

Characteristics of the Sample of Adolescent Girls by Age Category (April 2018 to May 2019 unless indicated)

article image

Older girls were significantly more likely than younger girls to believe that COVID-19 would cause them to complete less school than initially planned (18.4 percent of older girls as opposed to 11.3 percent of younger girls) and significantly less confident that they would return to school at all (87.3 percent as opposed to 90.2 percent) (see Table 3). In addition, fewer older girls reported learning or doing work from home (95.3 percent as opposed to 100 percent), although a larger percentage of older girls were using mobile phones to access schoolwork (33.5 percent as opposed to 24.1 percent). Very few girls of any age were using a tablet or computer to do so. Rather, the most common methods of at-home learning were reading books not provided by schools (56.9 percent), using school-issued written materials (41.7 percent), and listening to lessons on the television or radio (29.2 percent). Among all girls who were not confident that they would return to school, the majority (56.8 percent) believed that difficulty paying school fees would be a factor preventing their return.

Table 3  

Impact of COVID-19 on Adolescent Girls by Age Category

article image

Significant differences indicated as *** p < 0.001, ** p < 0.01, * p < 0.05.

Younger and older girls reported facing different economic impacts as a result of the COVID-19 response. A significantly larger percentage of older girls had lost personal income, begun earning money, or been looking for work unsuccessfully since the start of COVID-19 compared to younger girls. Across age groups, half of the girls (50.9 percent) reported spending more time on household chores since COVID-19, and 43 percent had a parent who had lost complete income since the pandemic began.

The secondary health impacts of COVID-19 also varied by age category. While younger girls were significantly more likely than older girls to be skipping meals or eating less since COVID-19 (89.1 percent younger girls as opposed to 73.6 percent older girls), they reported forgoing needed medical services in the past month less often (8.3 percent as opposed to 13.1 percent) and were less likely to report depression symptoms in the past two weeks (26.3 percent as opposed to 50.8 percent). Across ages, the majority of girls who had begun menstruating reported difficulty getting their preferred menstrual hygiene management product (51.3 percent), largely because they or their families no longer had enough money to purchase it (70.2 percent). At the time of the survey, few girls were trying to become pregnant or had recently been pregnant (1.9 percent). Approximately 45 percent of girls reported that there was less violence in their homes since COVID-19 mitigation measures began, although 8 percent had experienced physical, emotional, or sexual violence in the past month. Compared to before COVID-19, most girls had less freedom of movement (62.3 percent) and spent less time with friends (85.2 percent).

Protective Factors

Bivariate logistic regression analyses indicated that being enrolled in school before COVID-19 was negatively associated with looking for work since the pandemic began (Table 4). In a multivariable logistic regression model adjusted for age, wealth tercile, and informal settlement location, this association remained significant (AOR = 0.15, 95% CI 0.08-0.28). Bivariate analyses revealed a significant association between high social support score and looking for work unsuccessfully since the COVID-19 response began, and between high social support score and feeling depressed in the past two weeks (Tables 4 and 5).

Table 4  

Association between Potential Protective and Risk Factors and Girls’ Educational Outcomes during COVID-19

article image

Odds ratios (OR) from simple logistic regression models. 2 Adjusted odds ratios (AOR) from multivariable logistic regression models adjusting for age, wealth tercile (ref = lowest), and location (ref = Kibera). 3 Complete loss of parent income multivariable logistic regression models were adjusted for one or two parent household (ref = two parent). 4 Sexually active multivariable logistic regression models were restricted to girls aged 16 and older due to the small number of sexually active girls aged 10 to 15. Significant differences indicated as *** p < 0.001, ** p < 0.01, * p < 0.05.

Table 5  

Association between Potential Protective and Risk Factors and Girls’ Health Outcomes during COVID-19

article image

Odds ratios (OR) from simple logistic regression models. 2 Adjusted odds ratios (AOR) from multivariable logistic regression models adjusting for age, wealth tercile (ref = lowest), and location (ref = Kibera). 3 Complete loss of parent income multivariable logistic regression models were adjusted for one or two parent household (ref = two parent). 4 Sexually active multivariable logistic regression models were restricted to girls aged 16 and older because of the small number of sexually active girls aged 10 to 15. Significant differences indicated as *** p < 0.001, ** p < 0.01, * p < 0.05.

Risk Factors

In multivariable logistic regression models, ever experiencing GBV was associated with believing difficulty paying school fees could prevent a return to school (AOR = 3.57) and feeling depressed in the past two weeks (AOR = 1.75) (Tables 4 and 5). Complete loss of parent income because of COVID-19 was not significantly associated with any negative educational or health outcomes.

Discussion

Overall, this study suggests that adolescent girls in informal settlements in Nairobi were experiencing substantial losses in education, health, and social connection four months into the COVID-19 pandemic, threatening their safe transitions into adulthood. While all adolescent girls have been affected by the pandemic and mitigation response, we found that girls in different age groups and with prior risk factors for early marriage and fertility are facing different challenges. These findings align with the AGI-K Theory of Change and substantial literature demonstrating that girls’ needs shift as they progress through each stage of adolescence (Igras et al. 2014). As Kenya moves into what appears to be a COVID-19 recovery phase, it will be critical to ensure that all adolescent girls are supported to get back on a positive trajectory into adulthood.

While most younger adolescent girls feel confident that they will return to school, they are experiencing significant barriers to home learning. Younger girls have limited access to resources for learning at home such as mobile phones, relying, instead, on non-school-issued books and radio programming. While we did not collect the number of hours adolescents were spending learning from home, it is likely less than was spent attending classes prior to the pandemic since over half reported increased time spent on household chores since the pandemic began. Gaps in educational progress as short as four to five months may drive lifelong loses in earning potential (The World Bank 2020). Furthermore, economic losses during COVID-19 may prevent younger girls from returning to school when classrooms re-open.

The combination of economic losses and lack of school-provided meals has already taken a health toll on younger girls, with nearly 90 percent eating less or skipping more meals since the pandemic began. There was not a clear relationship between parental loss of income during the COVID-19 response and eating less since the prevalence of eating less since COVID-19 among girls in informal settlements was so high.

Compared to younger girls, older girls face more immediate risk of dropping out of school permanently. A larger percentage of older girls have begun earning money or are looking for work since the COVID-19 mitigation response began, potentially reducing the chance that they will return to school. A wealth of evidence indicates that dropping out of school increases girls’ risk of early marriage and childrearing (Wodon et al. 2017). While few adolescents in our study were currently pregnant, trying to become pregnant, married, or living with a partner, this may shift as the pandemic progresses. Many older girls reported forgoing needed health services in the past month, indicating that they may not be accessing needed SRH services during the pandemic and increasing their risk of unintended pregnancies.

Interestingly, we found that a larger percentage of girls reported less violence in their households since the pandemic began than reported more violence (45 percent as opposed to 6 percent). These reductions in household violence may be driven by Nairobi's city-wide curfew and closure of bars reducing alcohol-driven violence. In Kenya, reports of domestic violence have spiked since COVID-19 mitigation efforts began, and research has emphasized the risk of increased violence during this period (Johnson et al. 2020; Masiga 2020) but few studies have collected this information.

Overall, we found some protective or risk factors associated with outcomes of interest. As expected, being in school prior to COVID-19 closures was protective against looking for work since COVID-19. Unexpectedly, we found that having a high social support score was associated with feeling depressed in the past two weeks. This may be because those who had stronger social networks before the pandemic are experiencing more feelings of depression as a result of losing those social connections during closures. Girls who had experienced GBV prior to the pandemic had the highest risk of negative education and health outcomes, suggesting that these girls require targeted interventions.

We explored a number of other factors, but few were statistically significant. This may suggest that all girls in informal settlements have been experiencing poor outcomes as a result of COVID-19, not just those in the lowest wealth groups, those who experienced the largest economic shocks, or those who were already at higher risk of school dropout or early pregnancy. Despite variation in self-efficacy, social support, and wealth prior to COVID-19, the mitigation response has been so disruptive to the lives of adolescent girls in Nairobi that no protective effects were detected relative to the high prevalence of negative outcomes. Alternatively, given that the survey took place only four months into the pandemic, it may simply have been then too early to see the full effects of COVID-19 on adolescent girls. If COVID-19 becomes a prolonged crisis, its negative effects may worsen or be compounded.

Limitations and Contributions

There are several limitations to this study. First, characteristics measured during AGI-K and NISITU may have changed in the 6 to 12 months since that data was collected. For instance, the girls may have become sexually active or experienced GBV, which would have influenced our results. In addition, the study relied on self-reporting of sensitive topics, such as GBV and sexual partnerships. The reliability of results may be reduced because most respondent used a shared family mobile phone for the survey. Best practices on collecting sensitive information during COVID-19 stay-at-home orders are still in development (Peterman et al. 2020). In addition, since we could reach only AGI-K and NISITU adolescents with working phone numbers, we may have reached girls who were better off at that stage of the pandemic. Adolescents who participated in AGI-K or NISITU intervention groups may also have reported better outcomes. However, adjustments for study participation in our logistic regression analyses did not produce large changes.

This study also makes a number of valuable contributions. It combines information collected on the same cohort before and after the pandemic began, allowing for a detailed understanding of how the COVID-19 response influenced girls’ trajectories in the short-term, as well as an exploration of which characteristics made girls more or less susceptible to negative outcomes.

Conclusions

Adolescent girls in informal settlements are facing high levels of food insecurity and challenges with remote learning. Many are concerned that economic losses will cause them to drop out of school and others have begun looking for work, thus increasing their risk of early marriage and childrearing. To maintain their positive life-trajectories during COVID-19, adolescent girls require immediate concerted support. Interventions targeting younger adolescent girls should focus on increasing access to food and non-internet based educational materials while schools remain closed and have school fees waived after re-opening to ensure educational continuity. Interventions targeting older girls should reduce economic barriers to secondary education while improving access to free SRH services to protect against unintended pregnancy. Special attention should be placed on girls who have experienced GBV since they have increased risk of negative outcomes.

Acknowledgements

This work was supported by the Bill & Melinda Gates Foundation via a sub-grant from the UCSF EMERGE Project, the UK Department for International Development, and the NoVo Foundation. Thank you to Rhoune Ochako, Timothy Abuya, Eva Muluve, Faith Mbushi, and Daniel Mwanga of Population Council, Kenya, for supervision of data collection and quality assurance.

Notes

1

Protocol 936

2

Protocol 803/2020

References

  • Austrian, Karen, Eunice Muthengi, Joyce Mumah, Erica Soler-Hampejsek, Caroline W Kabiru, Benta Abuya, and John A Maluccio. 2016. “The Adolescent Girls Initiative-Kenya (AGI-K): Study Protocol.” BMC Public Health 16 (1): 114. https://doi.org/10.1186/s12889-016-2888-1

    • Search Google Scholar
    • Export Citation
  • Austrian, Karen, Jessie Pinchoff, James B Tidwell, Corinne White, Timothy Abuya, Beth Kangwana … and Faith Mbushi. 2020. “COVID-19 Related Knowledge, Attitudes, Practices and Needs of Households in Informal Settlements in Nairobi, Kenya.” The Lancet Pre-Print. https://doi.org/10.2139/ssrn.3576785.

    • Search Google Scholar
    • Export Citation
  • Austrian, Karen, Erica Soler-Hampejsek, Jere R Behrman, Jean Digitale, Natalie Jackson Hachonda, Maximillian Bweupe, and Paul C Hewett. 2020. “The Impact of the Adolescent Girls Empowerment Program (AGEP) on Short and Long Term Social, Economic, Education and Fertility Outcomes: A Cluster Randomized Controlled Trial in Zambia.” BMC Public Health 20 (1): 115. https://doi.org/10.1186/s12889-020-08468-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Beguy, Donatien, Alex C Ezeh, Blessing U Mberu, and Jacques BO Emina. 2017. “Changes in Use of Family Planning among the Urban Poor: Evidence from Nairobi Slums.” Population and Development Review 43: 216234. https://doi.org/10.1111/padr.12038.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Beguy, Donatien, Robert Ndugwa, and Caroline W Kabiru. 2013. “Entry into Motherhood among Adolescent Girls in Two Informal Settlements in Nairobi, Kenya.” Journal of Biosocial Science 45 (6): 721742. https://doi.org/10.1017/s0021932013000199

    • Search Google Scholar
    • Export Citation
  • Benight, Charles C., and Albert Bandura. 2004. “Social Cognitive Theory of Posttraumatic Recovery: The Role of Perceived Self-efficacy.” Behaviour Research and Therapy 42 (10): 11291148. https://doi.org/10.1016/j.brat.2003.08.008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chen, Gilad, Stanley M Gully, and Dov Eden. 2001. “Validation of a New General Self-efficacy Scale.” Organizational Research Methods 4 (1): 6283. https://doi.org/10.1177/109442810141004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Corburn, Jason, David Vlahov, Blessing Mberu, Lee Riley, Waleska Teixeira Caiaffa, Sabina Faiz Rashid … and Eliana Martínez-Herrera. 2020. “Slum Health: Arresting COVID-19 and Improving Well-being in Urban Informal Settlements.” Journal of Urban Health 97: 348357. https://doi.org/10.1007/s11524-020-00438-6.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Igras, Susan M., Marjorie Macieira, Elaine Murphy, and Rebecka Lundgren. 2014. “Investing in Very Young Adolescents’ Sexual and Reproductive Health.” Global Public Health 9 (5): 555569. https://doi.org/10.1080/17441692.2014.908230

    • Search Google Scholar
    • Export Citation
  • Johnson, Katy, Lindsey Green, Muriel Volpellier, Suzanne Kidenda, Thomas McHale, Karen Naimer, and Ranit Mishori. 2020. “The Impact of COVID-19 on Services for People Affected by Sexual and Gender-based Violence.” International Journal of Gynecology and Obstetrics 150 (3): 285287. https://doi.org/10.1002/ijgo.13285

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kabale, Nasibo. 2020. “Coronavirus: Kenya Takes Bold Steps After Cases Rise to Three.” The Nation, 24 March. https://nation.africa/kenya/news/coronavirus-kenya-takes-bold-steps-after-cases-rise-to-three-278692.

    • Search Google Scholar
    • Export Citation
  • Loades, Maria Elizabeth, Eleanor Chatburn, Nina Higson-Sweeney, Shirley Reynolds, Roz Shafran, Amberly Brigden … and Esther Crawley. 2020. “Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19.” Journal of the American Academy of Child and Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2020.05.009 (Epub ahead of print)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Masiga, Julie. 2020. “Domestic Violence on the Rise Amid Pandemic.” The Standard, 14 April. https://www.standardmedia.co.ke/opinion/article/2001367916/domestic-violence-on-the-rise-amid-pandemic

    • Search Google Scholar
    • Export Citation
  • Mutisya, Maurice, Moses W Ngware, Caroline W Kabiru, and Ngianga-bakwin Kandala. 2016. “The Effect of Education on Household Food Security in Two Informal Urban Settlements in Kenya: A Longitudinal Analysis.” Food Security 8 (4): 743756. https://doi.org/10.1007/s12571-016-0589-3

    • Search Google Scholar
    • Export Citation
  • Peterman, Amber, Amiya Bhatia, and Alessandra Guedes. 2020. “Remote Data Collection on Violence Against Women During COVID-19: A Conversation with Experts on Ethics, Measurement and Research Priorities (Part 1).” Washington DC: UNICEF.

    • Search Google Scholar
    • Export Citation
  • Population Council. 2005. Building Assets for Safe and Productive Lives: A Report on a Workshop on Adolescent Girls’ Livelihoods. New York: Population Council.

    • Search Google Scholar
    • Export Citation
  • Purdy, C. 2020. “Opinion: How Will COVID-19 Affect Global Access to Contraceptives—And what Can We Do about it?https://www.devex.com/news/sponsored/opinion-how-will-covid-19-affect-global-access-to-contraceptives-and-what-can-we-do-about-it-96745.

    • Search Google Scholar
    • Export Citation
  • Quaife, Matthew, Kevin van Zandvoort, Amy Gimma, Kashvi Shah, Nicky McCreesh, Kiesha Prem, Edwine Barasa … and Karen Austrian. 2020. “The Impact of COVID-19 Control Measures on Social Contacts and Transmission in Kenyan Informal Settlements.” MedRxiv. https://doi.org/10.1101/2020.06.06.20122689.

    • Search Google Scholar
    • Export Citation
  • Risso-Gill, Isabelle. 2015. Children's Ebola Recovery Assessment: Sierra Leone. Freetown, Sierra Leone: Save the Children, Plan International, UNICEF, and World Vision.

    • Search Google Scholar
    • Export Citation
  • Salon, Deborah, and Sumila Gulyani. 2010. “Mobility, Poverty, and Gender: Travel ‘Choices’ of Slum Residents in Nairobi, Kenya.” Transport Reviews 30 (5): 641657. https://doi.org/10.1080/01441640903298998

    • Crossref
    • Search Google Scholar
    • Export Citation
  • The World Bank. 2020. COVID-19 Could Lead to Permanent Loss in Learning and Trillions of Dollars in Lost Earnings. 18 June. Washington: The World Bank.

    • Search Google Scholar
    • Export Citation
  • Wodon, Quentin, Chata Male, Ada Nayihouba, Adenike Onagoruwa, Aboudrahyme Savadogo, Ali Yedan … and Lydia Murithi. 2017. “Economic Impacts of Child Marriage: Global Synthesis Report.”

    • Search Google Scholar
    • Export Citation

Contributor Notes

Meghan Bellerose (ORCID: 0000-0003-2281-8957) is an MPH student at Columbia University Mailman School of Public Health in the Department of Population and Family Health. Email: meb2308@cumc.columbia.edu

Maryama Diaw (ORCID: 0000-0002-9675-758X) is an MPH student at Columbia University Mailman School of Public Health in the Department of Population and Family Health. Email: md3848@cumc.columbia.edu

Jessie Pinchoff (ORCID: 0000-0003-3155-595X) is an Associate researcher at Population Council USA in the Poverty, Gender, and Youth program with the population, environmental risks and climate change (PERCC) initiative. Email: jpinchoff@popcouncil.org

Beth Kangwana (ORCID: 0000-0002-3013-2851) is a Senior Programme Officer at Population Council Kenya. She has conducted impact evaluations to understand how interventions can improve adolescent sexual and reproductive health outcomes. Email: bkangwana@popcouncil.org

Karen Austrian (ORCID: 0000-0001-5464-7908) is a Senior Associate at Population Council Kenya who has led several longitudinal, randomized trials evaluating the social, health, and economic effects of adolescent programs in East and Southern Africa. Email: kaustrian@popcouncil.org

Girlhood Studies

An Interdisciplinary Journal

  • Austrian, Karen, Eunice Muthengi, Joyce Mumah, Erica Soler-Hampejsek, Caroline W Kabiru, Benta Abuya, and John A Maluccio. 2016. “The Adolescent Girls Initiative-Kenya (AGI-K): Study Protocol.” BMC Public Health 16 (1): 114. https://doi.org/10.1186/s12889-016-2888-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Austrian, Karen, Jessie Pinchoff, James B Tidwell, Corinne White, Timothy Abuya, Beth Kangwana … and Faith Mbushi. 2020. “COVID-19 Related Knowledge, Attitudes, Practices and Needs of Households in Informal Settlements in Nairobi, Kenya.” The Lancet Pre-Print. https://doi.org/10.2139/ssrn.3576785.

    • Search Google Scholar
    • Export Citation
  • Austrian, Karen, Erica Soler-Hampejsek, Jere R Behrman, Jean Digitale, Natalie Jackson Hachonda, Maximillian Bweupe, and Paul C Hewett. 2020. “The Impact of the Adolescent Girls Empowerment Program (AGEP) on Short and Long Term Social, Economic, Education and Fertility Outcomes: A Cluster Randomized Controlled Trial in Zambia.” BMC Public Health 20 (1): 115. https://doi.org/10.1186/s12889-020-08468-0

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Beguy, Donatien, Alex C Ezeh, Blessing U Mberu, and Jacques BO Emina. 2017. “Changes in Use of Family Planning among the Urban Poor: Evidence from Nairobi Slums.” Population and Development Review 43: 216234. https://doi.org/10.1111/padr.12038.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Beguy, Donatien, Robert Ndugwa, and Caroline W Kabiru. 2013. “Entry into Motherhood among Adolescent Girls in Two Informal Settlements in Nairobi, Kenya.” Journal of Biosocial Science 45 (6): 721742. https://doi.org/10.1017/s0021932013000199

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Benight, Charles C., and Albert Bandura. 2004. “Social Cognitive Theory of Posttraumatic Recovery: The Role of Perceived Self-efficacy.” Behaviour Research and Therapy 42 (10): 11291148. https://doi.org/10.1016/j.brat.2003.08.008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chen, Gilad, Stanley M Gully, and Dov Eden. 2001. “Validation of a New General Self-efficacy Scale.” Organizational Research Methods 4 (1): 6283. https://doi.org/10.1177/109442810141004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Corburn, Jason, David Vlahov, Blessing Mberu, Lee Riley, Waleska Teixeira Caiaffa, Sabina Faiz Rashid … and Eliana Martínez-Herrera. 2020. “Slum Health: Arresting COVID-19 and Improving Well-being in Urban Informal Settlements.” Journal of Urban Health 97: 348357. https://doi.org/10.1007/s11524-020-00438-6.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Igras, Susan M., Marjorie Macieira, Elaine Murphy, and Rebecka Lundgren. 2014. “Investing in Very Young Adolescents’ Sexual and Reproductive Health.” Global Public Health 9 (5): 555569. https://doi.org/10.1080/17441692.2014.908230

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Johnson, Katy, Lindsey Green, Muriel Volpellier, Suzanne Kidenda, Thomas McHale, Karen Naimer, and Ranit Mishori. 2020. “The Impact of COVID-19 on Services for People Affected by Sexual and Gender-based Violence.” International Journal of Gynecology and Obstetrics 150 (3): 285287. https://doi.org/10.1002/ijgo.13285

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kabale, Nasibo. 2020. “Coronavirus: Kenya Takes Bold Steps After Cases Rise to Three.” The Nation, 24 March. https://nation.africa/kenya/news/coronavirus-kenya-takes-bold-steps-after-cases-rise-to-three-278692.

    • Search Google Scholar
    • Export Citation
  • Loades, Maria Elizabeth, Eleanor Chatburn, Nina Higson-Sweeney, Shirley Reynolds, Roz Shafran, Amberly Brigden … and Esther Crawley. 2020. “Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19.” Journal of the American Academy of Child and Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2020.05.009 (Epub ahead of print)

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Masiga, Julie. 2020. “Domestic Violence on the Rise Amid Pandemic.” The Standard, 14 April. https://www.standardmedia.co.ke/opinion/article/2001367916/domestic-violence-on-the-rise-amid-pandemic

    • Search Google Scholar
    • Export Citation
  • Mutisya, Maurice, Moses W Ngware, Caroline W Kabiru, and Ngianga-bakwin Kandala. 2016. “The Effect of Education on Household Food Security in Two Informal Urban Settlements in Kenya: A Longitudinal Analysis.” Food Security 8 (4): 743756. https://doi.org/10.1007/s12571-016-0589-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Peterman, Amber, Amiya Bhatia, and Alessandra Guedes. 2020. “Remote Data Collection on Violence Against Women During COVID-19: A Conversation with Experts on Ethics, Measurement and Research Priorities (Part 1).” Washington DC: UNICEF.

    • Search Google Scholar
    • Export Citation
  • Population Council. 2005. Building Assets for Safe and Productive Lives: A Report on a Workshop on Adolescent Girls’ Livelihoods. New York: Population Council.

    • Search Google Scholar
    • Export Citation
  • Purdy, C. 2020. “Opinion: How Will COVID-19 Affect Global Access to Contraceptives—And what Can We Do about it?https://www.devex.com/news/sponsored/opinion-how-will-covid-19-affect-global-access-to-contraceptives-and-what-can-we-do-about-it-96745.

    • Search Google Scholar
    • Export Citation
  • Quaife, Matthew, Kevin van Zandvoort, Amy Gimma, Kashvi Shah, Nicky McCreesh, Kiesha Prem, Edwine Barasa … and Karen Austrian. 2020. “The Impact of COVID-19 Control Measures on Social Contacts and Transmission in Kenyan Informal Settlements.” MedRxiv. https://doi.org/10.1101/2020.06.06.20122689.

    • Search Google Scholar
    • Export Citation
  • Risso-Gill, Isabelle. 2015. Children's Ebola Recovery Assessment: Sierra Leone. Freetown, Sierra Leone: Save the Children, Plan International, UNICEF, and World Vision.

    • Search Google Scholar
    • Export Citation
  • Salon, Deborah, and Sumila Gulyani. 2010. “Mobility, Poverty, and Gender: Travel ‘Choices’ of Slum Residents in Nairobi, Kenya.” Transport Reviews 30 (5): 641657. https://doi.org/10.1080/01441640903298998

    • Crossref
    • Search Google Scholar
    • Export Citation
  • The World Bank. 2020. COVID-19 Could Lead to Permanent Loss in Learning and Trillions of Dollars in Lost Earnings. 18 June. Washington: The World Bank.

    • Search Google Scholar
    • Export Citation
  • Wodon, Quentin, Chata Male, Ada Nayihouba, Adenike Onagoruwa, Aboudrahyme Savadogo, Ali Yedan … and Lydia Murithi. 2017. “Economic Impacts of Child Marriage: Global Synthesis Report.”

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 61 61 0
Full Text Views 832 832 104
PDF Downloads 473 473 41