Building young people's capacity around gender equality and livelihoods: the Stepping Stones and Creating Futures intervention

1. Stepping Stones and Creating Futures
Gender and Project Empower HEARD, UKZN University of
Health Unit, MRC Pretoria
Rachel Jewkes Mpume Mbatha Andy Gibbs Milly Mushinga
Nwabisa Jama- Laura Washington Alison Misselhorn
Shai
Yandisa Ntokozo Madlala Samantha Willan
Sikweyiya
Funded by: SIDA, the Joint Gender Fund and the MRC (South Africa)
Project Start Date: January 2011
Project End Date: August 2013

2. Session Objectives
This session has three main objectives:
• To enable participants to understand the importance of
tackling gender inequalities and poverty simultaneous
• To share initial findings of the Stepping Stones/Creating
Futures intervention
• To provide participants with the experience of a livelihoods
intervention

3. Outline of this session
• Why tackle gender inequalities and poverty for
HIV prevention? Power Walk (30 minutes)
• Stepping Stones and Creating Futures -
presentation (30 minutes)
• Creating Futures - experience (30 minutes)

4. Rationale
Assumption: Gender inequalities intersect with
livelihood insecurity to increase HIV risk behaviours
and gender-based violence:
• Women – poverty linked to IPV, challenges negotiating
condom use, transactional sex, inability to exit violent
relationships (Hunter, 2010; Jewkes & Morrell, 2012)
• Men – livelihood insecurity linked to perpetration of violence,
HIV prevalence, MCPs, alcohol use (Hunter, 2010)
Therefore: transform gender relationships and build
livelihoods…

5. Previous evaluations of similar
interventions
Intervention Approach Setting Outcomes
IMAGE Microfinance and South Africa: Women’s experience of IPV
gender Rural, av. age 41, reduced by 55%
transformation women
SHAZ! Gender Zimbabwe: Increase in HIV-related
transformation & urban, knowledge and relationship
vocational skills adolescent, power, no significant change in
women current sexual activity
or condom use at last sex
Micro- Microfinance, Kenya: urban, 45% reported leaving sex work.
enterprise peer education female sex
services workers These results were highly age
for sex dependent with older
workers women reporting better
outcomes
TRY Microfinance, Kenya: urban, Increased ability to insist on
educational topics adolescent condom use

6. Informal settlements and HIV
Informal settlements are a key HIV issue:
• 28% of people living with HIV/AIDS in southern and
eastern Africa live in 14; approximately 15% of the
global epidemic (van Renterghem & Jackson, 2009)
• In South Africa, 29.1% of the total estimated number of
new HIV infections are found in urban informal
settlements, even though only 8.7% of South Africans
older than 2 years live in these areas (Rehle et al.,
2007)
• Few scientific evaluations of interventions in these
communities (Gibbs et al., 2012)

7. Stepping Stones
Used globally since 1995 – aims to achieve HIV
prevention through greater gender equality
Two year evaluation (by MRC):
• Reduced HSV2 new infections by
33% in men and women
• Less risky drinking – men
• Reduced IPV – men
• Less transactional sex – women and
men (Jewkes et al., 2008)
10 session intervention

8. Creating Futures: supporting young
people in building their livelihoods
• Jointly created by the three partner
organisations
• It seeks to encourage reflection and action
among young people on their livelihoods
through participatory activities
• Ten sessions

9. Creating Futures
• Builds on a livelihoods framework:
• Human capital (education)
• Social capital (networks, relationships)
• Physical capital (housing)
• Financial capital (savings, work)
• Natural capital (land, rivers)
• Creating Futures encourages young people to
reflect on their activities and decisions within this
broad framework

10. Creating Futures
Process to develop manual
1. Workshop with a broad set of stakeholders early in
2011 to explore the context
2. Partnered with an ‘implementing’, grass roots
organisation
3. Literature scan- livelihoods and curriculum theory
4. Log-frame development
5. Expert review
6. Manual development
7. 2x pre-tests

11. Delivering Stepping Stones and Creating
Futures
Recruited 233 young people (110 men, 123
women) with an average age of 21.7 years
All from informal settlements around Durban
• Two-thirds of women had given birth to a child,
compared to one third of men who had fathered a
child
• Only 45% of men and 24% of women had finished high
school
• Men and women reported rates of intimate partner
violence (physical and sexual) in the past 12 months
of 40%, compared to a national average of 13%

12. Design of study
2 weeks
0 Months 12 Months
6 Months
Combined Stepping
Stones & Creating
Futures Intervention
(20 sessions)
Quantitative Quantitative
survey (233), survey (221 – Quantitative
FGDs – in- 95% followed- survey
depth up)
interviews In-depth
In-depth interviews
Quantitative
survey (206) interviews

13. Implementing the intervention
May – August 2012
• Retention/attendance:
• Attended 1 session: 183 (13%
drop out)
• Attendance – 50% overall
• Taxi strikes
• Highly mobile population:
CT, EC, Jo’burg, rural areas
Sbu facilitates a discussion on
• Boyfriends controlling
a body map participants have
girlfriends drawn

14. Outcomes: Warning!
1. Not final results – April 2013
2. No significance tests done
3. Instability of scales: reporting where we have
‘strong’ evidence of change/ correlate with Stepping
Stones outcomes
4. Small scale study with no control
Casper facilitating a discussion on
women’s expectations of men

15. Improving livelihoods
• Men and women increased mean income in past
month:
• Men from R411 (US$45) to R713 ($77 a 73% increase)
• Women R174 ($18) to R255 ($28 a 47% increase)
• Job seeking only changed among women:
• Looking for jobs in newspapers more in the past three
months, from 45% to 66%
• Sent off a job application in past 3 months – increased by
11%
• Stealing in the last month because hungry:
• 22% decline among men, 18% decline among women

16. Improved thinking around livelihoods
Improved navigation of work settings:
Young man: “Before I used to do things recklessly, drink alcohol and come
back home around 12am or 1am while I would be going to work that
morning, and I would go to work and get warnings, but Project Empower
showed me how to do things”
Improvement in savings
Male participant – focus group: What I have learnt is to stick to my budget
and also make a list and stick to those things that are in the list and not
spend money on unimportant things.

17. Critical thinking about gender
relationships
INTERVIEWER: According to you, what makes a good woman?
NOMZAMO (Female): Women who would be independent, they
would not expect to be controlled by men, firstly. They would
not allow a man to control them. They must know that they also
have rights and have to fight for them. She must work for
herself and not expect to be given things
Critical thinking about
relationships is a pre-
condition for acting in
new ways
Male participants acting out a role
play during Stepping Stones

18. Greater focus on main partner
Interviewer: let’s talk about the experience you had with the
program like what made you get involved with the project?
Mandla (male): this programme has helped me a lot like
workwise I’m holding on to it, and the person I am dating I have
committed myself to her and other things are progressive and
my child is growing well
Percentage men who reported that their last sexual act
was with main partner: 50% at baseline to 62% at
follow up, a 23% increase (potential decrease in
overlapping/concurrent relationships)
Percentage women reporting satisfactory sexual
relationship with main partner increased (up 12%)

19. Transactional sex
Men’s participation in transactional sex in the past
three months from 24% to 18% (a 23% decline)
Women’s participation in transactional sex in the past
three months increased – same as Stepping Stones.
But, there was a 23% reduction in women reporting
that their last experience of transactional sex was
conditional on the exchange

20. Mental Health
Severe depression amongst men: 50% down to
37% (74% decline)
Suicidal thoughts past 4 weeks: 28% decline
among men
No impact on mental health among women

21. Substance use
Vusi (Male): You see we sit down [my girlfriend and I] and
discuss things together, like maybe let’s for an example like
when I used to drink…
Interviewer: So have you stopped drinking?
Vusi: Yes.
Interviewer: Or you have taken a break?
Vusi: No I have stopped, but they [friends] try to get me to
drink again but they never are successful at it (laughing) no
they fail!
Arguing with a partner about alcohol use in the past
three months also declined among men (35%) and
women (27%)
Women’s use of drugs: declined from 17% to 8%

22. Outcomes Summary
Short-term positive trends:
• Strengthening livelihoods (more working, more
earnings, women ‘trying’ more)
• Gender relationships changing – parallel Stepping
Stones (esp. focus on main partner)
• Wider health benefits – parallel Stepping Stones
(reduction in substance abuse, decrease mental
health issues)
Sustaining these into the future - critical