A School Support Intervention and Educational Outcomes Among Orphaned Adolescents: Results of a Cluster Randomized Controlled Trial in Kenya

Abstract

Globally, significant progress has been made in primary school enrollment. However, there are millions of adolescents--including orphans in sub-Saharan Africa--who still experience barriers to remaining in school. We conducted a four-year cluster randomized controlled trial (cRCT) (N=835) in a high HIV prevalence area in western Kenya to test whether providing orphaned adolescents with a school support intervention improves their educational outcomes. The school support intervention consisted of directly paying tuition, exam fees, and uniform costs to primary and secondary schools for those students who remained enrolled. In addition, research staff monitored intervention participants’ school attendance and helped to address barriers to staying in school. This school support intervention had significant positive impacts on educational outcomes for orphaned adolescents. Over the course of the study, school absence remained stable for intervention group participants but increased in frequency for control group participants. Intervention group participants were less likely to drop out of school compared to the control group. Furthermore, the intervention participants were more likely to make age-appropriate progression in grade, matriculate into secondary school, and achieve higher levels of education by the end of the study. The intervention also increased students’ expectations of graduating from college in the future. However, we found no significant intervention impact on primary and secondary school test scores. Results from this cRCT suggest directly covering school-related expenses for male and female orphaned adolescents in western Kenya can improve their educational outcomes.

The impact of school support on depression among adolescent orphans: a cluster‐randomized trial in Kenya

“…As originally reported in Cho et al. (), the intervention reduced the odds of drop out by 59%. In the current analysis, we found that the intervention effect on depression was partially mediated by higher levels of continuous school enrollment among the intervention group, but this mediated effect was small.…”

“…Finding that school support increased school enrollment (Cho et al., ) and appeared to buffer against depression symptoms over time, we hypothesized that this effect on depression might be mediated by the effect of the intervention on school enrollment. We observed partial mediation.…”

“…In this study, we evaluate whether a program that provides school support‐affected depression symptoms among a sample of orphans in Kenya. As the intervention had positive impacts on school dropout and some HIV risk behaviors such as male circumcision and transactional sex (Cho, Ryberg, Hwang, Pearce, & Iritani, ; Cho et al., ), the current evaluation serves to determine whether it had an additional benefit for adolescents’ mental health.…”

“…In reporting the primary trial outcomes, Cho et al. () demonstrated that the intervention prevented school dropout, but did not improve test scores. We analyzed trial data on depression symptoms to estimate the impact of the intervention on adolescent mental health—a secondary outcome—hypothesizing that the intervention would lead to better mental health outcomes for orphans.…”

“…We analyzed trial data on depression symptoms to estimate the impact of the intervention on adolescent mental health—a secondary outcome—hypothesizing that the intervention would lead to better mental health outcomes for orphans. As it is possible that reductions in depression could be driven by sustained school enrollment in a setting where secondary school completion is only 41% (UNICEF, ), we also conducted a mediation analysis to test the hypothesis that intervention effects on mental health are mediated by continued school enrollment (a primary outcome reported in Cho et al., ).…”