(see Poster Gallery) What Are Effective Interventions for Preventing School Dropout for Girls in Schools in Sub Saharan Africa? a Systematic Review

Background: Adolescent girls from Least Developed Countries (LDCs) are faced with limited opportunities to attain an education at all levels. Studies showed that as girls transitioned to the different levels of school (i.e., from primary to secondary and to post-secondary school), 25% of girls in LDCs were reported not to be enrolled in school. Research indicated that girls from developing countries who drop out of school were more likely to engage in risky behaviors, experience unwanted pregnancies, experience health related problems, and poverty. Little is known about what types of interventions are most effective for preventing dropout in this population. Yet no systematic reviews have been conducted to better understand these interventions particularly in Sub-Saharan Africa (SSA). Thus, the purpose of this systematic review was to:1) identity and describe the types of interventions and common outcomes that have been conducted to prevent school dropout among adolescent girls, 2) describe the methodological rigor of the intervention studies, and 3) determine what interventions were most effective when considering the study’s methodological rigor.

Methods: A systematic search of 12 databases was conducted through the EBSCO search engine following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria included: 1) empirically based quantitative interventions 2) adolescent girls in (SSA); 3) treatment and control groups; and 4) published in English peer-reviewed journals. The 10-item Methodological Quality Rating Scale was used to assess study rigor, with possible total scale scores ranging from 0-12. Studies that scored at or above the mean were considered high rigor, and those below the mean were low rigor. Strength of study evidence combined outcome significance with study rigor where 1) strong evidence (high rigor and significant outcomes); 2) promising (low rigor and significant outcomes); 3) weak evidence (high and low rigor and non-significant outcomes).

Results: Eleven studies met the inclusion criteria for this review. Intervention types included educational subsidies (n=2), provision of menstrual products (n=4), school assistance programs (n=2), and cash transfers (n=3). Intervention types were categorized by mode of delivery i.e., group ( n=5) vs individual (n=6); and site of implementation (school-based; n=9 and community-based; n=2). The most common outcomes were school dropout (n=6) and school attendance (n=5). Methodological rigor was mixed: 45% scored above the mean (M=7.1, SD=1.4), and ranged from 5-9. Methodological strengths were statistical analysis and describing attrition. Methodological weaknesses were lack of reporting of validity and reliability of measures and generalizability. Of studies that measured school attendance, 2 of 5 were significant, with 1 of high rigor using an individual-focus, school-based format.

Conclusions and Implications: Findings indicate only 2 of 11 interventions demonstrated strong evidence for reducing school dropout and both are school based. Evidence is mixed about what is the best format, group or individual. Further research is needed to describe the characteristics of the school settings and implementation strategies of these effective studies. More work is warranted to develop and test other intervention models for this vulnerable population.