Mixed-Method Quasi-Experimental Study of Outcomes of a Large-Scale Multilevel Economic and Food Security Intervention on HIV Vulnerability in Rural Malawi. AIDS Behav 2017 Mar;21(3):712-723
Date
06/29/2016Pubmed ID
27350305Pubmed Central ID
PMC5306183DOI
10.1007/s10461-016-1455-1Scopus ID
2-s2.0-84976320739 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
The objective of the Savings, Agriculture, Governance, and Empowerment for Health (SAGE4Health) study was to evaluate the impact of a large-scale multi-level economic and food security intervention on health outcomes and HIV vulnerability in rural Malawi. The study employed a quasi-experimental non-equivalent control group design to compare intervention participants (n = 598) with people participating in unrelated programs in distinct but similar geographical areas (control, n = 301). We conducted participant interviews at baseline, 18-, and 36-months on HIV vulnerability and related health outcomes, food security, and economic vulnerability. Randomly selected households (n = 1002) were interviewed in the intervention and control areas at baseline and 36 months. Compared to the control group, the intervention led to increased HIV testing (OR 1.90; 95 % CI 1.29-2.78) and HIV case finding (OR = 2.13; 95 % CI 1.07-4.22); decreased food insecurity (OR = 0.74; 95 % CI 0.63-0.87), increased nutritional diversity, and improved economic resilience to shocks. Most effects were sustained over a 3-year period. Further, no significant differences in change were found over the 3-year study period on surveys of randomly selected households in the intervention and control areas. Although there were general trends toward improvement in the study area, only intervention participants' outcomes were significantly better. Results indicate the intervention can improve economic and food security and HIV vulnerability through increased testing and case finding. Leveraging the resources of economic development NGOs to deliver locally-developed programs with scientific funding to conduct controlled evaluations has the potential to accelerate the scientific evidence base for the effects of economic development programs on health.
Author List
Weinhardt LS, Galvao LW, Yan AF, Stevens P, Mwenyekonde TN, Ngui E, Emer L, Grande KM, Mkandawire-Valhmu L, Watkins SCAuthor
Lance S. Weinhardt MS,PhD Associate Dean for Research and Professor of Community and Behavioral Health Promotion in the Joseph. J. Zilber School of Public Health department at University of Wisconsin - MilwaukeeMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Agriculture
Developing Countries
Economics
Female
Food Supply
HIV Infections
Health Plan Implementation
Health Risk Behaviors
Humans
Malawi
Male
Middle Aged
Models, Economic
Non-Randomized Controlled Trials as Topic
Risk Assessment
Rural Population
Young Adult
