Effectiveness of the Sista2Sista programme in improving HIV and other sexual and reproductive health outcomes among vulnerable adolescent girls and young women in Zimbabwe
Outcomes: Child, Early, and Forced Marriage, Gender‑Based Violence, Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways The Sista2Sista programme demonstrates that peer group interventions rooted in dialogue, mentorship, and community involvement can influence social norms related to sexual health, education, and gender-based violence among adolescent girls and young women. The program’s emphasis on self-awareness, communication, gender and power, and rights-based decision-making helped shift individual attitudes and behaviors, contributing to reduced child marriage, increased HIV testing, and greater contraceptive use. This suggests that empowering girls through structured peer support can alter harmful norms and encourage help-seeking behaviors in contexts of vulnerability.
Objectives The study aimed to evaluate the effectiveness of the Sista2Sista programme in improving HIV and other sexual and reproductive health outcomes among vulnerable adolescent girls and young women in Zimbabwe.
Methods This was a quantitative analysis of program data from 91,612 adolescent girls and young women aged 10–24 who participated in the Sista2Sista programme between 2013 and 2019. Logistic regression was used to examine the relationship between program completion and predefined health outcomes, including HIV testing, school attendance, marriage, pregnancy, contraceptive use, and reporting of sexual abuse. Follow-up data were also collected from a subset of graduates to assess sustainability of outcomes.
Intervention Details Sista2Sista is a structured, peer-led mentorship programme implemented through girls-only clubs across 26 districts in Zimbabwe. Facilitated by trained female mentors called behavior change facilitators, the program includes a 40-session curriculum covering topics such as communication, gender norms, power, sexual and reproductive health, consent, and financial literacy. Clubs meet weekly for a year, and girls who complete at least 30 sessions are considered graduates. Individual sessions provide additional support and trauma counseling. Participants are selected using a risk assessment tool to identify vulnerability in five domains.
Results Graduates were significantly more likely to have taken an HIV test, remained in or returned to school, used contraception, and reported sexual abuse. They were also less likely to become married or pregnant as adolescents. Girls who completed the entire curriculum saw the greatest benefit, with a 62% reduction in the likelihood of teenage pregnancy and a nearly 60% reduction in child marriage. Individual mentoring sessions further increased programme completion rates and positive outcomes.
Conclusions The Sista2Sista programme positively influenced key sexual and reproductive health outcomes and helped mitigate risks faced by adolescent girls and young women in Zimbabwe. The intervention’s structure—emphasizing mentorship, peer engagement, and norm-shifting content—offers a promising model for addressing gendered vulnerabilities in similar contexts. Enhancing the program with structural supports and caregiver engagement could deepen its impact.
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