title: The Adolescent Girls Initiative-Kenya (AGI-K): study protocol.
abstract: BACKGROUND
  Many adolescent girls in Kenya and elsewhere face considerable risks and vulnerabilities that affect their well-being and hinder a safe, healthy, and productive transition into early adulthood. Early adolescence provides a critical window of opportunity to intervene at a time when girls are experiencing many challenges, but before those challenges have resulted in deleterious outcomes that may be irreversible. The Adolescent Girls Initiative-Kenya (AGI-K) is built on these insights and designed to address these risks for young adolescent girls. The long-term goal of AGI-K is to delay childbearing for adolescent girls by improving their well-being.
  
  
  METHODS
  AGI-K comprises nested combinations of different single-sector interventions (violence prevention, education, health, and wealth creation). It will deliver interventions to over 6000 girls between the ages of 11 and 14 years in two marginalized areas of Kenya: 1) Kibera in Nairobi and 2) Wajir County in Northeastern Kenya. The program will use a combination of girl-, household- and community-level interventions. The violence prevention intervention will use community conversations and planning focused on enhancing the value of girls in the community. The educational intervention includes a cash transfer to the household conditioned on school enrollment and attendance. The health intervention is culturally relevant, age-appropriate sexual and reproductive health education delivered in a group setting once a week over the course of 2 years. Lastly, the wealth creation intervention provides savings and financial education, as well as start-up savings.
  
  
  METHODS
  A randomized trial will be used to compare the impact of four different packages of interventions, in order to assess if and how intervening in early adolescence improves girls' lives after four years. The project will be evaluated using data from behavioural surveys conducted before the start of the program (baseline in 2015), at the end of the 2-year intervention (endline in 2017), and 2 years post-intervention (follow-up in 2019). Monitoring data will also be collected to track program attendance and participation. Primary analyses will be on an intent-to-treat basis. Qualitative research including semi-structured interviews of beneficiaries and key adult stakeholders in 2016 and 2018 will supplement and complement the quantitative survey results. In addition, the cost-effectiveness of the interventions will be assessed.
  
  
  CONCLUSIONS
  AGI-K will provide critical evidence for policy-makers, donors and other stakeholders on the most effective ways to combine interventions for marginalized adolescent girls across sectors, and which packages of interventions are most cost-effective.
  
  
  BACKGROUND
  ISRCTN77455458 , December 24, 2015.
authors.affiliation: Population Council, P.O. Box 17643-00500, Nairobi, Kenya. kaustrian@popcouncil.org.
authors.forename: Karen
authors.initials: K
authors.lastname: Austrian
authors.affiliation: Population Council, P.O. Box 17643-00500, Nairobi, Kenya. emuthengi@popcouncil.org.
authors.forename: Eunice
authors.initials: E
authors.lastname: Muthengi
authors.affiliation: African Population and Health Research Center, P.O. Box 10787-00100, Nairobi, Kenya. jmumah@aphrc.org.
authors.forename: Joyce
authors.initials: J
authors.lastname: Mumah
authors.affiliation: Population Council, One Dag Hammarskjold Plaza, New York, NY, 10017, USA. esolerhampejsek@popcouncil.org.
authors.forename: Erica
authors.initials: E
authors.lastname: Soler-Hampejsek
authors.affiliation: African Population and Health Research Center, P.O. Box 10787-00100, Nairobi, Kenya. ckabiru@aphrc.org.
authors.forename: Caroline W
authors.initials: CW
authors.lastname: Kabiru
authors.affiliation: African Population and Health Research Center, P.O. Box 10787-00100, Nairobi, Kenya. babuya@aphrc.org.
authors.forename: Benta
authors.initials: B
authors.lastname: Abuya
authors.affiliation: Middlebury College, 14 Old Chapel Rd, Middlebury, VT, 05753, USA. maluccio@middlebury.edu.
authors.forename: John A
authors.initials: JA
authors.lastname: Maluccio
mesh_terms: D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006801:Humans; D007630:Kenya; D015397:Program Evaluation; D036301:Qualitative Research; D011795:Surveys and Questionnaires