背景:莱索托政府在实施社会保护计划方面表现出了一贯的努力。然而,尽管最近的证据确定了其中一些方案与粮食安全之间存在积极的因果关系,但几乎没有证据表明这些举措在多大程度上与莱索托弱势青少年的教育、性健康和生殖健康成果有关。
结果:该研究使用横截面,来自2018年莱索托暴力侵害儿童和青少年调查的全国代表性数据。我们的研究检查了生活在贫困中的青少年和年轻人(13-24岁)的社会保护接收与教育,性健康和生殖健康结果之间的关系。我们采用多变量逻辑回归控制年龄,孤儿,艾滋病毒状况和性别。社会保护收据被定义为家庭从政府获得财政支持,非政府组织,或提供收入的基于社区的计划。此外,我们按性别拟合了边际效应模型。在生活在两个最低贫困五分之一的3506名青少年女性和男性中,接受社会保护与多个青少年结局的改善相关:持续使用避孕套的几率更高(aOR1.64,95%CI1.17-2.29),受教育程度(AOR1.79,95%CI1.36-2.36),和入学率(aOR2.19,95%CI1.44-3.34)。按性别进行的分层分析显示,获得社会保护也与女性童婚的可能性降低(aOR0.59,95%CI0.42-0.83)以及男性受教育程度和入学率较高(aOR2.53,95%CI1.59-4.03和aOR3.11,95%CI1.56-6.19,分别)。
结论:我们的研究提供了证据,表明社会保护计划与改善教育有关,贫困青少年的性健康和生殖健康以及童婚预防结果。实施和扩大这种社会保护举措可能有助于改善弱势青少年的福祉。
■撒哈拉以南非洲国家的社会保护计划一直在增加,在减贫中发挥着关键作用,莱索托也不例外。尽管《莱索托第一(2014-19)和第二(2021-2031)国家社会保护战略》的实施带来了乐观的前景,这些计划对莱索托最脆弱青少年生活相关的一些具体结果的影响在某种程度上仍未被探索。此外,莱索托的艾滋病毒感染率很高,青春期怀孕,童婚和早退,这可能进一步导致青少年长期健康和社会结果不佳。在这项研究中,我们使用2018年莱索托暴力侵害儿童和青少年调查(VACS)的数据来检查接受社会保护与多个青少年结果之间的关联:教育,性和生殖。调查结果显示,社会保护计划,特别是现有的政府提供的现金转移,与生活在莱索托最贫困家庭的青少年的多个更好的结果显著相关。莱索托的这种现金转移计划与改善青春期女性的性健康和生殖健康结果有关,包括降低童婚率,改善男性的教育成果。这些发现表明,政府主导的社会保护计划与有利的结果呈正相关,可以改善资源有限环境中青少年的生活质量。
BACKGROUND: Lesotho\'s government has shown consistent efforts to implement social protection programmes. However, while recent evidence established a positive causal relationship between some of these programmes and food security there is little evidence on the extent to which these initiatives are associated with better educational and sexual and reproductive health outcomes among vulnerable adolescents in
Lesotho.
RESULTS: The study uses cross-sectional, nationally representative data from the 2018
Lesotho Violence Against Children and Youth Survey. Our research examined the association between social protection receipt and educational and sexual and reproductive health outcomes among adolescents and young people (13-24 years) living in poverty. We employed multivariate logistic regression controlling for age, orphanhood, HIV status and sex. Social protection receipt was defined as household receipt of financial support from a governmental, non-governmental, or community-based program that provides income. Additionally, we fitted a marginal effects model by sex. Among the 3,506 adolescent females and males living in the two lowest poverty quintiles, receipt of social protection was associated with improvements in multiple adolescent outcomes: higher odds of consistent condom use (aOR 1.64, 95% CI 1.17-2.29), educational attainment (aOR 1.79, 95% CI 1.36-2.36), and school enrolment (aOR 2.19, 95% CI 1.44-3.34). Stratified analyses by sex showed that social protection receipt was also associated with reduced likelihood of child marriage among females (aOR 0.59, 95% CI 0.42-0.83) and higher odds of educational attainment and school enrolment among males (aOR 2.53, 95% CI 1.59-4.03 and aOR 3.11, 95% CI 1.56-6.19, respectively).
CONCLUSIONS: Our study provides evidence that social protection programs are associated with improved educational, sexual and reproductive health and child marriage prevention outcomes among adolescents living in poverty. Implementing and expanding such social protection initiatives could prove instrumental in improving the well-being of vulnerable adolescents.
UNASSIGNED: Social protection programs have been increasing in sub-Saharan African countries, playing a pivotal role in poverty reduction, with Lesotho being no exception. Despite the optimistic outlook brought about by the implementation of the National Social Protection Strategy Lesotho I (2014-19) and II (2021-2031), the impact of these programs on some specific outcomes that concern the lives of the most vulnerable adolescents in Lesotho remains to some extent unexplored. Additionally,
Lesotho grapples with high rates of HIV, adolescent pregnancy, child marriage and early school dropout, which can further contribute to poor long-term health and social outcomes among adolescents. In this study, we used data from the 2018
Lesotho Violence Against Children and Youth Survey (VACS) to examine the association between receiving social protection and multiple adolescent outcomes: educational, sexual and reproductive. The findings revealed that social protection programs, particularly the existing government-provided cash transfers, are significantly associated with multiple better outcomes among adolescents living in the poorest households in Lesotho. Such cash transfer schemes in Lesotho are associated with improved sexual and reproductive health outcomes for adolescent females, including reduced child marriage rates, and improved educational outcomes for males. These findings indicate that government-led social protection programmes are positively associated with favourable outcomes that can improve the quality of life for adolescents in resource-limited settings.