Economic Empowerment Program Suubi-Maka (Suubi-Maka)

SUUBI MAKA ("Hope for Families"): A Family-Based Economic Empowerment Model for Orphaned Children in Uganda

The overall goal of SUUBI-MAKA is to further develop and preliminarily examine a family economic empowerment intervention that creates economic opportunities (specifically Children Development Accounts) for families in Uganda who are caring for children orphaned due to the AIDS pandemic, and to lay groundwork for a bigger study with practice and policy implications for Sub-Saharan Africa.

Study Overview

• Status: Completed
• Conditions: Poverty
• Intervention / Treatment: Behavioral: Suubi-Maka ('Hope for Families'); Other: Usual Care

Detailed Description

The study has two specific aims (1) To conduct formative work in order to understand children and families´ ability and interest in participating in a family-level economic empowerment intervention focused on savings and family income generation, and their response to this family-focused economic empowerment approach alongside additional intervention components, including savings for youth education and adult mentorship. (2) Based on formative data (Aim #1), to adapt the intervention and examine issues related to feasibility and preliminary outcome on a small scale in order to prepare for a larger study.

The intervention, SUUBI-MAKA, uses a novel approach by focusing on economic empowerment of families caring for children orphaned due to AIDS. The intervention has three key components (1) it promotes family-level income generating projects (micro-enterprises) which we believe will enhance economic stability, reduce poverty, and enhance protective family processes for youth orphaned by AIDS. (2) It promotes monetary savings for educational opportunities for AIDS-orphaned children. (3) It provides an adult mentor to children. The intervention will be evaluated via a two-group randomized trial. The two groups are SUUBI-MAKA or Usual care for orphaned children. The participating children will be nested within 20 primary schools that will be randomly assigned such that all children from a particular school receive the same intervention.

• Study Type: Interventional
• Enrollment (Actual): 300
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Uganda
  • Rakai, Uganda
    • St. Joseph's Matale Parish

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 11 years to 16 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. An AIDS-orphaned child, defined as a child who has lost one or both parents to AIDS;
2. Enrolled in the last two years of primary school (even though possibly not attending regularly);
3. Between the ages of 11 to 16 years;
4. Living within a family.

Exclusion Criteria:

1. Any youth below 11 years or above 16 years at the time of enrollment in the study;
2. Any youth not enrolled in the final two years of primary school;
3. Any youth who does not self-identify as an AIDS-orphan;
4. Any youth not being raised primarily within a family context at the start of the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SUUBI-MAKA; Involves creating and broadening asset ownership opportunities and life options for children (ages 12 to 15 years) orphaned due to AIDS in Uganda.	Behavioral: Suubi-Maka ('Hope for Families'); Each child in the SUUBI-MAKA condition receive the usual care plus asset focused services, specifically: a matched Child Development Account (CDA); twelve 1-2 hour training sessions on career planning, setting short-term and long-term career goals, and how to save money; and monthly mentorship program with young adult peers (undergraduate students) on life options and how to avoid risk behaviors. In addition, participants receive a 2:1 match for their deposits into the account. Further, participants and their adult caregivers receive specific training on microenterprise development and specifically on how to start an income-generating project using up to 50% of the matched savings. The intervention is delivered over a period of 24 months.; Other Names: Children's savings account
Other: Usual Care; No intervention for asset ownership, development of future planning skills, enhancement of mental health and reduction of risk taking behaviors for children orphaned due to AIDS in Uganda.	Other: Usual Care; Each child in the control condition receives the usual services for orphaned children (counseling, school lunches, and textbooks).; Other Names: Usual services

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Savings and asset-accumulation	Formal and informal savings, wealth/assets (e.g. livestock, type of housing), and attitudes toward saving	12-month post-intervention
Educational outcomes	School enrollment, School attendance, School grades, Educational plans and aspirations	12-month post-intervention
Sexual risk taking	Sexual risk taking behavior (onset of sexual intercourse, unprotected sexual intercourse), Intentions to engage in sexual risk behaviors, HIV knowledge	12-month post-intervention
Savings and asset-accumulation	Formal and informal savings, wealth/assets (e.g. livestock, type of housing), and attitudes toward saving	24-month post-intervention
Educational outcomes	School enrollment, School attendance, School grades, Educational plans and aspirations	24-month post-intervention
Sexual risk taking	Sexual risk taking behavior (onset of sexual intercourse, unprotected sexual intercourse), Intentions to engage in sexual risk behaviors, HIV knowledge	24-month post-intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mental health	Self-esteem, depression, hopelessness, helplessness	12-month post-intervention
Social and family support	Child-caregiver relationship, family cohesion, family communication, family support	12-month post-intervention
Mental health	Self-esteem, depression, hopelessness, and helplessness scales	24-month post-intervention
Social and family support	Child-caregiver relationship, family cohesion, family communication, family support	24-month post-intervention

Collaborators and Investigators

• Sponsor: Columbia University
• Collaborators: National Institute of Mental Health (NIMH)

Publications and helpful links

General Publications

• Jennings L, Ssewamala FM, Nabunya P. Effect of savings-led economic empowerment on HIV preventive practices among orphaned adolescents in rural Uganda: results from the Suubi-Maka randomized experiment. AIDS Care. 2016;28(3):273-82. doi: 10.1080/09540121.2015.1109585. Epub 2015 Nov 7.
• Han CK, Ssewamala FM, Wang JS. Family economic empowerment and mental health among AIDS-affected children living in AIDS-impacted communities: evidence from a randomised evaluation in southwestern Uganda. J Epidemiol Community Health. 2013 Mar;67(3):225-30. doi: 10.1136/jech-2012-201601.

Study record dates

Study Major Dates

• Study Start: August 1, 2008
• Primary Completion (Actual): July 1, 2012
• Study Completion (Actual): July 1, 2012

Study Registration Dates

• First Submitted: July 14, 2010
• First Submitted That Met QC Criteria: August 10, 2010
• First Posted (Estimate): August 11, 2010

Study Record Updates

• Last Update Posted (Estimate): November 27, 2012
• Last Update Submitted That Met QC Criteria: November 22, 2012
• Last Verified: November 1, 2012

More Information

Terms related to this study

• Keywords: sub-Saharan Africa; economic empowerment model,; orphaned children and youth,; Uganda,
• Other Study ID Numbers: AAAD2525; R34MH081763-02 (U.S. NIH Grant/Contract)