Linkages Between Cash Incentives And Behaviour Change With Regards To Hiv Counselling And Testing Uptake In Adolescents: An Assessment Of The Rhiva Programme In The Khomas Region, Namibia

ABSTRACT

Adolescents must deal with a range of biological, social, emotional, and psychological

transitions in order to successfully enter the adult world. Yet, they lack the basic

knowledge, skills and structural support to prevent themselves from becoming infected

with HIV. Vulnerable children typically grow into vulnerable youth and vulnerable adults,

who in turn have vulnerable children of their own. This reinforces a cycle of poverty and

vulnerability for most families in Namibia. A clear understanding of the situation of young

people and their needs is required to design and successfully implement interventions such

as the Reduce HIV/AIDS in adolescents (RHIVA) programme.

The aim of the research was to assess the efficacy of the RHIVA programme’s cash

incentive based theory of change model, focusing on HCT uptake and HIV prevention in

Namibia. Consequently, the study sought to understand the impact of structural factors on

incentives and behaviour model proposed by the RHIVA theory of change model. The

study used secondary data from a pre-post quasi-experimental design collected from 529

baseline survey and 458 end line survey data of learners from the RHIVA pilot programme

in Khomas region. The study used a combination of confirmatory factor analysis (CFA)

and structural equation modelling (SEM) to answer the research questions.

The study found a significant cash incentives relationships, notably with HCT uptake (r

=0.487) and the use of drugs and alcohol among peers (r =0.121). Moreover, the findings

suggest that RHIVA intervention schools (IG2) received more cash incentives than

ii

RHIVA control schools (IG1) and Pure Control schools (CG). The study concludes that

strengthened school support structures and conditional cash transfers are important in

increasing HCT uptake of the learners. While teacher support, age and cash management

also plays a key role in increasing HCT uptake. The study recommends the active

engagement of young people and strengthening the school support system by training both

the teachers and the learners on sexual reproductive health. Teachers and parents are

structural agents encouraging learners towards positive sexual behaviours.

Keywords: Adolescents, RHIVA, HCT uptake, HIV/AIDS, CCTs, Behaviour change