In Sub-Saharan Africa, young girls drop out of school at higher rates than boys. Parents often invest more in sons than in daughters, by allowing them more resources for education, such as school fees, and time away from house chores for studying. Adolescent girls are also more likely to contract HIV from older, more sexually active male partners, on whom they often depend for financial resources. Girls’ education and negotiation skills for women are therefore viewed as important tools for reducing school dropout rates, early pregnancies and the HIV rate among young women. This study, conducted in the capital of Zambia, assesses the impact of teaching girls negotiation skills on health and education outcomes.

Policy Issue 

When young girls drop out of school, they are often unable to develop the skills necessary to support themselves. They often rely on male partners for resources, and those partners often demand sex in return for financial support. Such relationships are prevalent across sub-Saharan Africa, leaving young girls highly vulnerable to HIV infection and unwanted pregnancy, evidenced by the two-to-one ratio of HIV rates among young women versus their male counterparts. 1 The World Health Organization has identified negotiation skills for women and expanded efforts to keep girls in school as critical tools for reducing HIV rates among women in sub-Saharan Africa. 2 Designing school curriculum to provide girls with a stronger education and new skill sets has the potential to change gender dynamics and improve health outcomes for this vulnerable population.

Context of the Evaluation 

School data for Zambia shows a dramatic decline in female enrollment from primary to secondary school years.3 While this drop is normally attributed to the commencement of school fees in the eighth grade, a closer look reveals that school dropout rate increases prior to the fee increase. In grade five, the drop-out rate is three times higher for girls than boys. 4

This project tests the impact of negotiation training in addition to the current school curricula on HIV/AIDS, health, and education outcomes among Zambian girls. Through a randomized controlled trial, this study analyzes whether negotiation skills that allow a girl to reshape her understanding of a conflict and her communications with others, can ultimately result in more favorable resource allocations.

Details of the Intervention 

This study isolates the impact of teaching information versus teaching negotiation by layering two interventions on top of a "social capital" program, including time with other girls in a safe space.

About 2,400 grade eight girls from across 20 schools in Lusaka will be randomly assigned to participate in one of three two-week programs. About 120 girls will be engaged per school, with roughly 40 girls in each program:

  • Social capital: girls meet after school to play games; receive  a snack notebooks, and pens
  • Information: girls meet after school to learn information on HIV and importance of schooling and to play games, also receive a snack, notebooks, and pens
  • Negotiation plus information: girls receive above program plus negotiation training

The Negotiation Curriculum is structured by four principles: "Me," or identifying one’s own interests and options in conflict situations; "You," or identifying the other person’s interests, needs, and perspective; "Together," or identifying shared interests and small trades; and "Build," or developing win-win solutions. The curriculum also accounts for some negotiations in which it is necessary to be patient, or "Take 5," and others in which the only outcome to keep the girl safe and healthy is to walk away and not negotiate.

Outcome measures will measure both the size and source of impact, capturing transformations in the girl's capabilities, her interactions with others, and the outcomes of those interactions:

  • Survey data: Self-perception, outcomes of arguments and discussion, reported locus of control, intra-household allocations, and sexual risk exposure. Impact on the family measured through parent and sibling surveys to see if gains in participant well-being come at the expense of other family members.
  • Real outcomes (administrative data from schools): Rates of pregnancy, school attendance and advancement, and potentially STI/HIV rates
  • Behavioral measures: Take-up of an additional opportunity that requires child-parent negotiation, altered willingness to pay for schooling by parents, responses to negotiation scenario or partner game.
Results and Policy Lessons 

Results forthcoming. If successful, this program curriculum could be scaled up countrywide in partnership with the Ministry of Education to increase schooling attainment and lower HIV infections at a relatively low cost.

To watch a video about this project, click here.

The full curriculum is available for download here.


1. (UNAIDS (2010) "UNAIDS report on the global AIDS epidemic" p.183)

2. WHO's Gender, Inequalities, and Health (2009):

3.UNICEF (2011) "State of the World's Children." p.107

4. Zambia DHS 2007, p. 21