Context and Background:
The Soul Buddyz Clubs (SBC) Programme has been running in primary schools in South Africa since 2004. Implemented by the Soul City Institute for Social Justice, the SBC programme is a movement of young children supported by volunteer teachers (facilitators). The Clubs are primary school based and have 25 members per club, with approximately 60% girls. The clubs work together to create a platform that gives voice to and promotes real community action for and by children towards their health and wellbeing, with a large focus on HIV/AIDS and the promotion of positive gender norms. Clubs meet about once a week and undertake activities and projects guided by materials provided by Soul City. The SBC facilitators impart knowledge and help to develop skills amongst the club members to enable them to make healthy and safe choices. In addition, they create an environment of ongoing learning with peer support and help mobilise children and build agency to tackle issues affecting them in their school and communities (See Related Summaries below for more information on the Soul Buddyz Clubs).
Few evaluations of school-based interventions for young people have followed them once they leave school, which is often their period of greatest risk. For this reason, Soul City commissioned a study to determine the long-term impact of being a SBC member on their:
- Community participation
- Level of education attainment
- Employment status
- Overall health, including: Risky sexual behaviour; HIV status; alcohol and drug use; pregnancy status; sexually transmitted infections (STIs) status; and involvement in gender-based violence.
The researchers designed a retrospective cohort study design in order to determine the impact of being a SBC member. The study sample comprised people who were SBC members between 2004 and 2008. Cases comprised individuals aged 18-24 years who attended SBCs approximately 6-10 years ago (2004-2008). Controls were individuals aged 18-24 years who never attended SBC but grew up and attended schools in the same communities. The study interviewed over 900 respondents (300+ cases and 600 controls) between Gauteng and KwaZulu-Natal. Interviewers administered a structured questionnaire and captured data using a personal digital assistants (PDAs). 877 interviews were conducted face-to-face, and 39 were conducted telephonically. The research also included anonymous, linked HIV testing with those who agreed to be tested.
The researchers used a multi-pronged recruitment approach to recruit the ex-SBC members. Methods included radio adverts, a Facebook group, WhatsApp, and telephone calls to those identified through snowballing.
The study used multivariate logistic regression analysis to determine impact. Analysis was controlled for sex and age, as well as other covariates that were selected on a basis of theoretical relevance and being independently associated with the outcomes in bivariate analysis.
The findings showed that respondents used/accessed WhatsApp, TV, and the internet most frequently. Controls were more likely to watch TV every day of the week, while ex-Buddyz were more likely to access Facebook and the internet every day. Controls were less likely to access WhatsApp frequently.
Exposure to Soul Buddyz Clubs
Most ex-Buddyz joined in Grade 5, and the majority were involved for longer than a year. Just under half of ex-Buddyz reported being office bearers (such as a treasurer or a chairperson). The vast majority of respondents had watched the "Soul Buddyz" television series; however, ex-Buddyz were more likely to watch Soul Buddyz “very often” than controls.
Ex-Buddyz were more likely to be involved in their communities and were 4.8 times more likely to participate in community events compared to a control group.
SBC had an impact on a number of key sexual risk behaviours:
- Sexual Debut
Ex-Buddyz were less likely to have had sex before 15 years old: 19% control, 12% case.
Ex-Buddyz were less likely to have had sex before 18 years old: 82% control, 70% case.
In a multivariate analysis, there was no significant difference in sexual debut below 15 years for either male or female ex-Buddyz. There was also no significant difference in sexual debut below 18 years for male ex-Buddyz. However, young women who were ex-SBC members were 1.9 times more likely to have waited to have sex until after they were 18 years old.
- Multiple sexual partners (MSP)
Ex-Buddyz were less likely to have had MSP in the past year compared to a control group: 47% control, 34 % case.
Ex-Buddyz were less likely to have had MSP in the past month compared to a control group: 14% control, 4% case.
Controlling for age, female ex-Buddyz were less likely to have had MSP in the past 12 months. For male ex-Buddyz, there was no significant difference in MSP in the past 12 months.
- Condom use
Ex-Buddyz were 1.68 times more likely to have used a condom at first sex compared to a control group.
Controlling for age, female ex-Buddyz were 1.87 times more likely to have used a condom at first sex. However, there was no significant difference in condom use at first sex for male ex-Buddyz.
Female ex-Buddyz were less likely to be HIV positive than a control group: 19% control and 8% case.
For male ex-Buddyz, there was no significant difference in HIV status.
Ex-buddyz were more likely to have completed matric: 62% control and 73% case.
Ex-Buddyz were more likely to have completed Grade 12 or higher.
Controlling for age, female ex-Buddyz were 3.1 times more likely to have a high educational attainment.
For male ex-Buddyz, there was no significant difference in educational attainment.
Ex-Buddyz were 2.7 times more likely to be employed compared to a control group.
Alcohol and drug use
Ex-Buddyz were less likely to drink at hazardous levels: 47% control and 37% case. However, this was not significant in the multivariate analysis.
SBC exposure had little impact on pregnancy. Although fewer female ex-Buddyz reported being pregnant (35.29%) compared to controls (46.74%), this was not significant in the multivariate analysis.
Sexually transmitted infections and health seeking behaviour
There was no significant difference in health seeking behaviour in female ex-Buddyz and controls.
Male ex-Buddyz were more likely to have gone to a health facility for assistance than controls.
There was no significant difference by exposure to SBC.
Implications for implementation
- Soul City should continue to promote SBC as a way to reduce HIV risk in young women.
- They should examine why SBC exposure has not been as effective in the long-term in young men.
Click here for more information in the Powerpoint presentation of the impact evaluation results.
Soul Buddyz Impact Evaluation - Powerpoint Presentation and "Positve impact of Soul Buddyz Clubs on young women" article on Genesis website on January 16 2017.