Case Studies on Leaving No One Behind

9. A better chance in life for the most vulnerable adolescent girls and boys in Tanzania

Nicole McHugh

Emer O’Brien

Many adolescents from poor households are at risk of being left behind

The United Republic of Tanzania (“Tanzania”) has a young population. The country is home to 12 million adolescents (10-19 years), and this is expected to grow to 30 million by 2050. Adolescents in Tanzania face many barriers to safe transitions to adulthood, including health-related risks, barriers to schooling, and limited livelihood opportunities. Poverty is a key driver of poor educational opportunities and risks to health, such as early pregnancy, gender-based violence and sexually transmitted infections, including HIV. Findings from a 2018 UNICEF baseline study conducted jointly with the Government of the Republic of Tanzania show that many adolescents from poor households live in particularly vulnerable circumstances, with one in three not living with a parent or guardian, and half of those being double orphans. About two in three households are headed by women, with household heads approximately 60 years old on average.

Social protection has been recognised as a leading tool in the fight against poverty and has also shown potential in facilitating safe transitions to adulthood. However, global evidence suggests that providing cash transfers alone to families is not a sufficient solution to address risks faced by adolescents. A tailor-made and locally relevant package is required to ensure that adolescents from poor households are not left behind in the development agenda.

A programme complementing cash transfers with training, small grants and tailored health services

Motivated by the large numbers of adolescents in Tanzania entering their economically productive years, along with the idea that social cash transfers can be leveraged with complementary programming, the Tanzania Social Action Fund, with support from UNICEF, Irish Aid and the Oak Foundation, is implementing a programme developed for adolescent girls and boys from the poorest households in Tanzania. The “Cash Plus” programme is a unique, multisectoral, government‑implemented intervention targeted to vulnerable adolescents in impoverished households. It jointly addresses livelihood skills and education on HIV, sexual and reproductive health (SRH) and gender equity, and also facilitates linkages to adolescent-responsive SRH services. This approach recognises that social cash transfers alone are not sufficient, and that adolescents need a combination of social, health and financial assets to safely transition to adulthood.

A consultative process informed the design of the programme, bringing together the government, United Nations, development partners and researchers to identify salient needs and vulnerabilities of Tanzanian adolescents, as well as best practices to support them.

Cash Plus is operated within the Government of the Republic of Tanzania’s Productive Social Safety Net (PSSN). The “Plus” element consists of:

• Integrated training in livelihood, HIV, SRH, gender equity and violence prevention.

• Mentoring and small grants - adolescents are accompanied by an adult mentor to access vocational training, benefit from a small grant to start an economic activity, and discuss SRH and HIV-related challenges in a safe and confidential environment.

• Linkages to improved adolescent-responsive health services.

A randomised control trial is running alongside the programme to assess the impact of the intervention, inform national scale-up plans and generate global evidence.

A strong partnership building on government structures and local capacities as a key to success

The synergistic nature of the Cash Plus interventions has the potential to function as an accelerator to advance vulnerable adolescents’ health and livelihoods simultaneously by combining sector interventions to address the particular needs of both girls and boys. Key factors for success of the programme are:

• A robust partnership between the Government of the Republic of Tanzania, Irish Government, UNICEF, Oak Foundation and researchers that has been fundamental in the development, implementation and evaluation of this multisector Cash Plus programme. The partnership is grounded in the common vision to leave no adolescent girls or boys behind.

• Building on the existing government PSSN programme, which delivers cash transfers to 1.1 million poor families. Implementing the Cash Plus programme through the government structures maximises possible opportunities for future scale up.

• Grounding the programme at the outset in the local context and identifying community-based adult mentors and local opportunities has been critical in ensuring that adolescents receive continued support in applying new knowledge and skills.

• The design of the Cash Plus programme, brokering new relationships with global actors, and advocating for domestic resources can bring additional funding for scale up to Tanzania. One major success in this regard has been a commitment by the Global Fund to support the scale up of the programme with a grant of USD 16 million over the period 2018-2020.

What next?

Implementation of Cash Plus and evaluation in the intervention and control sites are set to be completed by 2019. Evaluation findings will inform the strategy for scale up and sustainable financing options and new aid modalities will continue to be explored. The government and its partners will facilitate ongoing learning and sharing of “what works” in similar types of programme at the national and global levels.