Journal of Reproductive Health, Gender, and HIV in Africa | 11 March 2004
Conditional Cash Transfers, School Attendance, and Transactional Sex among Adolescent Girls in Mbarara, Uganda: A Systematic Review
R, u, t, h, N, a, l, w, o, g, a, ,, J, a, d, e, H, e, n, d, e, r, s, o, n, ,, N, a, k, a, t, o, M, b, a, b, a, z, i, ,, J, u, l, i, u, s, K, a, t, o
Abstract
Transactional sex among adolescent girls in sub-Saharan Africa is a significant public health concern, increasing vulnerability to HIV, unintended pregnancy, and gender-based violence. In Mbarara, Uganda, poverty and constrained educational opportunities are understood to be key drivers. Conditional cash transfers (CCTs) linked to school attendance represent a structural intervention that may address these underlying economic and educational factors. This systematic review aimed to synthesise evidence on the effect of CCT programmes, conditional on school attendance, on engagement in transactional sex among adolescent girls in Mbarara, Uganda. Its objectives were to assess programme efficacy and explore proposed mechanisms of impact. A systematic search of peer-reviewed literature was performed across major electronic databases. Included studies evaluated CCT programmes with a school attendance condition for adolescent girls in Mbarara, Uganda, and measured transactional sex as an outcome. Study quality was appraised using standard critical assessment tools. The search identified a limited number of studies meeting the inclusion criteria. The available evidence, while not extensive, suggests a promising association. One included study reported a notable reduction in the likelihood of engaging in transactional sex, with a 40% lower incidence observed among programme participants compared to non-participants. Key themes identified included increased school enrolment as a protective factor and the alleviation of direct economic pressure as a primary mechanism. CCT programmes conditional on school attendance show potential for reducing transactional sex among adolescent girls in this context, primarily by mitigating economic vulnerability and maintaining attendance in the protective school environment. However, the evidence base specific to Mbarara remains underdeveloped. Further rigorous, longitudinal research is required to establish causal evidence in this specific geographical context. Future programme designs should incorporate robust monitoring and evaluation frameworks with sensitive measurement of transactional sex outcomes. conditional cash transfers, transactional sex, adolescent girls, school attendance, Uganda, HIV prevention This review consolidates the limited existing evidence on CCTs and transactional sex in Mbarara, Uganda, highlighting a potential intervention pathway and the clear need for context-specific research to inform policy and programming.