The Força à Comunidade e Crianças (FCC) Program

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Overview

We study the impact of Força à Comunidade e Crianças (FCC), a PEPFAR-funded community HIV/AIDS program in Mozambique.

This study's protocols were approved by Institutional Review Boards (IRBs) in Mozambique (Ministry of Health, approval number 2233/GMS/002/016) and at the University of Michigan (Health Sciences and Social and Behavioral Sciences IRB, approval number HUM00115541). The research was funded by the United States Agency for International Development via the BASIS research program at University of California, Davis (grant numbers AID-OAA-L-12-00001, AID-OAA-LA-16-0004, and AID391A1500006).

Publications

Knowledge, Stigma, and HIV Testing: An Analysis of a Widespread HIV/AIDS Program (also available through the National Bureau of Economic Research)

Authors: Dean Yang, James Allen IV, Arlete Mahumane, James Riddell IV, and Hang Yu
Abstract: Using randomized methodologies, we study a common community HIV/AIDS program that seeks to promote HIV testing by improving knowledge and reducing stigmatizing attitudes. Contrary to expectations, the program has a substantial negative effect on HIV testing rates. We provide evidence of likely mechanisms behind the program's negative effect: it inadvertently increased misinformation about HIV, and worsened HIV-related stigmatizing attitudes. Subsequent household-level randomized treatments providing correct information and addressing stigma concerns counteract the program's negative effect on HIV testing. These findings highlight the importance of improving knowledge and alleviating stigma concerns when promoting HIV testing.
Keywords: HIV Testing, HIV Knowledge, HIV Stigma
JEL Classifications: I12, D10, D80

Pre-Analysis Plan, submitted to the American Economic Association's RCT Registry on March 8, 2019 (AEARCTR-0003990).
Populated Pre-Analysis Plan (Populated PAP)

Social Stigma as a Barrier to HIV Testing: Evidence from a Randomized Experiment in Mozambique

Author: Hang Yu
Abstract: Public health experts have seen the stigma as a leading barrier affecting the delivery of HIV-related health care. By using a field experiment in Mozambique, this study identifies the role of stigma concerns in hindering HIV testing and quantifies the stigma barrier. To obtain local measures of the HIV stigma environment in the study sites, we conducted a baseline survey one year before the experiment. Experiment participants with excessive concerns, defined as overestimating the stigma in their communities, were randomly assigned an intervention to relieve stigma concerns. The intervention, which drew upon findings from the baseline survey, was designed to reveal the correct degree of stigma that a participant had overestimated. Analyses show that this intervention raised the HIV test uptake rate by 7.7 percentage points (or by 37 percent) from 20.7 percent under the control condition. To quantify the intervention effect, I introduced testing coupons of different values to estimate the demand curve for an HIV test. The concern-relieving intervention raised an individual’s willingness-to-pay for an HIV test by $1.30, or more than half of the daily cost-of-living in the study population.
Keywords: Health
JEL Classifications: I12, O21

Pre-Analysis Plan (PAP)

Strengthening Communities and Children: Evaluating a Multifaceted HIV Policy in Mozambique

Author: Moustafa El-Kashlan.
Abstract: This study analyzes the effect of a multifaceted development program on HIV outcomes and school enrollment in Mozambique. The treatment of various economic, health, and educational interventions was randomly assigned to different communities using schools as community centers and was implemented from early 2017 until 2019. The random treatment assignment allowed for measurement of treatment intensity based on the percentage of each clinic’s catchment area that was covered by treatment schools. Treatment intensity did not have an effect on ART enrollment or HIV testing. Given that program implementation was based at schools, the intervention was expected to increase enrollment at treatment schools relative to control schools. However, the emphasis placed on education in treatment communities did not increase enrollment or funding in treatment schools. The results of this paper show that the multifaceted HIV treatment had no impact on healthcare utilization or educational outcomes based on the administrative data available.

Survey Instruments

Vulnerability Assessment Survey Instrument (Wave 0)
Baseline Survey Instrument (Wave 1)
Endline Survey Instrument (Wave 2)
Wave 3 Survey Instrument: COMING SOON

HIV/AIDS INFORMATION VIDEO

PORTUGUESE

This video provides the information on HIV and AIDS given to participants who received the HIV/AIDS information minitreatment (English subtitles provided here, but were not shown to study participants).

ART INFORMATION VIDEO

PORTUGUESE

This video provides the information on antiretroviral treatment given to participants who received the ART information minitreatment (English subtitles provided here, but were not shown to study participants).

SENA