Quasi-experimental Evaluation Using Confirmatory Procedures: A case study of an economic and social empowerment intervention to reduce girls’ vulnerability to HIV in rural Mozambique

The purpose of the evaluation was to determine whether an economic and social empowerment intervention implemented in Zambézia Province, Mozambique reduced girls’ vulnerability to HIV. We use this experience to discuss challenges of evaluating real-world interventions. Although our study did not find evidence of impact on the a priori selected outcomes, we report on our experience implementing this robust methodologic design and describe how the challenges encountered in this program setting affected our ability to attain results. We recommend prospective evaluation designs with random allocation be accommodated early during planning. When not possible, quasi-experimental studies should collect data from large samples. To reduce measurement bias, biological endpoints such as sexually transmitted infections should serve as primary outcomes for programs intending to reduce sexual behaviors.