47.6%42.9% 50.0% 28.6% 41.2% 40.0% 38.9% 27.8% School SuppliesHousehold Items Food Percent income use by category Food Household items School Supplies 48%54%44%

Average Weekly Sales by Years of School

Graduates 1 st Kit 3 rd Kit 2 nd Kit

Programmatic Recommendations Continued business training Initial orientation is the only business training More support for graduates Transitional kits, follow up assessments Cultivate relationship with Banco de Oportunidade Stronger long term focus on capacity building Give groups tools to create their own associations, business groups Emphasis on connecting groups with private sector Expand market flexibility Build distributor base More responsiveness to womens product requests Make available more products that correspond to health messaging, e.g. bed nets

Health Outcomes

Health Training Modules Developed by a health consultant with IRD input 52 weekly modules covering topics such as Cells, Body Systems, and Major Organs. Provides comprehensive but accessible health information along with messaging Presented in minute sessions by IRD staff member Focus on comprehension and retention

Research Goals: Health Health Indicators Actual % Change from Baseline Target % Change from Baseline % change of interviewed women (KAP study) that know at least two prevention methods, by age/marital status 20% % change of interviewed women (KAP study) that received results of an HIV test in the last six months 25% % change of interviewed women (KAP study) that had an extra-marital relationship -15% % change of interviewed women (KAP study) that used condom in their last extra-marital sexual intercourse 15% % of increase of hand washing (KAP study) with soap before eating 30% % of increase of boiled or purified water consumption (KAP study) 25%

Family Health Discussion

HIV Prevention Knowledge

HIV Testing

Discussion of HIV testing with husband

Water Purification

Food Security

Health Recommendations Link with existing organizations to increase access to HIV testing (preferably through mobile testing facilities) Address perception that one must be sick to get tested for HIV Leave a usable manual and trained instructor to continue health sessions after IRD support ends Perform baseline health studies at new sites, as well as ongoing assessments of health status Focus on emphasizing link between higher income & better health

Inhambane: Zavala Experience Funded for six months of operation in 2005, then discontinued Shows programs potential and womens strengths: resilience, determination, enthusiasm and self-sufficiency Women continue to operate businesses, continue health monitoring with materials from local HIV testing facility.

Hygiene Practices

Inhambane: Continued Health Training Why is it important to know if Im HIV positive? What do I do if my HIV test is positive? If my test is negative, what steps can I take to avoid HIV infection?

Inhambane: Zavala Experience If my test is positive, will everybody know? Where do I go for an HIV test? What is HIV test counseling?

Discussion and Conclusions The Women First program is performing well with respect to its stated health objectives. IRD strategies are relevant and effective for achieving Women First program goals Ability to identify and address gaps or shortcomings The Women First program provides a successful model for incorporating health education into an income generation program

Key IRD Staff Ilidio Matusse: Women First Program Coordinator Nick Ahlers: Inhambane Provincial Coordinator

Acknowledgments World Vision: Colette Powers, Lara Evans and Joyce Murray Denis Brown & Staff IRD Field Staff: Ilidio Matusse, Nick Ahlers, Fatima Daude,Themos Ntasis, Mark Heffernan, Nelson Lemos, Sabino Matos, Cidalia Pedro, Pereira