Pregnancies in school
By study endline in 2020 (R3-PI), there were noteworthy reductions in the numbers of adolescent pregnancies following exposure to the CSE linkage program, with marked reductions documented in Arms 2 and 3 (see Fig. Cumulative number of school-level pregnancies, by year and study armA test of proportion was conducted to compare the pre-intervention (2016 and 2017) and post intervention (2020) trends in pregnancy (see Table Pregnancy test of proportion at pre and post interventions by armAt endline (P3-PI), Arm 1 recorded a pregnancy fraction of 2.70 per 100 AGYW (Proportion of enrolled schoolgirls who were pregnant in 2020Figure Schematic description of pregnancies over time in each arm, from which difference in difference tests were conductedA difference-in-differences analysis was applied to compare the pre-intervention (2016) and post intervention (2020) IRR in pregnancy, between the control arm (Arm1 2016 and 2020) as compared with Arms 2 and 3, respectively, to estimate the relative measure of intervention effect (see Table Differences in pregnancies between the arms before and after interventionsPregnancy metadata were also analyzed within each school to subsequently inform school-based targeted pregnancy reduction strategies, in conformity with implementation feedback SOPs. At R2-PI and R3-PI, schools in Arm 1 showed no notable reductions, with a high number of pregnancies in two schools, while in Arm 2, one school had a high pregnancy rate, and in Arm 3, there was concern at one school. Feedback was provided in each case, in line with developed implementation science research protocols.