Determinants of participation in WORTH Yetu economic empowerment intervention among caregivers of orphaned and vulnerable children in Tanzania: a longitudinal multivariable logistic regression analysis

Abstract

Orphaned and Vulnerable Children (OVC) are disproportionately found in economically disadvantaged households, where the added burden of caregiving often exacerbates financial hardship. In response, economic empowerment programmes have been recommended as a key strategy to enhance household economic stability and resilience. However, there is a limited understanding of the factors affecting participation in such programmes across different populations. This study examines the factors affecting OVC caregivers’ participation in the WORTH Yetu economic empowerment programme in Tanzania. This longitudinal study utilises baseline (2016–2019) and follow-up (2019–2020) data from the USAID Kizazi Kipya project in Tanzania. The primary outcome was caregivers’ participation status in the WORTH Yetu programme at follow-up. Baseline factors associated with participation were examined using a multivariable binary logistic regression model, with a 5 % significance level. The analysis included 247,638 OVC caregivers with a mean age of 49.2 (±14.5) years at baseline. Of these, 70 % were women and 30 % were men. At follow-up, overall participation in WORTH Yetu was 10.1 %, with 10.4 % among women and 9.6 % among men ( p < 0.001). Multivariable analysis identified several baseline factors significantly associated with participation in WORTH Yetu, including gender, age, place of residence, marital status, disability, health insurance, HIV status, family size, socioeconomic status (SES), and duration in the USAID Kizazi Kipya project. Some of these factors, particularly marital status, HIV status, and age showed significant variation between women and men. Over an average follow-up period of 1.6 years, caregivers’ participation in the WORTH Yetu programme increased from 0 % at baseline to 10.1 % at follow-up, with women significantly more likely to participate compared to men. However, not all caregivers were equally positioned to engage in the programme, as participation varied according to their background characteristics. To enhance participation, targeted efforts are needed to address these disparities, particularly for caregivers with a lower likelihood of participation, such as men, individuals living with HIV, and those facing gender-specific barriers. Supporting these groups more effectively could enhance participation in economic empowerment programmes and contribute to improved socio-economic outcomes. • Gender influenced WORTH Yetu participation, with higher rates in women than men. • Gender disparities in WORTH Yetu participation arose from marital status, HIV status, age, and hunger. • Project duration, SES, iCHF, disability, and family size increased WORTH Yetu participation for all. • Urban caregivers were less likely to join WORTH Yetu than rural, for both genders.