Increased awareness:
The radio drama intervention raised awareness among adolescent girls and young women about what transactional sex is and the risks and dynamics of ADTS.
Solutions
Learning Initiative on Norms, Exploitation, and Abuse (LINEA), Tanzania, 2021
"Edutainment" to shift beliefs on harmful gender norms and change behavior to prevent age-disparate transactional sex among hard-to-reach populations.
Published: 06 May 2025
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Quick facts
Intervention details (1)
Effectiveness of the intervention type |
Needs more evidence |
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INSPIRE pillar |
Norms and values |
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Evidence type |
Qualitative/quantitative mixed-methods study |
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Context
Harmful gender-norms, transactional sex and sexual violence for girls
Age-disparate transactional sex (ADTS), in which an adolescent girl under age 18 has sex with a man 5-10 years older in exchange for material support or benefits [1], is inherently exploitative [2] due to imbalanced power dynamics. It is also associated with experiences of sexual violence and a wide range of negative sexual and reproductive health, developmental, and social outcomes, including HIV, unintended pregnancy, unsafe abortions, school dropout, and early/forced marriage [3].
An impact evaluation of a promising “cash+” economic support intervention in Tanzania, Ujana Salama, indicated that the prevalence of transactional sex among adolescent girls and young women ages 14-19 years was 26%. While transactional sex increased with age and decreased with more education, it did not decrease with receipt of economic support through the intervention [4]. In Tanzania, qualitative research reveals that ADTS is driven by deep-seated gender norms, such as masculinity, the social expectation that men provide material support or benefits to women in exchange for sex, and a cultural expectation for women to reciprocate through sex [5,6,7]
The Learning Initiative on Norms, Exploitation, and Abuse (LINEA) is one of the first interventions implemented in Tanzania whose primary goal is to prevent ADTS [8]. It uses a novel education-entertainment ‘edutainment’ approach to leverage media and technology to challenge harmful gender norms and equip community members with knowledge and skills to prevent ADTS. The program builds on formative research and growing global evidence of the use of entertaining mass media to shift beliefs and change behavior, in particular, among hard-to-reach populations or where face-to-face implementation is challenging [7,9].
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About the program
What it is and how it works
LINEA is an evidence-based, multi-component, norms-change intervention developed through a partnership between Amani Girls Organization, Media for Development International Tanzania, and the London School of Hygiene and Tropical Medicine (LSHTM). The intervention was developed based on iterative research, including (1) a systematic review of norms related to childhood sexual exploitation [10,11] and (2) formative research on the social norms associated with ADTS [6]. LINEA aims to shift harmful gender norms, highlight protective norms, and provide community members with the skills to identify and avoid age-disparate sexual relationships and transactional sex.
The full radio program targets entire communities, broadcasting 39 individual 15-20-minute episodes over 9 months and aiming to reach rural and low-resource families. The radio drama features 13-year-old Amali, a student in secondary school, and 23-year-old Tuma, a motorcycle taxi driver who gives her free rides to school and later demands sex, as they receive helpful and harmful advice from community members and have to learn to distinguish between the two. The radio series, ‘Msichana wa Kati’, presents engaging and relatable narratives and challenges the behaviors, attitudes, and beliefs driving ADTS. The program design allows it to reach broad audiences with a specific focus on adolescents, a group particularly vulnerable to exploitation. Collaboration with community members and local organizations promotes grassroots engagement.
In addition, two tailored curricula targeting adolescent girls and young men complemented the radio program [7,9,10]. The curriculum addresses men’s motivations to engage in ADTS and promotes girls’ short and long-term aspirations [12,5]. Over 4 months, 15-25 girls ages 13-15 years participate in 17 one-and-a-half hour sessions to foster critical thinking related to gender, power, norms and values, and adolescent girls’ goal achievement. Similarly, 18 2-hour sessions are held for men ages 23 years and over [7,9,13]. Homework assignments further reinforce session topics.
Following feasibility testing, the Tanganyika Christian Refugee Service (TCRS) implemented a condensed version of the LINEA radio drama among 331 very low-income TCRS beneficiary families across 24 communities in Kishapu district in Shinyanga, Tanzania, in 2021. Each family had at least one household member living with a disability and had previously received a solar-powered radio from TCRS. TCRS distributed USB drives containing the LINEA audio program and asked recipient households to listen to the program over 7 weeks. Trained community volunteers facilitated household discussions with sixty randomly selected households to encourage engagement.
Similarly, Kiota Women’s Health and Development (KIWOHEDE) led implementation of the condensed radio program in Kigoma Ujiji District in Northwestern, Tanzania. This district is one of the poorest in Tanzania with a young and culturally diverse population (e.g., many long-term residents from neighboring countries). The district faces a high prevalence of sexual violence and early pregnancy. Adolescent girls from seven schools, along with their male and female caregivers, were asked to listen to the radio broadcast of the episodes at home over 7 weeks. Girls also listened to the program and some participated in facilitated group discussions at an after-school girls’ club twice a week.
Evaluation and program outcomes
AGO led an evaluation of the impact of the condensed 7-week LINEA implementation through a longitudinal, mixed-methods study among participating households with girls ages 12-16 years between September and December 2021.
In an initial exploratory study, 34 girls, along with 31 female and 30 male caretakers, completed baseline and endline surveys [13]. The evaluation also included 59 in-depth interviews with girls (both in and out of school) and their caregivers [13,15,16].
Similarly, KIWOHEDE held baseline and endline focus group discussions (FGDs) with 70 13-15-year-old adolescent girls in five randomly participating schools, along with two FGDs, one with female caregivers and one with male caregivers [14,17].
Family conversations:
Listening to the drama gave families more opportunities to talk to their daughters about the challenges they face. The program facilitated discussions about sex and age-disparate transactional sex particularly between men caregivers and girls, giving them a greater role in educating girls in these topics.
*[16]Attitude shifts
Caregivers’ understanding of men’s responsibility in initiating transactional sex increased, indicating a shift away from victim-blaming. Evidence suggested a slight improvement in girls’ gender-equitable beliefs and mixed results for men’s gender equitable beliefs. Research shows shifting perceptions of fatherhood, making male caregivers more aware of the joint responsibility in preventing transactional sex together with mothers.
*[16]Behavioral intentions:
Following participation, adolescent girls expressed greater confidence to ‘say no to men,’ increased reluctance to engage in transactional sexual relationships, and a renewed motivation to focus on education and pursue long-term goals. Some caregivers expressed a greater feeling of responsibility to support girls in avoiding transactional sexual relationships.
*[16]Gendered participation and impact
Men’s participation in and the program's impact on men were low compared with girls and women, indicating a need to explore ways to engage men more effectively.
*[16]Broader community effects
Encouraging support for women entrepreneurs and those working in male-dominated professions and fostering positive discussions and challenging norms surrounding transactional sex where such conversations are traditionally taboo.
*[13,15]Shared responsibility
The participants showed an increased belief that protecting girls from transactional sex is a shared responsibility across community members.
*[16]Radio drama messages focusing on long-term goals to build a better future, rather than risking long-term harm to meet short-term needs through ADTS, were particularly pertinent.
LINEA showed evidence of change among adolescent girls in three thematic areas: 1) Motivation to focus on studies, 2) ability to move forward in the face of life challenges, and 3) Avoiding sexual and reproductive health risks, including ADTS. Participants also demonstrated a deeper understanding of how transactional relationships perpetuate cycles of exploitation [15,17].
“ These outcomes suggest that culturally tailored mass-media interventions like radio dramas can address public health challenges related to sexual health and exploitative relationships; however, more research is needed to determine adaptability to other regions of Tanzania and to understand the direct and long-term impacts on childhood exploitation and experiences of sexual violence. ”
Pichon, M., Buller, A., Gimunta, V., Rutenge, O., Thiaw, Y. et al [15]
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Real-world impact
The LINEA evaluation findings provide early evidence that the radio program may be effective in improving gender-equitable attitudes toward work, increasing girls’ skills in identifying transactional sex and saying no to men, and increasing caregivers’ engagement with girls and support for avoiding transactional sex [14,15,16]. It also indicates that LINEA may be an accessible, cost-effective way to disseminate messages in local languages using cultural storytelling techniques to spark conversations about sexual exploitation within communities that might have remained silent.
The full LINEA cluster randomized controlled trial evaluating the radio drama and the curricula is planned for 2023-2026 [8].
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Challenges and lessons learned
Challenges:
- Sustained behavior change remains difficult to measure due to limited long-term data.
- Some adult community members felt it was inappropriate to discuss sexual health with young adolescent girls.
- Digital access inequality limits the reach of technology-based interventions.
Lessons learned:
- Context-specific narratives and tools are critical for engaging target audiences effectively.
- Combining media campaigns with on-ground community engagement worked well.
- Providing radio drama on USB flash drives allows participants to listen to episodes repeatedly, at a time and place convenient for them.
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Sources and contact
1.Stoebenau, K., Heise, L., Wamoyi, J., & Bobrova, N. (2016). Revisiting the understanding of “transactional sex” in sub-Saharan Africa: A review and synthesis of the literature. Social Science & Medicine, 168, 186–197. https://doi.org/10.1016/j.socscimed.2016.09.02
2. Greijer, S. (2025). Terminology guidelines for the protection of children from sexual exploitation and sexual abuse (2nd ed.).
3. Tener, D. (2019). Money, status, love, and death: Sexual relations with considerably older persons in African societies—A systematic review. Trauma, Violence, & Abuse, 22(3), 527–540. https://doi.org/10.1177/1524838019869092
4. Ranganathan, M., Quinones, S., Palermo, T., Gilbert, U., Kajula, L. et al. (2022). Transactional sex among adolescent girls and young women enrolled in a cash plus intervention in rural Tanzania: A mixed-methods study. Journal of the International AIDS Society, 25(12). https://doi.org/10.1002/jia2.26038
5. Howard-Merrill, L., Pichon, M., Wamoyi, J., Kyegombe, N., Ignacio, C. et al. (2022a). Attitudes, beliefs and normative influences linked to transactional sex: Insights from LINEA formative research in Brazil, Tanzania and Uganda.
6. Howard-Merrill, L., Zimmerman, C., Sono, R., Riber, J., Wamoyi, J. et al. (2023). Shifting social norms to prevent age-disparate transactional sex in Tanzania: what we can learn from intervention development research. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.926531
7. Howard-Merrill, L., Pichon, M., Sono, R., Riber, J., Wajoyi, J. et al. (2022b). LINEA intervention development process.
8. Buller, A., Pichon, M., McAlpine, A., Cislaghi, B., Heise, L. et al. (2020). Systematic review of social norms, attitudes, and factual beliefs linked to the sexual exploitation of children and adolescents. Child Abuse & Neglect, 104, 104473. https://doi.org/10.1016/j.chiabu.2020.104473
9. Pichon, M., Howard-Merrill, L., & Buller, A. (2020). Systematic review of social norms linked to the sexual exploitation of children and adolescents.
10. Wamoyi, J., Gafos, M., Howard-Merrill, L., Seeley, J., Meiksin, R., et al. (2021). Capitalising on aspirations of adolescent girls and young women to reduce their sexual health risks: Implications for HIV prevention. Global Public Health, 1–10. https://doi.org/10.1080/17441692.2021.2011822
11. Howard-Merrill, L., Wamoyi, J., Nyato, D., Kyegombe, N., Heise, L., & Buller, A. M. (2020). “I trap her with a CD, then tomorrow find her with a big old man who bought her a smartphone”: Constructions of masculinities and transactional sex—A qualitative study from North-Western Tanzania. Culture, Health & Sexuality, 1–14. https://doi.org/10.1080/13691058.2020.1830964
12. Buller, A., Tilouche, N., Pichon, M., Gimunta, V., Sono, R. et al. (2023). The Learning Initiative on Norms, Exploitation and Abuse (LINEA) Trial to Prevent Age-disparate Transactional Sex in Tanzania.
13. Pichon, M., Carter, D., Howard-Merrill, L., Sono, R., Gimunta, V. et al. (2022). A mixed-methods, exploratory, quasi-experimental evaluation of a radio drama intervention to prevent age-disparate transactional sex in Tanzania. Frontiers in Reproductive Health, 4, 1000853. https://doi.org/10.3389/frph.2022.1000853
14. Howard-Merrill, L., Pichon, M., Witt, A., Sono, R., Gimunta, V. et al. (2024).“I have learned that nothing is given for free”: an exploratory qualitative evaluation of a social norms edutainment intervention broadcast on local radio to prevent age-disparate transactional sex in Kigoma, Tanzania. BMC Public Health. https://doi.org/10.1186/s12889-024-20440-w
15. Pichon, M., Buller, A., Gimunta, V., Rutenge, O., Thiaw, Y. et al. (2024a). Qualitative evaluation of an edutainment intervention to prevent age-disparate transactional sex in Tanzania: Changes in educational aspirations and gender equitable attitudes towards work. PLOS Global Public Health, 4(4), e0002527. https://doi.org/10.1371/journal.pgph.0002527
16. Sharif, L., Pichon, M., Gimunta, V., Rutenge, O., Revocatus, S., et al. (2025). “The child of your fellow is your child”: Building on existing protective norms to engage men as caregivers—Qualitative findings from an exploratory evaluation of an edutainment intervention to prevent age-disparate transactional sex. PLOS ONE. (In Press).
17. Pichon, M., Howard-Merrill L., Witt, A., Sono, R., Gimunta, V. et al. (2024b). An exploratory qualitative evaluation of an edutainment intervention to prevent age-disparate transactional sex in Kigoma, Tanzania. SVRI Forum.
Special thanks to Ms. Marjorie Pichon, Dr. Ana Maria Buller, and Dr. Joyce Wamoyi for co-developing this case study and for sharing early results, challenges, and lessons learned related to implementation.
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Last updated: 06 May 2025