This pilot study found that a combined financial literacy and reproductive health intervention adapted for indigenous youth in Ecuador showed positive associations with financial literacy and sexual health knowledge, with focus group participants valuing both components and reporting improved decision-making around sex and relationships.
The study successfully recruited 96.7% of the target intervention sample but only 60.0% of the target control sample.
The intervention was significantly associated with improved financial literacy scores among participants.
The intervention was significantly associated with improved sexual health knowledge scores among participants.
The intervention showed modest positive but non-significant associations with several secondary outcomes including entrepreneurial self-efficacy, income-generating activities, gender empowerment, and sexual behavior.
All focus group participants valued the financial management and entrepreneurship components of the intervention, and most reported the curriculum improved their decision-making around sex and relationships.
The intervention was developed by adapting an existing entrepreneurship curriculum to the local indigenous context using the ADAPT-ITT framework and integrating it with an existing reproductive health education platform.
This research suggests that combining financial literacy training with reproductive health education can be both acceptable and potentially beneficial for indigenous teenagers in Ecuador. The study tested a 4-month school-based program with 29 adolescents aged 15-19 in Cotacachi, Ecuador, comparing them to 18 peers who did not receive the program. The curriculum was carefully adapted from an existing entrepreneurship program to fit the local indigenous cultural context and was combined with an established reproductive health education platform. The study found that teenagers who received the program scored meaningfully higher on both financial literacy and sexual health knowledge tests compared to the control group, and these differences were statistically significant. There were also encouraging trends toward greater entrepreneurial self-efficacy, more participation in income-generating activities, higher gender empowerment, and less frequent sexual intercourse among program participants, though these differences were not statistically significant, likely due to the small study size. In focus groups, all participating youth expressed that they valued the financial and entrepreneurship parts of the program, and most felt the program helped them make better decisions about sex and relationships. This research suggests that pairing economic empowerment with reproductive health education is a promising and culturally acceptable approach for reducing teen pregnancy risk in indigenous communities in Ecuador. However, because this was a small pilot study without random assignment to groups, stronger evidence from a larger randomized trial is needed before drawing firm conclusions about whether the program truly causes improvements in income generation and pregnancy reduction over the long term.
Tituaña A, Wilson-Barthes M, Desrosiers A, Jardine S, Srinivasan M, Palacios I, et al.. (2026). Adaptation, acceptability and preliminary impacts of a sexual health and financial literacy intervention for indigenous adolescents in Ecuador: A mixed-methods pilot study.. Public health. https://doi.org/10.1016/j.puhe.2025.106088