Empowering Married Young Women in India and Improving Their Sexual and Reproductive Health
"Despite increasing efforts to prevent early marriage in India, substantial numbers of girls will continue to marry as children, which carries immense social and health disadvantages," says K.G. Santhya, a Population Council researcher. "This calls for increased investment in supporting married adolescent girls." As recently as 2005-06, more than two-fifths of all women in India aged 20-24 were married by age 18. A growing body of evidence from India and elsewhere shows that the reproductive health situation and needs of married adolescents and young women are substantially different from those of both unmarried adolescent girls and married adult women, so that providing them with services is challenging. Recent policies and programs are attempting to address the particular needs of married adolescents and young women. Whether these programs will be effective is not clear because little evidence exists concerning the kinds of program models that improve the situation of married girls.
To address this knowledge gap and improve programs, the Population Council, in partnership with the Child In Need Institute in Kolkata, the Deepak Charitable Trust in Vadodara, and the International Institute for Population Sciences, Mumbai, initiated the First-time Parents Project. The project aimed to develop and test an integrated package of health and social services to improve married young women's reproductive and sexual health knowledge and practices, enhance their ability to act in their own interest, and expand their social support networks. The project was formulated on the hypothesis that the periods immediately following marriage and surrounding the first pregnancy and birth, although they are times of substantial vulnerability, offer unique and powerful entry points for improving the situation of married young women.
First-time Parents Project
The team implemented the First-time Parents Project in two rural settings in India--Diamond Harbour Block in the state of West Bengal and Vadodara Block in the state of Gujarat. The project served several types of participants: newly married young women, young women pregnant for the first time, postpartum first-time mothers, husbands of these young women, their mothers and mothers-in-law, health-care providers, and the wider community. The project comprised three mutually reinforcing components: information provision, health-care service adjustments, and peer-group formation as a means of enhancing young women's social support networks. The Council and its partners implemented project activities in 24 villages--12 in Diamond Harbour and 12 in Vadodara, each with a population of about 25,000. The project was launched in January 2003 and concluded in December 2004.
In order to track the extent of married young women's exposure to the project and assess the intensity and breadth of their participation in it, the team adopted a monitoring system. This system also enabled the Child In Need Institute and the Deepak Charitable Trust to monitor the progress of each component of the project and make adjustments in the implementation process when necessary.
The team used a quasi-experimental research design, with cross-sectional surveys undertaken prior to the implementation of the project (baseline) and at its conclusion (endline) in control and project villages. Respondents for the baseline survey included young women married during the two years preceding the survey, young women pregnant for the first time at the time of the survey, and young women who had delivered their first child during the 18 months preceding the survey. At the endline, the team expanded the eligibility criteria in order to track as many baseline respondents as possible. Hence, respondents for the endline survey included young women married during the four years prior to the endline survey who had never been pregnant; young women who were pregnant for the first time at the time of the endline survey; and young women who had delivered their first child during the four years prior to the survey. …