Meeting the Health and Social Needs of Married Girls in India: The First Time Parents Project's Implementation and Reach
Description
Published in October 2006 by Horizons/Population Council, this 2-page research update is a concise presentation of the First-Time Parents Project, which was carried out in India over a 2-year period in an effort to improve married young women's reproductive and sexual health knowledge and practices, and to expand their ability to act in their own interests.

The case study begins by providing background on the prevalence of young married adolescent girls in India - characterised here as one of the highest in the world, with figures to support this claim - and by describing the related social, educational, and health disadvantages. For instance, in addition to having restricted access to mass media that may otherwise inform them about obstetric risks and the like, married adolescents aged 18 or younger in India are significantly less likely than women aged 19-23 to use skilled delivery, or to fully immunise their children; they also tend to experience elevated levels of obstetric risks, and are more vulnerable to sexually transmitted infection (STI) or HIV infection due to frequent and/or unprotected sex. In response, the Population Council engaged in a partnership with Child in Need Institute (West Bengal) and Deepak Charitable Trust (Gujarat) to carry out activities from January 2003 to December 2004 in 12 villages; the communication strategies and activities shaping these activities, and their reach, are outlined here.

A key concern informing the design of the intervention was the need to involve husbands of the young women (who were newly married, pregnant, or postpartum - for the first time), as well as senior family members and health care providers who might influence them. Activities included:

1. Information provision - Outreach workers conducted home visits (women visited young women; men visited young men), providers carried out counselling sessions in clinic settings, young women's groups hosted discussions, and community-oriented celebrations took place (e.g., to mark breastfeeding week).
2. Health-care service adjustments - Government and private health providers were oriented about the special needs of this group, and refresher training on safe delivery was provided to traditional birth attendants. In addition to the provision of condoms and oral contraceptives, detailed information was offered to women and couples alongside existing antenatal services. Safe delivery planning was carried out, and postpartum home visits were provided.
3. Group formation - With facilitation by project staff, married young women's groups were formed; they met for 2-3 hours every fortnight. During these sessions, the groups adopted a participatory learning approach. Ideas for topics (e.g., legal literacy, vocational skills, pregnancy and postpartum care, available local resources, etc.) were identified by the girls themselves through activities such as community mapping. To increase married girls' contact with peers and mentors, expose them to new ideas, and help them identify and articulate their own point of view, participants visited various places in the community - such as active women's groups - and worked together on development projects, celebrated common festivals, and organised welcome ceremonies for newly married members.

Based on a quasi-experimental study with surveys at baseline and endline, preliminary findings indicate that - as expected - reaching husbands proved to be more difficult than reaching young women. However, the findings also suggest improvements in young women's social networks, reproductive health knowledge, and maternal and child health practices.

Rationale
This resource is quite brief, yet offers a "snapshot" of a programme that appears to have been well-crafted to successfully meet a specific need - using health communication strategies to do so. The key, as indicated here, seems to be that the approach investigated here is "feasible and is sustainable since it is not creating a new structure but orienting existing services to special needs of married adolescents and making links with existing programmes." Communication appears to have played a central role in that the focus is on stimulating young women's agency and social networks, their reproductive health knowledge and practices, and their partner support and communication - toward better maternal and child health practices.

Source(s)
New Evidence on Young People from the Population Council, India, forwarded to The Communication Initiative by Asha Matta on November 16 2006; and Meeting the Health and Social Needs of Married Girls in India: The First Time Parents Project's Implementation and Reach [PDF].

Contact Information
Asha Matta
Population Council
Zone 5A, Ground Floor
India Habitat Center
Lodi Road
New Delhi - 110003
India
Tel: 011 24642901/02
amatta@popcouncil.org
info-india@popcouncil.org

Full Resource
Click here for the full resource in PDF format.