Meeting the Health and Social Needs of Married Girls in India:
The First Time Parents Project's Implementation and
ReachDescriptionPublished 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:
- 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).
- 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.
- 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.
RationaleThis 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 InformationAsha Matta
Population
Council
Zone 5A, Ground Floor
India Habitat Center
Lodi Road
New
Delhi - 110003
India
Tel: 011 24642901/02
amatta@popcouncil.orginfo-india@popcouncil.orgFull
ResourceClick here for the full resource in PDF
format.