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Full-Text Articles in Social and Behavioral Sciences

The Copperbelt Model Of Integrated Care For Survivors Of Rape And Defilement: Testing The Feasibility Of Police Provision Of Emergency Contraceptive Pills, Jill Keesbury, Mary Zama, Sudha Shreeniwas Jan 2009

The Copperbelt Model Of Integrated Care For Survivors Of Rape And Defilement: Testing The Feasibility Of Police Provision Of Emergency Contraceptive Pills, Jill Keesbury, Mary Zama, Sudha Shreeniwas

Reproductive Health

The Zambian Ministry of Home Affairs (Police Service), Ministry of Health (MOH) and the Population Council collaborated on an operations research study designed to improve services for survivors of gender-based violence (GBV). Specifically, the study tested the feasibility of police provision of emergency contraception (EC). It also hypothesized that the intervention could strengthen GBV services at both police and health facilities through an increased emphasis on multisectoral collaboration. Based on the study’s findings, national scale-up of this program has been widely endorsed. The following recommendations are offered to guide such scale-up: ensure that a dedicated EC pill is available through …


Revitalizing Family Planning: Lessons Learned On Strengthening Contraceptive Provision, Frontiers In Reproductive Health Jan 2009

Revitalizing Family Planning: Lessons Learned On Strengthening Contraceptive Provision, Frontiers In Reproductive Health

Reproductive Health

Attention and resources have gradually shifted from family planning (FP) in the past decade, but globally need remains high, with an estimated 350 million couples lacking access to FP. FRONTIERS in Reproductive Health Program findings can help address this need by providing useful lessons on process and impact of improving quality of care in clinics, feasibility and effectiveness of community‐based distribution, and proven ways to increase access to underutilized contraceptive methods. This evidence can help strengthen programs and can be used for advocacy in revitalizing FP efforts, particularly in sub‐Saharan Africa where modern method contraceptive prevalence is only 16 percent. …


Maximizing Utilization Of Research, Frontiers In Reproductive Health Jan 2009

Maximizing Utilization Of Research, Frontiers In Reproductive Health

Reproductive Health

Operations research (OR) can only be judged successful if results are utilized for making decisions to strengthen RH/FP policies and service delivery. How can this best be achieved? How can both process and impact of OR be measured? Drawing from ten years of FRONTIERS in Reproductive Health OR experience, a number of key principles for promoting research utilization, illustrated with documented examples, are presented here. One important first step is clarifying terms used, almost interchangeably, in research utilization, as it incorporates a range of ways in which research can be used for making decisions to strengthen RH/FP policies and programs. …


Capacity Building: Creating A Culture Of Evidence-Based Decisionmaking, Frontiers In Reproductive Health Jan 2009

Capacity Building: Creating A Culture Of Evidence-Based Decisionmaking, Frontiers In Reproductive Health

Reproductive Health

For research to have significant impact, it is important to have not only trained individuals and institutions capable of conducting research, but also program managers and donors who believe in making decisions based on evidence. The focus on fostering research utilization through capacity building has been a major contribution of the FRONTIERS legacy. The FRONTIERS capacity-building initiative began in 1999 in response to the need for developing-country partners and institutions to conduct research, understand study findings, and develop policies and programs based on evidence. This is one of eight Legacy Papers synthesizing major lessons learned in research conducted under the …


Pilot Community-Based Intervention To Address The Needs Of Elderly Caregivers In The Eastern Cape Province, South Africa, Priscilla Reddy, Shegs James, H. Mutumba Bilay-Boon, Eka Esu-Williams, Hena Khan Jan 2009

Pilot Community-Based Intervention To Address The Needs Of Elderly Caregivers In The Eastern Cape Province, South Africa, Priscilla Reddy, Shegs James, H. Mutumba Bilay-Boon, Eka Esu-Williams, Hena Khan

HIV and AIDS

The HIV epidemic in South Africa has placed a substantial burden on elderly caregivers, mainly women, who are often tasked with caring for their grandchildren who are orphaned and rendered vulnerable by the death or illness of their parents. The Medical Research Council (MRC), Age-in-Action, and the Horizons Program conducted formative research, as described in this research summary, to assess the needs of elderly caregivers in the Eastern Cape Province of South Africa in 2005. The investigations revealed that elderly caregivers faced a number of challenges including difficulty communicating with youth, fears and a sense of hopelessness around matters regarding …


Formative Evaluation: Presidential Initiative On Aids Strategy For Communication To Youth, Netsayi N. Mudege, Chi-Chi Undie Jan 2009

Formative Evaluation: Presidential Initiative On Aids Strategy For Communication To Youth, Netsayi N. Mudege, Chi-Chi Undie

HIV and AIDS

HIV prevention programming is increasingly taking place in school settings, which provide an expansive population of young people and offer immense potential for impact on the lives of this target group. The Presidential Initiative on AIDS Strategy for Communication to Youth (PIASCY) is a school-based program that has sought to address the HIV/AIDS epidemic in Uganda in a holistic manner since 2002, targeting young people, school personnel, parents, and the wider community. A formative evaluation was conducted by the African Population and Health Research Center in February 2009 to provide an understanding of: the extent to which PIASCY is achieving …


The Overlooked Epidemic: Addressing Hiv Prevention And Treatment Among Men Who Have Sex With Men In Sub-Saharan Africa, National Aids Control Council Of Kenya, Population Council Jan 2009

The Overlooked Epidemic: Addressing Hiv Prevention And Treatment Among Men Who Have Sex With Men In Sub-Saharan Africa, National Aids Control Council Of Kenya, Population Council

HIV and AIDS

Globally, less than 1 out of 20 men who have sex with men (MSM) has access to HIV prevention and care. UNAIDS has estimated that at least 5 to 10 percent of all HIV infections globally occur through male-to-male sexual activity. In spite of the high risk of HIV infection and evidence of extensive sexual networks, national HIV programs in Africa have been slow to address MSM in prevention and treatment efforts. To address these issues, the Population Council and the National AIDS Control Council of Kenya convened a meeting on May 14–15, 2008. The goals of the meeting were …


Mainstreaming Ec In Africa: The Ec Facilitative Re-Granting Program—Final Narrative Report, Jill Keesbury, Wilson Liambila, Youmane Niang Faye, Victoria Rumbold Jan 2009

Mainstreaming Ec In Africa: The Ec Facilitative Re-Granting Program—Final Narrative Report, Jill Keesbury, Wilson Liambila, Youmane Niang Faye, Victoria Rumbold

Reproductive Health

Since 2006, ECafrique has been working to build the capacity of African nongovernmental organizations to design, implement, and evaluate successful emergency contraception (EC) mainstreaming projects. Through a process of “facilitative regranting,” ECafrique annually awarded nine grants ranging from $25,000 to $30,000 to organizations from across Anglophone and Francophone Africa. The program’s objectives were to increase access to EC across Africa by supporting projects intended to introduce, scale up, or mainstream the method, and build the capacity of African NGOs to design, implement, and evaluate successful EC mainstreaming projects. Each grantee participated in an international proposal development workshop and received individualized …


Operational Research For The Introduction Of An Adolescent Health Package In The Context Of Cervical Cancer Prevention, Marieke G. Van Dijk, Katherine Wilson, Claudia Diaz, Sandra G. Garcia Jan 2009

Operational Research For The Introduction Of An Adolescent Health Package In The Context Of Cervical Cancer Prevention, Marieke G. Van Dijk, Katherine Wilson, Claudia Diaz, Sandra G. Garcia

Reproductive Health

This report provides findings from a WHO/PAHO/UNFPA meeting that took place in Mexico City in 2009. Participants discussed a proposed operational research study on adolescent health and cervical cancer prevention that would help support countries that have already made or will soon make a policy decision to introduce the HPV vaccine. Adolescents typically have little contact with health services, particularly for immunization programs. Since new HPV vaccines target adolescent girls, the introduction of HPV vaccines may provide an opportunity for adolescents to engage more with health services and this may create openings to offer packages of adolescent health services that …


Implementation Of Maternal Health Financial Scheme In Rural Bangladesh, Md. Moshiur Rahman, Ubaidur Rob, Tasnima Kibria Jan 2009

Implementation Of Maternal Health Financial Scheme In Rural Bangladesh, Md. Moshiur Rahman, Ubaidur Rob, Tasnima Kibria

Reproductive Health

The maternal mortality ratio in Bangladesh has declined from more than 600 per 100,000 live births in 1980 to 322 in 2004, yet it is still unacceptably high. Economic barriers are an important factor in deterring pregnant women from seeking services at health facilities. To achieve the country’s Millennium Development Goal of reducing the maternal mortality ratio to 143 by 2015, the Population Council conducted an operations research study to test the feasibility and effectiveness of introducing an innovative model of health care financing to increase utilization of maternal health services by poor, rural women. As this report notes, “Voucher …


Special Needs Of In-School Hiv Positive Young People In Uganda, Francis Obare, Harriet Birungi, Anne Katahoire, Hannington Nkayivu, Aggrey David Kibenge Jan 2009

Special Needs Of In-School Hiv Positive Young People In Uganda, Francis Obare, Harriet Birungi, Anne Katahoire, Hannington Nkayivu, Aggrey David Kibenge

Reproductive Health

Since 2006, the Population Council has pioneered operations research in collaboration with local partners in Uganda to promote the sexual and reproductive health and rights of young people aged 10–19 years infected with HIV. Key findings show that many young people perinatally infected with HIV want to be in school to avoid social isolation, and about 70 percent of them attend school. However, there has been limited understanding of how the education sector should support this vulnerable group of learners. The objective of this study was to explore the special needs of HIV-positive young people in primary and secondary schools …


Manual For Designing Community Based Interventions For Preventing Postpartum Hemorrhage (Pph) Using Misoprostol: Standardized Pilot-Test Training Manual, Saumya Ramarao, Tekle-Ab Mekbib, Sarah Raifman Jan 2009

Manual For Designing Community Based Interventions For Preventing Postpartum Hemorrhage (Pph) Using Misoprostol: Standardized Pilot-Test Training Manual, Saumya Ramarao, Tekle-Ab Mekbib, Sarah Raifman

Reproductive Health

This manual is a comprehensive, standardized, step-by-step guide for Population Council staff to use when designing and implementing community-based pilot interventions for the prevention of postpartum hemorrhage using misoprostol. The introduction and background section provide basic information about maternal mortality, normal and abnormal pregnancy, and postpartum hemorrhage. This section also describes prevailing methods of prevention and treatment for postpartum hemorrhage, active management of the third stage of labor, and use of misoprostol for the prevention and control of postpartum hemorrhage. The second half of the manual focuses on how to develop a protocol for an intervention study on misoprostol. It …


Ecp Handbook: Introducing And Mainstreaming The Provision Of Emergency Contraceptive Pills In Developing Countries, Sharif M.I. Hossain, M.E. Khan, Ricardo Vernon, Jill Keesbury, Ian Askew, John Townsend, Victoria Rumbold Jan 2009

Ecp Handbook: Introducing And Mainstreaming The Provision Of Emergency Contraceptive Pills In Developing Countries, Sharif M.I. Hossain, M.E. Khan, Ricardo Vernon, Jill Keesbury, Ian Askew, John Townsend, Victoria Rumbold

Reproductive Health

For many women, emergency contraceptive pills (ECPs) offer an opportunity to prevent unintended pregnancy following contraceptive method failure, rape, or unprotected sex. Access to this safe, effective option remains an essential element of women’s quality reproductive health care. However, ECPs remain inaccessible across much of the world, particularly in developing countries where limited commodity supplies, provider competency, public awareness, and misinformation routinely coalesce to restrict availability. While ECPs have been introduced on a pilot basis in many countries, their effective integration into both the public and private sectors has lagged. Successful interventions are guided by the principle that provision of …


Enquête Sur La Contraception D'Urgence (Cu) Au Niveau Des Pharmacies, Nafissatou J. Diop, Babacar Mane, Ousseynou Faye, Cheikh Ibrahima Niang, Thiaba Thiaw, Aissatou Sano Coly, Fatou Mbow, Youmane Niang Faye Jan 2009

Enquête Sur La Contraception D'Urgence (Cu) Au Niveau Des Pharmacies, Nafissatou J. Diop, Babacar Mane, Ousseynou Faye, Cheikh Ibrahima Niang, Thiaba Thiaw, Aissatou Sano Coly, Fatou Mbow, Youmane Niang Faye

Reproductive Health

La Division de la santé de la reproduction (DRH) avec l’aide du Population Council a mené ces dernières années un programme de recherche opérationnelle sur la contraception d’urgence (CU). L’objectif de cette recherche a été de fournir des informations de base à utiliser dans l’élaboration d’une stratégie pour la promotion de l’utilisation de la CU au Sénégal. Des études ont montré qu’un accès rapide à une méthode de CU entraînerait une réduction significative de l’étendue des grossesses non désirées et des avortements chez les femmes. Cependant, malgré le fait que l’OMS ait recommandé l’intégration de la CU dans les programmes …


Hazards And Gender In Children's Work: An Egyptian Perspective, Nadia Zibani Jan 2009

Hazards And Gender In Children's Work: An Egyptian Perspective, Nadia Zibani

Poverty, Gender, and Youth

Girls and boys can and do work. They work for a variety of reasons related to poverty or failures in educational systems, and they work to support themselves and their families or to learn skills for future careers. The types of work carried out by children often differ according to the gender of the child. Additionally, the hazards they face in their work can also be differentiated on the basis of gender. The present study attempts to develop a better understanding of the gender aspects of children’s work with a particular focus on the gender-differentiated hazards that exist therein. This …


Trade Liberalization, Inter-Industry Wage Differentials And Job Quality In Egyptian Manufacturing, Shireen Al Azzawi, Mona Said Jan 2009

Trade Liberalization, Inter-Industry Wage Differentials And Job Quality In Egyptian Manufacturing, Shireen Al Azzawi, Mona Said

Poverty, Gender, and Youth

This working paper investigates the impact of trade openness on wage and job quality outcomes in the Egyptian manufacturing sector over a period of rapid trade liberalization. Results indicate that institutional factors of job quality (social security, medical insurance, a contract, paid casual leave, paid sick leave, and membership in a trade union) have the strongest correlation with the trade variables and the industry-specific characteristics used in the analysis. Tariff reduction per se, does not seem to have had a significant impact on either wages or job quality. On the other hand, increased export orientation exerts a strong positive impact …


Kwazulu-Natal Department Of Health Policy And Guidelines For Integrated Ante And Postnatal Care At District Hospital Community Health Centre And Clinic Level, Population Council Jan 2009

Kwazulu-Natal Department Of Health Policy And Guidelines For Integrated Ante And Postnatal Care At District Hospital Community Health Centre And Clinic Level, Population Council

Reproductive Health

A 2006 baseline survey conducted by CARE Kenya indicated that sexual and gender-based violence (SGBV) is widespread throughout Kenya’s North Eastern Province. Other findings revealed that high levels of stigma and gender imbalances are associated with sexual violence and female genital mutilation (FGM) and that a coordinated approach to responding to the service needs of survivors is missing. As noted in this report, there is limited awareness of the legal mechanisms available to survivors. The Population Council’s study in Wajir District ascertained the need for and possible components of an integrated and comprehensive services model that could meet the needs …


Gender And Reproductive Health Services: Putting Gender Perspective Into Practice, Frontiers In Reproductive Health Jan 2009

Gender And Reproductive Health Services: Putting Gender Perspective Into Practice, Frontiers In Reproductive Health

Reproductive Health

Promoting gender equity is widely acknowledged as important for improving reproductive health (RH) programs, as gender shapes all aspects of RH service delivery. Thus promoting gender equity—fairness and justice in responsibilities and access to benefits for women, men, girls, and boys—is a major goal for RH programs. But how can programs operationalize the concept of gender perspective when delivering family planning (FP) and other RH services? What impact does this have on use and effectiveness? FRONTIERS projects have improved understanding of the impact of gender issues on RH and have helped identify effective actions for incorporating gender perspective into services. …


Improving The Health Care Response To Gender-Based Violence: Phase Ii, Meiwita P. Budiharsana, Mai Quoc Tung Jan 2009

Improving The Health Care Response To Gender-Based Violence: Phase Ii, Meiwita P. Budiharsana, Mai Quoc Tung

Reproductive Health

In 2009, the Population Council/Vietnam in collaboration with the Hanoi Health Service carried out an evaluation survey among Duc Giang Hospital staff to assess the extent to which awareness and perceptions of gender-based violence (GBV) had changed since the project commenced in 2005. The survey also assessed the extent to which the response of the hospital and Women’s Center for Counseling and Health had been strengthened, and made recommendations on changes to improve the situation. Overall, this project has been effective in raising awareness and willingness to integrate GBV screening into health services. The project conducted its training program at …


Reference Guides For Health Care Organizations Seeking Accreditation For High-Quality, Gender-Sensitive Reproductive Health Services, Patricia Riveros, Erica Palenque, Ricardo Vernon, Ignacio Carreno, John H. Bratt Jan 2009

Reference Guides For Health Care Organizations Seeking Accreditation For High-Quality, Gender-Sensitive Reproductive Health Services, Patricia Riveros, Erica Palenque, Ricardo Vernon, Ignacio Carreno, John H. Bratt

Reproductive Health

Bolivia’s Integral Health Coordination Program (PROCOSI), a network of 33 nongovernmental organizations (NGOs) providing reproductive health care, has long promoted gender sensitivity as a necessary component of high-quality health care. PROCOSI encourages member NGOs to address gender-based differences in roles, relationships, access to services, and service needs in their reproductive health programs. The Reference Guides in this publication provide guidance to help health-care organizations and NGOs implement high-quality, gender-sensitive standards to achieve certification for their member clinics and administrative centers. The procedures and standards included here are based on the process developed by PROCOSI, but the approach and standards can …


Demographic Data For Development: Senegal, Rose Maruru, Wendy Baldwin, Sarah Engebretsen Jan 2009

Demographic Data For Development: Senegal, Rose Maruru, Wendy Baldwin, Sarah Engebretsen

Poverty, Gender, and Youth

Current global developmental frameworks, including the Millennium Development Goals and Poverty Reduction Strategy Papers, require recent and reliable data to measure the achievement of targets. At the same time, increased decentralization and democratization have expanded the role that data play in informing development policies and evaluating development interventions at the national level. Increasingly, programs and policies are assessed by their ability to reach goals that have evidence-based indicators, placing a greater demand on countries to produce clear, timely, reliable, and relevant data. The Senegal case study that forms the basis of this report aimed to develop a general picture of …


Youth Participation In Civil Society And Political Life In Jharkhand, International Institute For Population Sciences (Iips), Population Council Jan 2009

Youth Participation In Civil Society And Political Life In Jharkhand, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

Youth participation in civil society and political life is increasingly recognized as an important development objective. The opportunities for participation that young people experience in their communities may influence their development and the kind of transitions they make to adulthood. Behaviors and attitudes relating to community participation that individuals adopt as young people predict their lifelong civic affiliations and perspectives. In India, the National Youth Policy 2003 has underscored the role of India’s youth in political decision-making, and has argued for greater representation of youth in appropriate bodies as well as more extensive youth participation in the design and implementation …


Youth Participation In Civil Society And Political Life In Bihar, International Institute For Population Sciences (Iips), Population Council Jan 2009

Youth Participation In Civil Society And Political Life In Bihar, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

Youth participation in civil society and political life is increasingly recognized as an important development objective. The opportunities for participation that young people experience in their communities may influence their development and the kind of transitions they make to adulthood. Moreover, behaviors and attitudes relating to community participation that individuals adopt as young people predict their lifelong civic affiliations and perspectives. In India, the National Youth Policy 2003 underscored the role of India’s youth in political decision-making and argued for greater representation of youth in appropriate bodies as well as more extensive youth participation in the design and implementation of …


Sexuality Education Matters: Experiences Of Youth In Tamil Nadu, International Institute For Population Sciences (Iips), Population Council Jan 2009

Sexuality Education Matters: Experiences Of Youth In Tamil Nadu, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

Serious reservations have been expressed about providing family life or sex education for school-going youth in India. Tamil Nadu is a state in India that had introduced the School AIDS Education Programme in 1997. Data from the “Youth in India: Situation and Needs” study conducted in Tamil Nadu permit an exploration of whether or not exposure to family life or sex education is associated with safe and healthy behaviors among young people. This policy brief documents the extent of exposure to family life or sex education among youth in Tamil Nadu and the extent to which sexual and reproductive health …


Measuring And Operationalizing Job Quality In Egypt [Arabic], Ragui Assaad, Rania Roushdy, Ali Rashed Jan 2009

Measuring And Operationalizing Job Quality In Egypt [Arabic], Ragui Assaad, Rania Roushdy, Ali Rashed

Poverty, Gender, and Youth

No abstract provided.


Analyse Secondaire Des Données De L'Analyse Situationnelle Des Services De Santé De La Reproduction, Gisele Kaboré, Idrissa Kabore Jan 2009

Analyse Secondaire Des Données De L'Analyse Situationnelle Des Services De Santé De La Reproduction, Gisele Kaboré, Idrissa Kabore

Poverty, Gender, and Youth

En début 2002, l’UNFPA a soutenu un projet intitulé Renforcement des services sanitaires et sociaux pour faire face aux besoins de santé sexuelle et reproductive des adolescentes. Le projet avait pour objectif d’améliorer la connaissance des adolescentes mariées en ce qui concerne la législation et leurs propres droits; les éduquer à prendre soin de leur propre santé et de celle de leurs enfants; et augmenter leur accessibilité aux services de santé reproductive, particulièrement dans les régions les plus pauvres du Burkina Faso. Le projet a affirmé que les normes de fonctionnement ne sont pas remplies en termes d’infrastructures, d’équipement, de …


Broadening Girls' Horizons: Effects Of Life Skills Education Programme In Rural Uttar Pradesh, Rajib Acharya, Shveta Kalyanwala, Shireen J. Jejeebhoy, Vinita Nathani Jan 2009

Broadening Girls' Horizons: Effects Of Life Skills Education Programme In Rural Uttar Pradesh, Rajib Acharya, Shveta Kalyanwala, Shireen J. Jejeebhoy, Vinita Nathani

Poverty, Gender, and Youth

This report is the result of a collaborative project undertaken by Prerana, a Delhi-based NGO, and the Population Council to implement a life-skills education program for unmarried adolescent girls in rural Uttar Pradesh and to evaluate its effectiveness. The intervention program aimed to empower unmarried adolescent girls aged 13–17 years and address their vulnerabilities by: building their agency, fostering egalitarian gender role attitudes, building awareness about sexual and reproductive health matters, developing vocational skills and future work aspirations, and influencing perceptions about marriage and the ability to negotiate marriage-related decisions (delaying marriage and first pregnancy).


Making Pregnancy Safe For Women In Rajasthan: Targeting The Most Vulnerable, K.G. Santhya Jan 2009

Making Pregnancy Safe For Women In Rajasthan: Targeting The Most Vulnerable, K.G. Santhya

Poverty, Gender, and Youth

As recently as 2005–06, almost two out of three women in Rajasthan, India were married before age 18 years (of those aged 20–24). Moreover, half of currently married girls aged 15–19 years in the state had already begun childbearing. The dangers of childbearing among adolescent girls, whose bodies have not physically matured, are widely acknowledged, as are the links between poverty and unsafe pregnancy. Yet, less is known about whether morbidity and mortality experiences vary within the subgroup of adolescent girls, whether such experiences differ between adolescent and adult women of similar parity, and whether treatment-seeking behaviors and the delays …


Ensuring Education For All In Jharkhand: Highlighting The Obstacles, International Institute For Population Sciences (Iips), Population Council Jan 2009

Ensuring Education For All In Jharkhand: Highlighting The Obstacles, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

The extent to which India will be able to successfully harness its demographic dividend depends significantly on the situation of its youth, notably on the levels of education and market-oriented skills they attain. While many states have made progress on the education front, many other states, including Jharkhand, have lagged behind. Lack of educational facilities for youth is a major concern acknowledged in the Jharkhand Youth Policy 2007. Looking at the current educational situation of youth in Jharkhand, this policy brief argues that significant investments in terms of appropriate policies and programs are required to: enable the state to achieve …


Transition To Marriage And Parenthood Among Youth In Bihar, International Institute For Population Sciences (Iips), Population Council Jan 2009

Transition To Marriage And Parenthood Among Youth In Bihar, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

Delaying the transition to marriage and parenthood among young people has been a policy and program priority for several years in India. Several national-level policies formulated since 2000 have advocated special program attention to delay age at marriage and age at first birth. Despite these commitments, substantial proportions of girls continue to marry in adolescence. As recently as 2005–06, more than two-fifths of women aged 20–24 were married by 18 years nationally. Likewise, over one-fifth of women aged 20–24 had given birth before age 18 and two-fifths before age 20. While the magnitude of early marriage and childbearing has been …