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Full-Text Articles in Medicine and Health Sciences

What Do Users Really Want?, Saumya Ramarao, John Townsend, James Sailer Jan 2017

What Do Users Really Want?, Saumya Ramarao, John Townsend, James Sailer

Reproductive Health

No abstract provided.


Method-Specific Attributes That Influence Choice Of Future Contraception Among Married Women In Nairobi’S Informal Settlements, Joyce Mumah, John B. Casterline, Kazuyo Machiyama, Marylene Wamukoya, Caroline W. Kabiru, John C. Cleland Jan 2017

Method-Specific Attributes That Influence Choice Of Future Contraception Among Married Women In Nairobi’S Informal Settlements, Joyce Mumah, John B. Casterline, Kazuyo Machiyama, Marylene Wamukoya, Caroline W. Kabiru, John C. Cleland

Reproductive Health

No abstract provided.


More Than Brides Alliance: Baseline Report, Mali, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Mouhamadou Gueye Jan 2017

More Than Brides Alliance: Baseline Report, Mali, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Mouhamadou Gueye

Poverty, Gender, and Youth

The More Than Brides Alliance seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted baseline surveys of adolescents in select areas of two regions in Mali (Sikasso and Segou) as part of an evaluation of interventions to delay marriage. Findings suggest that girls in these communities have a demonstrated need for interventions to address their vulnerabilities. Additional data collection will help explore some of these topics in greater depth and provide a more nuanced understanding of the situation of adolescent …


Feasibility Of Screening And Referring Women Experiencing Marital Violence By Engaging Frontline Workers: Evidence From Rural Bihar—Policy Brief, K.G. Santhya, Shireen J. Jejeebhoy Jan 2017

Feasibility Of Screening And Referring Women Experiencing Marital Violence By Engaging Frontline Workers: Evidence From Rural Bihar—Policy Brief, K.G. Santhya, Shireen J. Jejeebhoy

Poverty, Gender, and Youth

The Do Kadam Barabari Ki Ore (Two Steps Towards Equality) project sought to support frontline health workers (FLWs) to screen women for their experience of marital violence, inform women about their options in case of such an experience, and provide basic counseling and referral, as appropriate, to women reporting the experience. The Population Council together with partners, the Centre for Catalyzing Change and the London School of Hygiene and Tropical Medicine, with support from UKaid, implemented the project in one district (Patna) of Bihar. This brief describes the intervention and presents evidence on its acceptability and feasibility from the perspective …


Evaluation Of The Herhealth Intervention In Bangladesh: Baseline Findings From An Implementation Research Study, Md. Irfan Hossain, Abdullah Al Mahmud Shohag, Ashish Bajracharya, Ubaidur Rob, Laura Reichenbach Jan 2017

Evaluation Of The Herhealth Intervention In Bangladesh: Baseline Findings From An Implementation Research Study, Md. Irfan Hossain, Abdullah Al Mahmud Shohag, Ashish Bajracharya, Ubaidur Rob, Laura Reichenbach

Reproductive Health

The Business for Social Responsibility's (BSR) HERproject is a collaborative initiative that strives to empower low-income women working in global supply chains in 14 countries worldwide. One of the HERproject’s three pillars is HERhealth, which seeks to improve the health-related knowledge and behaviors, and access to health services and products, of low-income working women. In Bangladesh, HERhealth specifically addresses reproductive health and family planning needs. BSR asked the Evidence Project/Population Council to conduct an implementation science study assessing the effectiveness of BSR’s HERhealth model in Bangladesh. This study is one of the first studies of female garment workers in Dhaka …


Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In South Africa, Population Council Jan 2017

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In South Africa, Population Council

HIV and AIDS

The Population Council is conducting implementation research in South Africa, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in Uganda, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in South Africa and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.


Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar Jan 2017

Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar

HIV and AIDS

In Malawi, and other resourced-constrained, sub-Saharan African countries with a high HIV burden, several service delivery models have emerged to increase prevention of mother-to-child transmission care retention by strengthening connections between health facilities and their surrounding communities. Yet there has been little documentation of the unique characteristics of each model and their comparative impact on mother-infant pair (MIP) care retention and other health outcomes. This brief describes how Project SOAR is responding to these knowledge gaps by conducting research to identify components of community-based MIP support that are associated with maternal care retention and infant HIV-free survival. This research will …


Optimizing Community Services For An Improved Continuum Of Hiv Care, Project Soar Jan 2017

Optimizing Community Services For An Improved Continuum Of Hiv Care, Project Soar

HIV and AIDS

Project SOAR, together with Aurum Institute, is conducting research in Ekurhuleni District and Bojanala District in South Africa to improve the availability of effective care continuum services to meet the communities’ HIV treatment needs. The two districts have a combined population of 3.6 million inhabitants and approximately 350 public clinics and hospitals. Through improved information on community HIV care services and their relationship to care continuum outcomes, the study will provide valuable new knowledge about service gaps and approaches to planning and delivering services that best achieve HIV treatment goals.


Policymakers' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council Jan 2017

Policymakers' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

There is limited evidence from Tanzania to inform decisionmaking on whether and how to introduce oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW). To help fill this evidence gap, the Population Council in collaboration with the National AIDS Control Program and CSK Research Solutions Limited conducted implementation science research in one urban district (Dar es Salaam) and one rural district (Mbeya) in Tanzania to explore policymakers’ and key stakeholders’ perceptions and attitudes toward the introduction of PrEP to different groups, including AGYW, as well as to identify key issues that must be considered prior to its introduction. …


Private Sector Costing Of Voluntary Medical Male Circumcision In South Africa, Michel Tchuenche, Steven Forsythe Jan 2017

Private Sector Costing Of Voluntary Medical Male Circumcision In South Africa, Michel Tchuenche, Steven Forsythe

HIV and AIDS

In 2010, after voluntary medical male circumcision (VMMC) had been shown to be one of the most cost-effective strategies for preventing HIV infections, South Africa initiated a VMMC program with an ambitious target of performing 4.3 million circumcisions by 2016. However, because of a gap in knowledge concerning the overall cost of scaling up services, the South African National Department of Health requested that Project SOAR—Supporting Operational AIDS Research—conduct a private-sector costing of providing VMMC services in South Africa. The findings presented in this report provide a detailed investigation, through a comprehensive bottom-up approach, of the costs to private providers …


Rates Of Hiv And Hsv-2 Among Young People In Machinga, Malawi, Barbara Mensch, Erica Soler-Hampejsek Jan 2017

Rates Of Hiv And Hsv-2 Among Young People In Machinga, Malawi, Barbara Mensch, Erica Soler-Hampejsek

HIV and AIDS

To better understand the epidemiological context for the DREAMS programming, Project SOAR analyzed previously collected quantitative cohort data from the Population Council’s Malawi Schooling and Adolescent Study (MSAS) to identify the prevalence and incidence of HIV and the herpes simplex virus, commonly referred to as genital herpes. SOAR’s analysis provides a deeper understanding of the changing epidemiological and gendered context of the HIV epidemic in Machinga. The youth cohort data from the MSAS provide accurate estimates of HIV prevalence over time and HIV incidence, thereby filling important data gaps.


Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar Jan 2017

Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar

HIV and AIDS

Project SOAR is conducting implementation science research in Malawi to build needed evidence to inform decisionmaking about effective programming to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. Specifically, SOAR is: examining approaches to identify the most at-risk girls, particularly those out of school, and enroll and retain them in DREAMS programming; assessing HIV-risk and health-seeking behaviors before and after AGYW’s engagement in DREAMS interventions; exploring how to reach AGYW’s male sexual partners and increase their uptake of HIV services; and assessing facilitators and barriers to HIV service uptake by men living with HIV. …


Measuring Gender Equality In Education: Lessons From 43 Countries, Stephanie Psaki, Katharine Mccarthy, Barbara Mensch Jan 2017

Measuring Gender Equality In Education: Lessons From 43 Countries, Stephanie Psaki, Katharine Mccarthy, Barbara Mensch

Poverty, Gender, and Youth

Through the 2015 Sustainable Development Goals (SDG), governments committed to achieving universal secondary school completion, including eliminating gender disparities, by 2030. The period from 1997 to 2014 saw considerable progress in closing gender gaps in school enrollment and attainment in many, but not all, low- and middle-income countries. However, as this research brief explains, claims that gender parity in primary education now exists are premature, especially in the poorest countries and new gender gaps, or gender-related challenges, may emerge as attainment increases. Moreover, the extremely low levels of secondary school enrollment—and even moreso completion—demonstrate that the SDG target of universal …


Empowering Women And Addressing Marital Violence Through Self-Help Groups: Evidence From Rural Bihar—Policy Brief, K.G. Santhya, Shireen J. Jejeebhoy Jan 2017

Empowering Women And Addressing Marital Violence Through Self-Help Groups: Evidence From Rural Bihar—Policy Brief, K.G. Santhya, Shireen J. Jejeebhoy

Poverty, Gender, and Youth

In recognition of the need to reverse gender disparities, India has instituted numerous policies, laws, and programs intended to empower women and to protect women from violence. However, evidence on what works and what does not work to change notions of masculinity and femininity, reverse the widespread acceptability of marital violence at community level, and reduce women’s experience of intimate partner violence remains limited in the country. The Do Kadam Barabari Ki Ore (Two Steps Towards Equality) was implemented among married women who were members of self-help groups (SHGs) and their husbands. The Population Council together with partners implemented the …


More Than Brides Alliance (Mtba): Mariage N’Est Pas Un Jeu D’Enfat, Rapport De Référence Mali, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Mouhamadou Gueye Jan 2017

More Than Brides Alliance (Mtba): Mariage N’Est Pas Un Jeu D’Enfat, Rapport De Référence Mali, Andrea J. Melnikas, Sajeda Amin, Sarah Engebretsen, Mouhamadou Gueye

Poverty, Gender, and Youth

L’Alliance « Plus qu’une épouse » vise à améliorer la vie des adolescentes et propose des interventions dans plusieurs domaines (la santé reproductive, l’éducation, les normes de genre et les moyens de subsistance, entre autres). Dans le cadre d’une évaluation des interventions visant à retarder l’âge du mariage, le Population Council a mené des enquêtes de référence sur les adolescentes dans les régions de Sikasso et Ségou au Mali. Les résultats suggèrent que des interventions sont nécessaires pour répondre aux vulnérabilités rencontrées par les filles qui vivent dans ces communautés. La collecte de données supplémentaires contribuera à examiner certains de …


Modifying Behaviours And Notions Of Masculinity: Effect Of A Programme Led By Locally Elected Representatives, Shireen J. Jejeebhoy, A.J. Francis Zavier, K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Santosh Kumar Singh, Komal Saxena, Aparajita Gogoi, Madhu Joshi, Sandeep Ojha Jan 2017

Modifying Behaviours And Notions Of Masculinity: Effect Of A Programme Led By Locally Elected Representatives, Shireen J. Jejeebhoy, A.J. Francis Zavier, K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Santosh Kumar Singh, Komal Saxena, Aparajita Gogoi, Madhu Joshi, Sandeep Ojha

Poverty, Gender, and Youth

The Population Council, together with the Centre for Catalyzing Change and the London School of Hygiene and Tropical Medicine, and with support from UKaid, implemented the Do Kadam Barabari Ki Ore (Two Steps Towards Equality) program. The project, situated in Patna district, India aimed to orient and engage locally elected leaders—namely, members of Gram Panchayats and Gram Kachehris—in changing community norms relating to the acceptability of violence against women, and preventing violence against women as well as one factor closely associated with the perpetration of such violence, namely alcohol abuse. Specifically, it assessed: 1) the feasibility of sensitizing and training …


Married Adolescent Girls In Rural Assiut And Souhag: Limited Choices And Unfulfilled Reproductive Health Needs, Nahla G. Abdel-Tawab, Doaa Oraby, Omaima El-Gibaly, Manal Darwish, Mirette Aziz, Amira Elgazzar, Heba Mahmoud Jan 2017

Married Adolescent Girls In Rural Assiut And Souhag: Limited Choices And Unfulfilled Reproductive Health Needs, Nahla G. Abdel-Tawab, Doaa Oraby, Omaima El-Gibaly, Manal Darwish, Mirette Aziz, Amira Elgazzar, Heba Mahmoud

Poverty, Gender, and Youth

According to the Survey of Young People in Egypt 2014, a significant proportion of young women residing in rural Upper Egypt were reported to be married before 18. Early marriage deprives a girl of education and employment opportunities and places her at risk of early and repeat pregnancy, gender-based violence, and sexually transmitted infections. The present study examines the sexual and reproductive health needs of married adolescent girls (MAGs) in rural Upper Egypt and identifies key contextual and cognitive factors that could mitigate or exacerbate the effects of early marriage on their sexual and reproductive health. The report finds that …


Project Brief: Understanding The Lives Of Adolescents And Young Adults (Udaya), Population Council Jan 2017

Project Brief: Understanding The Lives Of Adolescents And Young Adults (Udaya), Population Council

Poverty, Gender, and Youth

The program “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” is designed to establish the levels, patterns and trends in the situation of younger (10–14) and older (15–19) adolescents in India. UDAYA is funded by the Bill and Melinda Gates Foundation and the David and Lucile Packard Foundation, and the study is conducted by the Population Council, New Delhi. This project brief outlines the UDAYA project, which will explore the extent to which younger and older adolescents have acquired a set of assets that can help them make a healthy, safe, and successful transition …


More Than Brides Alliance: Baseline Report, Malawi, Christine A. Kelly, Andrea J. Melnikas, Sajeda Amin, James Mkandawire, Hamza Daud Jan 2017

More Than Brides Alliance: Baseline Report, Malawi, Christine A. Kelly, Andrea J. Melnikas, Sajeda Amin, James Mkandawire, Hamza Daud

Poverty, Gender, and Youth

The More Than Brides Alliance seeks to improve the lives of adolescent girls and includes activities across multiple domains (reproductive health, education, gender norms, and livelihoods, to name a few). The Population Council conducted baseline surveys of adolescents in select areas of two districts in Malawi as part of an evaluation of interventions to delay marriage. The goals of the baseline were to: 1) provide information about the current situation and context for adolescent girls in select areas in Malawi in order to inform the intervention; 2) provide a benchmark against which changes resulting from the intervention may be measured …


The Impact And Cost Of Child Marriage Prevention In Rural Burkina Faso, Annabel Erulkar, Girmay Medhin, Eva Weissman Jan 2017

The Impact And Cost Of Child Marriage Prevention In Rural Burkina Faso, Annabel Erulkar, Girmay Medhin, Eva Weissman

Poverty, Gender, and Youth

The negative impact of child marriage, frequently prevalent in rural locations of poor countries, spans health, development, and demographic consequences. While evidence is limited, a systematic review of child marriage interventions in developing countries found that the most effective approaches in delaying child marriage were those that empower girls by offering incentives such as conditional cash transfers. However, most impact evaluations of community-based programs lack rigorous costing data, a particular weakness of cash transfer schemes where programmatic cost would affect the ability to scale up successful interventions for large populations. To address the limited information on cost and scalability of …


The Journey Of Out-Of-School Girls In Ethiopia: Examining Migration, Livelihoods, And Hiv, Annabel Erulkar, Girmay Medhin, Lemi Negeri Jan 2017

The Journey Of Out-Of-School Girls In Ethiopia: Examining Migration, Livelihoods, And Hiv, Annabel Erulkar, Girmay Medhin, Lemi Negeri

Poverty, Gender, and Youth

Rates of urbanization in Ethiopia are increasing, and based on available data, HIV prevalence among urban girls who are in-migrants is significantly higher than among girls who are native to the area. Likewise, a significant number of out-of-school girls who migrate end up in low-status, exploitative, or risky professions, such as domestic work and sex work. This study of out-of-school girls in six regions of Ethiopia aimed to explore patterns of migration, transitions into different work roles, and situations that may put out-of-school migrant girls at increased risk of HIV infection or be protective and beneficial. Based on the study’s …


The Nia Project: Baseline Survey Instruments, Karen Austrian Jan 2017

The Nia Project: Baseline Survey Instruments, Karen Austrian

Poverty, Gender, and Youth

This document includes all of the Nia Project baseline survey instruments used to collect data in Kenya, providing a multidimensional description of a sample of the participating girls and the schools they attend. The Project is one of the first randomized controlled trials to explore the role of sanitary pad distribution and reproductive health education—individually and in combination—to improve girls’ educational and sexual and reproductive health outcomes. The study collected data from 3,489 girls from 140 schools in three rural Kilifi subcounties: Magarini, Kaloleni, and Ganze.


The Nia Project—Brief, Eunice N. Muthengi, Emily Farris, Karen Austrian Jan 2017

The Nia Project—Brief, Eunice N. Muthengi, Emily Farris, Karen Austrian

Poverty, Gender, and Youth

This brief provides highlights from the Nia Project conducted in Kenya. The study found that while gaps exist in girls’ capabilities, particularly knowledge and attitudes related to menstruation and reproductive health, the Nia Project has the potential to bridge those gaps. The Project is one of the first randomized controlled trials to explore the role of sanitary pad distribution and reproductive health education—individually and in combination—to improve girls’ educational and sexual and reproductive health outcomes. The findings of this study will make a critical contribution to filling an evidence gap in the field of menstrual health and hygiene management, and …


The Nia Project: Baseline Report, Eunice N. Muthengi, Emily Farris, Karen Austrian Jan 2017

The Nia Project: Baseline Report, Eunice N. Muthengi, Emily Farris, Karen Austrian

Poverty, Gender, and Youth

The onset of puberty and menarche is a particularly vulnerable time for girls, when external pressures are exacerbated by their lack of knowledge of their bodies, their rights, and the implications of their decisions, and by their inability to manage puberty and adolescence safely and comfortably with appropriate menstrual health and hygiene management (MHM) products. Although several programs have previously been developed to address girls’ MHM needs globally, few have been evaluated, and where evidence does exist the results have been mixed. In collaboration with ZanaAfrica, the Population Council is evaluating the Nia Project, a set of interventions for adolescent …


Training Locally Elected Representatives To Act As Change Agents To Promote Egalitarian Gender Norms: Lessons Learned From The Do Kadam Barabari Ki Ore Programme—Policy Brief, K.G. Santhya, Shireen J. Jejeebhoy Jan 2017

Training Locally Elected Representatives To Act As Change Agents To Promote Egalitarian Gender Norms: Lessons Learned From The Do Kadam Barabari Ki Ore Programme—Policy Brief, K.G. Santhya, Shireen J. Jejeebhoy

Poverty, Gender, and Youth

This policy brief describes an intervention, the Do Kadam Barabari Ki Ore (Two Steps Towards Equality) project in Patna district, India that sought to train locally elected representatives to act as change agents to promote egalitarian gender norms among men and women in their communities, and the effects of exposure to the project among members of the Panchayati Raj Institutions (PRIs, local self-governance bodies) and men and women from the community. The project was undertaken by the Population Council, together with partners, the Centre for Catalysing Change and the London School of Hygiene and Tropical Medicine, and with support from …


Understanding The Lives Of Adolescents And Young Adults (Udaya): Uttar Pradesh, Population Council Jan 2017

Understanding The Lives Of Adolescents And Young Adults (Udaya): Uttar Pradesh, Population Council

Poverty, Gender, and Youth

This factsheet provides a comprehensive picture of adolescents’ situation and needs in Uttar Pradesh. Based on the “Understanding the lives of adolescents and young adults” (UDAYA) program of research conducted by the Population Council, the graphs and charts explore the situation and needs of younger (10−14 years) and older (15−19 years) adolescents; describe changes in their situation and needs over time; and assess factors that determine the quality of their transitions from adolescence to young adulthood. These graphs highlight findings on: education, employability and economic inclusion, agency, community and citizenship, entry into marriage and motherhood, health and nutrition, violence in …


Youth And Domestic Violence [Arabic], Population Council Jan 2017

Youth And Domestic Violence [Arabic], Population Council

Poverty, Gender, and Youth

[In Arabic] Women in Egypt, like most women in the world, are exposed to domestic violence—physical, verbal, and emotional—which has many social, economic, and psychological effects. These effects are felt not only by the women, but also by their families and society as a whole, ultimately affecting the national economy. This brief reports on results from the 2014 Demographic and Health Survey which found that there is still widespread tolerance of domestic violence among the population. Key findings include: education can influence young girls’ attitudes toward violence (high school–educated girls are more likely to reject violence); early marriage may be …


Construyendo Activos Protectores En Niñas Adolescentes: Una Colección De Herramientas Para El Diseño De Programas, Population Council Jan 2017

Construyendo Activos Protectores En Niñas Adolescentes: Una Colección De Herramientas Para El Diseño De Programas, Population Council

Poverty, Gender, and Youth

Las niñas adolescentes se han convertido en una población clave para las iniciativas que promueven el empoderamiento, mejoras en salud y desarrollo en países de renta baja y media. Esta colección de herramientas se elaboró con el objetivo de proveer recursos a las organizaciones comprometidas con la expansión de sus programas, a modo que incluyan a los grupos y subpoblaciones de mujeres y niñas que han sido excluidas de la cobertura y participación comunitaria—como las niñas adolescentes que viven en los hogares y comunidades en mayores condiciones de pobreza, niñas adolescentes entre los 10 y 14 años que están fuera …


Empowering Women And Addressing Violence Against Them Through Self-Help Groups (Shgs), Shireen J. Jejeebhoy, K.G. Santhya, Rajib Acharya, A.J. Francis Zavier, Neelanjana Pandey, Santosh Kumar Singh, Komal Saxena, Shilpi Rampal, Sharmistha Basu, Aparajita Gogoi, Madhu Joshi, Sandeep Ojha Jan 2017

Empowering Women And Addressing Violence Against Them Through Self-Help Groups (Shgs), Shireen J. Jejeebhoy, K.G. Santhya, Rajib Acharya, A.J. Francis Zavier, Neelanjana Pandey, Santosh Kumar Singh, Komal Saxena, Shilpi Rampal, Sharmistha Basu, Aparajita Gogoi, Madhu Joshi, Sandeep Ojha

Poverty, Gender, and Youth

This report details results of a program implemented by the Population Council, together with the Centre for Catalyzing Change and the London School of Hygiene and Tropical Medicine: Do Kadam Barabari Ki Ore (Two Steps Towards Equality). The primary objective of the program was to test whether strengthening existing village-level self-help groups (SHGs); orienting members on violence against women and girls, and supporting them in prevention activities; and helping women who experience violence had changed their gender-role attitudes and reduced the experience of marital violence. On the whole, findings show that the program was acceptable and effective in many ways. …


Ensuring Adolescents In Bihar Stay—And Learn—In School, Sapna Desai, Neelanjana Pandey, Ashish Kumar Gupta Jan 2017

Ensuring Adolescents In Bihar Stay—And Learn—In School, Sapna Desai, Neelanjana Pandey, Ashish Kumar Gupta

Poverty, Gender, and Youth

The Government of India has invested in improving education through two key programs for universal access to, and retention in, secondary education. In Bihar, the Population Council found high levels of enrollment among younger adolescents, with limited gender disparity. Retention beyond elementary school, however, was low, and learning outcomes—literacy and numeracy—were poor. This policy brief focuses on two challenges to preparing Bihar's adolescents for the future: universal enrollment and retention in secondary school. The brief outlines recommendations that the government invest in secondary schooling, improve school facilities, support and evaluate quality teaching inputs and curriculum changes, remove economic and social …