Medicine and Health Sciences Commons^™

The Impact And Cost Of Child Marriage Prevention In Rural Tanzania, 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 …

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 …

Understanding The Lives Of Adolescents And Young Adults (Udaya) In Bihar, India, K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Santosh Kumar Singh, Shilpi Rampal, A.J. Francis Zavier, Ashish Kumar Gupta

Poverty, Gender, and Youth

The goal of the “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh” program is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and to assess factors that influence the quality of transitions they make. The study is designed to provide robust insights on how investments in adolescents influence their life course by the time they reach young adulthood; enable evidence-based decisions on the types of programs worthy of scale-up; and furnish important baseline indicators against which the long-term impact of programs can be measured. This …

Adolescent Girls Initiative-Kenya: Financial Education Audio Training Script, Wajir, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Initiative project-Kenya (AGI-K) helps young, vulnerable adolescent girls build their social, health, and economic assets. AGI-K tests combinations of interventions in health, violence prevention, wealth creation, and education to determine which package of interventions delivers the most impact and at what cost. The project was led by the Population Council and implemented in two marginalized areas, Kibera in Nairobi and Wajir county in Northeastern Kenya, by Plan International and Save the Children, respectively. This scripted guide was designed to support the delivery of the financial education sessions in Wajir in response to challenges with mentor capacity in …

Acceptability And Effectiveness Of Helpline Services: Perspectives Of Women In Distress And Service Providers—Policy Brief, K.G. Santhya, Shireen J. Jejeebhoy

Poverty, Gender, and Youth

In Bihar, characterized by the highest prevalence of marital violence in India, helplines for women who experience violence exist in almost every district. Notwithstanding the availability of these helplines, little is known about the perspectives and experiences of women who have these services. This brief describes, from the perspectives of women who sought services from the helpline, the range and perceived quality of services received, and the extent to which these services succeeded in helping them to stop the violence; access permanent shelter, economic opportunities, and resources; resolve claims on family assets; or improve overall well-being. It also presents, from …

Adolescent Girls Empowerment Program (Agep): Adapting The Safe Spaces Model In Rural Settings, Population Council

Poverty, Gender, and Youth

The Adolescent Girls Empowerment Program (AGEP) was implemented with over 10,000 vulnerable adolescent girls aged 10–19 between 2013 and 2016 in five rural and five urban sites in Zambia. Safe Spaces was the core program element in AGEP, and was adapted based on prior programs implemented mainly in urban and peri-urban areas in East and Southern Africa. Given the key differences in the living environments and demographic data for adolescent girls in urban as compared to rural areas in Zambia, one key programmatic learning question for AGEP was if the Safe Spaces model could be adapted and successfully implemented in …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram (Rksk) In Uttar Pradesh, Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

Adolescent Health: Priorities And Opportunities For Rashtriya Kishor Swasthya Karyakram, Sapna Desai

Poverty, Gender, and Youth

The Government of India in 2014 signaled its commitment to adolescent health through introduction of a national strategy, Rashtriya Kishor Swasthya Karyakram (RKSK). Targeting adolescents aged 10–14 and 15–19, the program aims to ensure universal coverage of health information and services for all adolescents—those in and out of school, married or unmarried, and in vulnerable groups. Envisaged as a paradigm shift to address adolescent health beyond sexual and reproductive health, RKSK spans six domains: nutrition, sexual and reproductive health, mental health, injuries and violence including gender-based violence, substance misuse, and non-communicable diseases. This policy brief presents evidence on adolescent health …

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. …

Enabling Adolescent Boys To Adopt Attitudes That Espouse Gender Equality And Oppose Violence Against Women And Girls: Evidence From Rural Bihar—Policy Brief, Shireen J. Jejeebhoy, K.G. Santhya

Poverty, Gender, and Youth

More than a decade after the enactment of the Protection of Women from Domestic Violence Act, 2005, violence against women and girls remains widespread in India, and patriarchal norms and attitudes continue to underpin gender roles. While programs that focus on empowering women and girls are necessary, they are not sufficient in themselves to prevent violence; men and boys are key players, and violence prevention programs must include them. This brief describes an intervention, the Do Kadam Barabari Ki Ore (Two Steps Towards Equality) project, implemented among boys and young men ages 13–21 who were members of youth clubs that …

Executive Summary: Understanding The Lives Of Adolescents And Young Adults (Udaya) In Uttar Pradesh, India (2015–16), K.G. Santhya, Rajib Acharya, Neelanjana Pandey, Ashish Kumar Gupta, Shilpi Rampal, Santosh Kumar Singh, A.J. Francis Zavier

Poverty, Gender, and Youth

A program of research titled, “Understanding the lives of adolescents and young adults (UDAYA) in Bihar and Uttar Pradesh,” implemented by the Population Council, aimed to understand the factors that determine healthy transitions from childhood to adolescence and adulthood. The goal of UDAYA is to establish the levels, patterns, and trends in the situation of younger (10–14) and older (15–19) adolescents and assess factors that influence the quality of transitions they make. The specific objectives of UDAYA are: 1) to explore the situation of adolescents, with a focus on assessing the extent to which both younger and older adolescents have …

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 …

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 …

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 …

More Than Brides Alliance: Baseline Report, India, Sharmistha Basu, Rajib Acharya, Andrea J. Melnikas, Sajeda Amin

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 surveys of adolescent girls and young women aged 12–19 in nine districts in four states in India to examine girls’ experiences, including education, marriage and relationships, literacy and numeracy, livelihoods, and gender-equitable attitudes. The study found that few girls were currently involved in any programs, despite demonstrated vulnerabilities (e.g., more than half of the sample was currently out of school) suggesting that there is a clear …

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 …

The Impact And Cost Of Child Marriage Prevention In Three African Settings—Brief, Population Council

Poverty, Gender, and Youth

Child marriage affects a significant number of girls in developing countries. The negative consequences of the practice are numerous and powerful, spanning health, welfare, development, and demographic domains. Yet there is limited evidence on what works to delay child marriage in different cultural contexts and even less information on programmatic cost. This brief reports on a study that aims to identify the most effective and minimum basic package approaches to delay marriage among adolescent girls in different African settings. The study was undertaken in rural areas of Burkina Faso, Ethiopia, and Tanzania. The study also measures the cost of implementing …

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 …

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 …

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 …

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 …

Measuring Disrespect And Abuse To Promote Respectful Maternity Care, Population Council

Reproductive Health

The Heshima project developed several study instruments to measure disrespect and abuse throughout the study’s formative, baseline, and endline stages. The quasi-experimental implementation research design applied a mixed methods approach to understanding the meaning and factors that drive disrespect and abuse in maternity settings in Kenya. These tools allowed the project to measure the prevalence of disrespect and abuse in this setting, as well as the changes affected by the project.

The Heshima project involved a complex set of multi-level interventions that sought to curb disrespectful and abusive practices during childbirth and promote dignified and respectful maternity care. The evidence …

Risk Factors For Pre-Eclampsia And Eclampsia In Belize, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Belize.

Risk Factors For Pre-Eclampsia And Eclampsia In Cambodia, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Cambodia.

Risk Factors For Pre-Eclampsia And Eclampsia In Guatemala, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Guatemala.

Risk Factors For Pre-Eclampsia And Eclampsia In Nepal, Population Council

Reproductive Health

Each day around the world, 830 women die from pregnancy- and childbirth-related causes. The second most common cause (after postpartum hemorrhage) is a hypertensive disorder during pregnancy, such as pre-eclampsia and eclampsia (PE/E)—life-threatening, pregnancy-induced high blood pressure and excess protein in urine—which can lead to seizures and other fatal complications. One in four preterm infants dies as a result of its mother’s PE/E. These deaths are preventable, yet essential medicines and tools to treat this disorder are often unavailable in low-resource settings. This factsheet provides a graphic overview of the data surrounding this issue with a specific focus on Nepal.

Status Of Sexual And Reproductive Health And Rights In Zambia: Comprehensive Sexuality Education And Adolescents Sexual And Reproductive Health, Population Council

Reproductive Health

In 1994, the International Conference on Population and Development affirmed that sexual and reproductive health and rights (SRHR) are human rights. The Government of the Republic of Zambia has fully committed to fulfilling the SRHR of all people by ratifying 11 international instruments of law (seven global and four regional treaties). This brief is Part 2 of a three-part series entitled “Status of Sexual and Reproductive Health and Rights in Zambia,” reporting on progress, gaps, and existing challenges in SRHR. The brief shows that overall, based on the assessment framework and informed by desk reviews and consultative processes, Zambia is …

Strengthening The Role Of Patent And Proprietary Medicine Vendors In The Provision Of Injectable Contraception In Nigeria, Salisu Mohammed Ishaku

Reproductive Health

In Nigeria, overall modern contraceptive use is very low, however 60 percent of modern contraceptive services are obtained from private providers, including Patent and Proprietary Medicine (PPM) shops, which provide more than half of these private-sector services. PPM shops are owned by Patent and Proprietary Medicine Vendors (PPMVs) licensed to sell patent or proprietary drugs. Current regulations do not permit PPMVs to sell or administer injectable contraceptives, though, because they are not regarded as sufficiently trained. Given this, it is an opportune time to generate evidence that can drive policy action to formally engage and train PPMVs in the provision …

The Need For Improved Information Exchange Between Family Planning Providers And Clients, Population Council

Reproductive Health

The information exchanged during a contraceptive visit is important because providers need to understand clients’ reproductive intentions and clients need to receive adequate information about the method options and possible method-related side effects and problems. Little is known about how information exchange has changed over time and across countries, so FP2020 identified 17 core indicators to track progress made by FP programs, including the method information index (MII). The purpose of this study is to address the following issues: how the MII varies among countries, how it changes between two surveys in the same country, how it varies by type …

Understanding Adolescent And Youth Sexual And Reproductive Health-Seeking Behaviors In Ethiopia: Implications For Youth Friendly Service Programming, Aparna Jain, Hussein Ismail, Elizabeth Tobey, Annabel Erulkar

Reproductive Health

To meet the unique sexual and reproductive health needs of its large adolescent and youth population, Ethiopia’s government has expanded and institutionalized youth-friendly services (YFS) at all levels of the health system. To help inform and improve these efforts, the Evidence Project, in collaboration with USAID/Ethiopia and the Ethiopian Federal Ministry of Health, conducted a study on adolescents’ and young people’s use of and opinions on YFS. Results showed that young people were satisfied overall with the health services they received, regardless of whether it was basic health services or YFS. Awareness and use of YFS was low, but many …