Life Skills – 1

Impact of Life Skills Education on Age Impact of Life Skills Education on Age at Marriage of Adolescent Girlsat Marriage of Adolescent Girls Manisha Khale, Ashok Dyalchand, Kathleen KurzManisha Khale, Ashok Dyalchand, Kathleen Kurz

3131stst Annual GHC Conference: June 1 - 4, 2004 Annual GHC Conference: June 1 - 4, 2004

Institute of Health Management, Pachod

International Centre for Research on Women

in collaboration with

Institute of Health Management Pachod

Community Community BBased ased

Intervention Study Intervention Study

Conducted in Conducted in

72 Villages of 72 Villages of

Rural MaharashtraRural Maharashtra

Pachod

INDIA

Institute of Health Management, Pachod

Project supported by Christian Aid, UK, & ICCO, Netherlands

Research supported by Ford Foundation & Rockefeller Foundation

Life Skills – 2

Preparatory Phase

Conceptual Model

1. Life Skills Education

2. Health Services

3. BCC: Parents and Community

Interventions ExpectedImpact

MMR

NMR

Abortions

LBW

RTIs /STIs

TFR

Outputs

Cognitive Skills

Negotiation and Communication

Skills

Self-esteem and Confidence

Utilization of Health Services

Social Approval

Outcome

Delayed

Age at

Marriage

Life Skills – 3

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Preparatory Phase

Needs Assessment - Quantitative

Life Skills – 4

Proportion of Girls Married Before Age18 Years- Rural Aurangabad……… 81 %

Source: IHMP, 1997

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Proportion of Girls Getting Married BeforeAge 18 Years, Maharashtra

35

4

60

0

20

40

60

80

100

Marathwada Sindhudurg Maharashtra

Source: RCH District–wise study, IIPS, 2001

Perc

ent g

irls

mar

ried

befo

re 1

8 ye

ars

Preparatory Phase

Needs Assessment - Quantitative

Life Skills – 5

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Reproductive Morbidity Higher in Married Adolescent Girls Compared to Adult women

15.8%25.2%Domestic Violence

2.9%9.2%Abortions

Adult Women ( 20 years)

Married Adol. Girls ( 19 years)

Health Indicator

Source: Female Sample Survey,IHMP, 1998-99

Prevalence of Anaemia in Adolescent Girls …. 60 %

Source: IHMP, 1999

Age

Percent GirlsTotal Girls

(N)Going to School

Not going to School

11-13 Yr. 73.1 26.9 767

14-17 Yr. 51.1 48.9 472

Preparatory Phase

Source: IHMP, 1998-99

School Attendance Among Adolescent Girls Drops After Age 13 Years

Needs Assessment - Quantitative

Life Skills – 6

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Preparatory Phase

Needs Assessment - Qualitative

Restriction on mobility after reaching puberty

Girls have heavy work-load compared to boys

Poor menstruation hygiene

Poor communication between mothers and daughters

regarding reproduction and sexuality

Low confidence, self esteem, decision making

Married early, attain motherhood prior to adulthood

Life Skills – 7

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Preparatory Phase

Curriculum Developed With Participation of:

Life Skills – 8

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Mothers participating in planning workshop - 1999

Parents, Village Health Committees, Adol. Girls.

Experts – Lawyers, Social Workers, Doctors, etc.

Implementation Phase

Life Skills Course

Initiated in: 1999 Target Group: Adolescent girls age 11-18 years Duration of Course: One Year Conducted at: Village level, 1½ hour sessions Life Skills teacher: Village woman - 7 years educ.

Community based Life Skills teachers -1999

Life Skills – 9

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Implementation Phase

Objectives of the Life Skills Course

1. Delay age at marriage for adolescent girls

2. Improve social status through skills related to gender, legal literacy, team building, etc.

3. Improve health status by increasing their cognitive and practical skills in health and nutrition.

4. Promote self development, increase self-confidence through community and individual projects.

Life Skills – 10

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Life Skills Course

225 one-hour sessions

Designed for a grassroots trainer

Implementation Phase Life Skills – 11

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1. Social Issues and Institutions

2. Local Bodies

3. Life Skills

4. Child Health and Nutrition

5. Reproductive and Sexual Health

6. Legal Literacy / Women’s Rights

7. Vocational Training

8. Gender Sensitization

Scope of Life Skills

Implementation Phase Life Skills – 12

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Implementation Phase

Projects

Community Nutrition Education

BCC by Adolescent Girls and Life Skills Teachers

Non-Formal Education

School-going Girls Teach Non-school-going Girls

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Impact Phase

Impact on Community DemandLife Skills – 14

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Enrolment Increased From 450 to 2000 Girls

Adolescent girls attending certificate distribution function - 2001

Impact Phase

Median Age at Marriage and Percent Girls Getting Married Before Age 18, IHMP Project Area

17

16 16 16 16

74.269.4

61.8

73.7 72.6 7180.7

74.8

15

16

17

18

19

20

1997 1998 2000 2001

Year

Me

dia

n a

ge

at

ma

rria

ge

in y

ea

rs

0

10

20

30

40

50

60

70

80

90

Pe

rce

nt

gir

ls g

ett

ing

ma

rrie

d

be

fore

ag

e 1

8

Median age at marriage (Study Area)

Median age at marriage (Control Area)

Percent girls getting married before 18 (Study Area)

Percent girls getting married before 18 (Control Area) Source: IHMP, 1997-2001

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Impact Phase

After Life Skills Education - Girls Less Likely to Marry < 18 Years Logistic regression

VariablesAdjusted odds ratio

95% confidence interval

Mothers occupation Working Non-working +

2.42*1

( 1.08 - 5.42 )

Adolescent girls from Intervention area + Control area

13.96** ( 2.09 - 7.51 )

Pseudo R square = 0.2436

+ Reference category

* p <0.05 ** p <0.001 NS – Not significant

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Variables 95% confidence interval

Age at the time of enrolment 11-13 Yr. + 14-17 Yr.

13.89** ( 2.13 - 7.08 )

Level of education Upto Primary + Middle & above

11.56NS ( 0.71 - 3.39 )

School going status School going + Non-school going

12.87** ( 1.35 - 6.09 )

Socio-economic status Lower + Middle-Lower Middle-Upper Upper

11.79NS

1.78NS

2.28NS

( 0.79 - 4.04 )( 0.85 – 3.75 )( 0.97 - 5.33 )

Mothers education Illiterate Literate +

1.67NS

1

( 0.84 - 3.31 )

Adjusted odds ratio

Impact Phase

Pseudo R square = 0.1543 + Reference category * p <0.05

Variable Adjusted Odds Ratio

95%

Confidence Interval

Attendance at Life Skills Course

Never attended

Partially attended

Fully attended+

2.583*

2.423*

1

(1.433-4.656)

(1.272-4.617)

Girls Never Attended Course, 2.6 Times More Likely to Marry Before Age 18

Logistic regression

Life Skills – 17

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Impact Phase

Meera Wagh:Learnt about HIV/AIDS

during Life Skills course.

Insisted that prospective husband

gets tested before marriage.

She made him undergo test along

with herself.

Life Skills – 18

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Manju - 13 Year Old Girl (Name Changed)

Impact PhaseLife Skills – 19

Molested by a man on the road while walking home from school

Went straight to police station to lodge complaint & demanded a copy of FIR

Told police inspector she learnt about this in the ‘Life Skills’ course

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Policy Implications

Policy Implications

Life Skills course of longer duration needed for empowerment of adolescent girls

Needs to go beyond reproductive / sexual health

Needs to be community based to ensure social support / approval

Programme should engage key decision makers

Replication possible in India through ICDS

Life Skills – 20

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