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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
Institute of Health Management, Pachod
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
Institute of Health Management, Pachod
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
Institute of Health Management, Pachod
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
Institute of Health Management, Pachod
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
Life Skills – 13
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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
Life Skills – 15
Institute of Health Management, Pachod
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
Life Skills – 16
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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
Institute of Health Management, Pachod
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
Institute of Health Management, Pachod
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