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Life Skills – 1. Impact of Life Skills Education on Age at Marriage of Adolescent Girls Manisha Khale, Ashok Dyalchand, Kathleen Kurz. 31 st Annual GHC Conference: June 1 - 4, 2004. Institute of Health Management, Pachod. in collaboration with.

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Life skills 1

Life Skills – 1

Impact of Life Skills Education on Age at Marriage of Adolescent Girls

Manisha Khale, Ashok Dyalchand, Kathleen Kurz

31st Annual GHC Conference: June 1 - 4, 2004

Institute of Health Management, Pachod

in collaboration with

International Centre for Research on Women


Life skills 1

Life Skills – 2

Community Based

Intervention Study

Conducted in

72 Villages of

Rural Maharashtra

INDIA

Pachod

Institute of Health Management, Pachod

Institute of Health Management Pachod

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

Research supported by Ford Foundation & Rockefeller Foundation


Life skills 1

Life Skills – 3

Interventions

Outputs

Expected

Impact

Outcome

  • Life Skills Education

  • Health Services

  • BCC: Parents and Community

 Cognitive Skills

Delayed Age at Marriage

  •  MMR

  •  NMR

  •  Abortions

  •  LBW

  •  RTIs /STIs

  •  TFR

 Negotiation and Communication Skills

 Self-esteem and Confidence

 Social Approval

Utilization of Health Services

Institute of Health Management, Pachod

Preparatory Phase

Conceptual Model


Life skills 1

Life Skills – 4

Proportion of Girls Married Before Age

18 Years- Rural Aurangabad……… 81 %

Source: IHMP, 1997

Proportion of Girls Getting Married Before

Age 18 Years, Maharashtra

Percent girls married before 18 years

Source: RCH District–wise study, IIPS, 2001

Institute of Health Management, Pachod

Preparatory Phase

Needs Assessment - Quantitative


Life skills 1

Life Skills – 5

Reproductive Morbidity Higher in Married Adolescent Girls Compared to Adult women

Health Indicator

Married Adol. Girls ( 19 years)

Adult Women ( 20 years)

Abortions

9.2%

2.9%

Domestic Violence

25.2%

15.8%

Source: Female Sample Survey,IHMP, 1998-99

Prevalence of Anaemia in Adolescent Girls …. 60 %

Source: IHMP, 1999

Institute of Health Management, Pachod

Preparatory Phase

Needs Assessment - Quantitative


Life skills 1

Life Skills – 6

Needs Assessment - Quantitative

School Attendance Among Adolescent Girls

Drops After Age 13 Years

Institute of Health Management, Pachod

Preparatory Phase

Source: IHMP, 1998-99


Life skills 1

Life Skills – 7

Institute of Health Management, Pachod

Preparatory Phase

Needs Assessment - Qualitative

  • Restriction onmobility after reaching puberty

  • Girls haveheavy work-loadcompared to boys

  • Poor menstruation hygiene

  • Poor communicationbetween mothers and daughters regarding reproduction and sexuality

  • Low confidence, self esteem, decision making

  • Married early, attain motherhoodprior to adulthood


Life skills 1

Life Skills – 8

  • Parents, Village Health Committees, Adol. Girls.

  • Experts – Lawyers, Social Workers, Doctors, etc.

Mothers participating in planning workshop - 1999

Institute of Health Management, Pachod

Preparatory Phase

Curriculum Developed With Participation of:


Life skills 1

Life Skills – 9

  • 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

Institute of Health Management, Pachod

Implementation Phase

Life Skills Course


Life skills 1

Life Skills – 10

Institute of Health Management, Pachod

Implementation Phase

Objectives of the Life Skills Course

  • Delay age at marriage for adolescent girls

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

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

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


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Life Skills – 11

Institute of Health Management, Pachod

Implementation Phase

Life Skills Course

  • 225 one-hour sessions

  • Designed for a grassroots trainer


Life skills 1

Implementation Phase

Life Skills – 12

Institute of Health Management, Pachod

Scope of Life Skills

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


Life skills 1

Life Skills – 13

Institute of Health Management, Pachod

Implementation Phase

Projects

Non-Formal Education

Community Nutrition Education

  • BCC by Adolescent Girls and Life Skills Teachers

  • School-going Girls Teach Non-school-going Girls


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Life Skills – 14

Enrolment Increased From 450 to 2000 Girls

Adolescent girls attending certificate distribution function - 2001

Institute of Health Management, Pachod

Impact Phase

Impact on Community Demand


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Life Skills – 15

Source: IHMP, 1997-2001

Institute of Health Management, Pachod

Impact Phase

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


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Life Skills – 16

Adjusted odds ratio

95% confidence interval

95% confidence interval

Adjusted

odds ratio

Variables

Variables

Mothers occupation

Working

Non-working +

Age at the time of enrolment

11-13 Yr. +

14-17 Yr.

( 1.08 - 5.42 )

2.42*

1

( 2.13 - 7.08 )

1

3.89**

Adolescent girls from

Intervention area +

Control area

Level of education

Upto Primary +

Middle & above

( 0.71 - 3.39 )

1

1.56NS

( 2.09 - 7.51 )

1

3.96**

School going status

School going +

Non-school going

( 1.35 - 6.09 )

1

2.87**

Socio-economic status

Lower +

Middle-Lower

Middle-Upper

Upper

( 0.79 - 4.04 )

( 0.85 – 3.75 )

( 0.97 - 5.33 )

1

1.79NS

1.78NS

2.28NS

Mothers education

Illiterate

Literate +

( 0.84 - 3.31 )

1.67NS

1

Institute of Health Management, Pachod

Impact Phase

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

Pseudo R square = 0.2436

+ Reference category

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


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Life Skills – 17

Institute of Health Management, Pachod

Impact Phase

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

Logistic regression

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


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Life Skills – 18

Learnt about HIV/AIDS during Life Skills course.

Insisted that prospective husband gets tested before marriage.

She made him undergo test along with herself.

Institute of Health Management, Pachod

Impact Phase

Meera Wagh:


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Life Skills – 19

Institute of Health Management, Pachod

Impact Phase

Manju - 13 Year Old Girl(Name Changed)

  • 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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Life Skills – 20

Institute of Health Management, Pachod

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


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