Evaluation of a Reproductive Health Program to Support Married Adolescent Girls in Rural Ethiopia

Annabel Erulkar, Tigest Tamrat

Abstract

Few reproductive health programs are targeted to married adolescent girls.  This study measures changes associated with a program for married adolescent girls and a parallel husbands’ program, in rural Ethiopia.  The married girls’ program provided information on communication, self-esteem, reproductive health and gender through girls’ groups.  The husbands’ program focused on non-violence, support to families, and reproductive health.  Population-based surveys were undertaken among married girls, at midterm and end line.  Outcomes of interest were husbands’ assistance with domestic work, accompaniment to the clinic, family planning use, voluntary counseling and testing (VCT), and domestic violence.  Overall, 1,010 married girls were interviewed.  Participation in the girls’ groups was associated with improvements in help with domestic work, accompaniment to the clinic, family planning and VCT.  Further improvements were recorded when both partners participated.  For example, participating girls were nearly 8 times more likely to receive VCT (OR 7.7) than nonparticipants, and more than 18 times more likely if both partners participated (OR 18.3).  While these results are promising, there were indications of selectivity bias that could have contributed to the positive results.  Programs engaging both wives and husbands can result in incremental improvements to the health and well-being of girls married early. Afr J Reprod Health 2014; 18[2]: 68-76).

 

Keywords:  Early marriage, male involvement, reproductive health, gender

 

Résumé

 

Peu de programmes de santé de la reproduction sont destinés aux adolescentes mariées. Cette étude mesure les changements associés à un programme destiné aux adolescentes mariées et un programme destiné aux  maris parallèles  en Ethiopie rurale. Le programme pour les jeunes filles mariées a fourni des informations sur la communication, l'estime de soi, la santé de la  reproduction et les sexes à travers des  groupes de filles. Le programme destiné aux  maris a mis l’accent sur la non-violence, le soutien des familles, et  la santé de la reproduction. Les enquêtes basées sur la population ont été menées auprès des filles mariées, à mi-parcours et en fin d'étude. Les résultats d'intérêt étaient l'aide rendu par les maris au travail domestique, l'accompagnement à la clinique, l'utilisation de la planification familiale, le conseil et dépistage volontaire (CDV) et la violence domestique. Dans l'ensemble, 1 010 jeunes filles mariées ont été interrogées. La participation à des groupes de filles a été associée à l'amélioration de l'aide aux travaux ménagers, l’accompagnement à la clinique, la planification familiale et le CDV. D'autres améliorations ont été enregistrées lorsque les deux partenaires ont participé. Par exemple, les filles qui ont participé étaient presque huit fois plus susceptibles de recevoir des CDV (OR 7,7 ) que celles qui n’ont pas participé et plus de 18 fois plus susceptibles  si les deux partenaires ont participé ( ou 18.3 ). Bien que ces résultats soient prometteurs, il y avait des indications de biais de sélection qui pourraient avoir contribué aux résultats positifs. Les programmes qui engagent à la fois les  femmes et les maris peuvent  aboutir à  des améliorations progressives de  la santé et du bien-être des filles qui se sont mariées tôt. Afr J Reprod Health 2014; 18[2]: 68-76).

 

Mots-clés: mariage précoce, la participation des hommes,  santé de la reproduction,  sexes

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