Empowering married young women and improving their sexual and reproductive health: Effects of the First-time Parents Project

Santhya, K.G.; Haberland, Nicole; Das, Arup; Ram, Faujdar; Sinha, Rajesh Kumar; Ram, Usha; Mohanty, Sanjay K.

doi:10.31899/pgy5.1005

Cited by 32 publications

(67 citation statements)

References 6 publications

(4 reference statements)

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“…Eight project reports [23–30] met the inclusion criteria for the systematic review. We have assigned acronyms for easy reference: FP (Promoting Healthy Timing and Spacing of Births in India through a Community-based Approach- Frontiers Program) [23], FTP (First Time Parents) [24], PRACHAR (Promoting Change in the Reproductive Behavior of Youth) [25], ACQUIRE (Mobilizing Married Youth in Nepal to Improve Reproductive Health: The Reproductive Health for Married Adolescent Couples project) [26], REWARD (Reaching and Enabling Women to act on Reproductive Health Decision) [27], MMM (Encouraging Contraceptive Uptake by Motivating Men to Communicate about Family Planning: The Malawi Male Motivator Project) [28], KEM (Reproductive and Sexual Health Education, Care and Counseling for Married Adolescents In Rural Maharashtra) [29] and FRHS (Social Mobilization or Government Services: What influences Married Adolescents’ Reproductive Health in Rural Maharashtra, India) [30] (Table 2). …”

Section: Resultsmentioning

confidence: 99%

“…Wall Paintings3. Comparison between intervention and controlSanthya et al 2008, [24] India, 2003–05, (FTP) a 1. To develop and test an integrated package of health and social interventions to improve married young women’s reproductive and sexual health knowledge and practices,1.…”

Section: Resultsmentioning

confidence: 99%

“…Of the five projects implemented in India, FTP by Santhya et al [24] was conducted in 12 villages of two districts each in the states of Gujarat and West Bengal; whereas KEM and FRHS were implemented in Maharashtra, [29, 30] covering two blocks of a district each. FP (Khan et al 2008) was implemented in one district of Uttar Pradesh [23].…”

Section: Resultsmentioning

confidence: 99%

“…MMM [28] used a 2 × 2--randomized control design in which young men either married or having a female partner less than 25 years of age were assigned randomly. Three project reports– FTP, MMM and KEM [24, 28, 29] compared baseline and end line measures in the intervention and control arms. FRHS [30] used a feasibility approach focusing on the processes and dynamics of implementation rather than on its outcome.…”

Section: Resultsmentioning

confidence: 99%

“…In other projects, this was not done. The sample selection process was not mentioned in the project reports [24, 25, 29, 30]. …”

Section: Resultsmentioning

confidence: 99%

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Community based reproductive health interventions for young married couples in resource-constrained settings: a systematic review

et al. 2015

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BackgroundMost pregnancies among adolescent girls and young women aged 15–24 years occur in low- and middle-income countries (LMICs), and do so within marriage. The mortality rates and pregnancy-related morbidities are significantly higher among the women of younger age group in many South Asian and Sub-Saharan African countries. This paper presents a review of the available evidence on the effectiveness of community-based health interventions to improve the reproductive health status of young married couples in LMICs.MethodWe carried out a systematic review of research studies and evaluation reports of different community-level initiatives in improving access to contraception, pregnancy care and safe abortion services by young married couples, where women were in the age-group of 15–24 years.ResultsOf the 14 projects, which met inclusion criteria, eight met the quality criteria and were included in the review (five from India, two from Nepal and one from Malawi). Our analysis shows that community-based interventions consisting of counseling of young married women, and their husbands, family and community members, as well as capacity building of health workers were some of the effective measures in increasing contraceptive use, delaying pregnancy and improving pregnancy care. Stratifying young women in line with their specific reproductive health needs (newly married woman, pregnant woman, mother of one/more children) was found to be a successful innovative strategy. None of these projects explicitly addressed improving access to safe abortion care.ConclusionOur review suggests that multi-layered community-based interventions, targeting young married women, their families and the health system can improve utilization of reproductive health services among young couples in resource-constrained settings. There is less focus on strategies to delay first pregnancy as compared to spacing among young women. Further, family and community level barriers in most of the project settings restricted its effective implementation. The paper emphasizes the need for further research to fill the knowledge gaps that exist about improving utilization of reproductive healthcare services, especially safe abortion care among young married women in LMICs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…In other projects, this was not done. The sample selection process was not mentioned in the project reports [24, 25, 29, 30]. …”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Community based reproductive health interventions for young married couples in resource-constrained settings: a systematic review

et al. 2015

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A Systematic Review of Adolescent Girl Program Implementation in Low- and Middle-Income Countries: Evidence Gaps and Insights

Haberland

McCarthy

Brady

2018

Journal of Adolescent Health

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Increasing attention to adolescent girls has generated an abundance of programs and a growing body of research on adolescent girls in low- and middle-income countries. Despite this, questions remain about what implementation approaches in program design are most effective, hindering efficient resource allocation, program scale-up, and replication across settings. To address these questions, we conducted a systematic review to identify lessons learned and gaps in the evidence base. We searched four electronic databases to identify studies published between 1990 and 2014 that evaluated health, social, and/or economic development programs targeting adolescent girls in low- and middle-income countries. Seventy-seven (77) studies meeting specified criteria were identified, of which 19 presented results that allowed conclusions relevant to implementation science. Studies examining the following questions were assessed: To what extent, if any, do multicomponent interventions (as opposed to single-component interventions) improve outcomes for girls? What is the added value of involving actors in addition to the girl herself such as parents, guardians, husbands (i.e., multilevel interventions)? What is the threshold proportion of girls who need to participate in a program to bring about normative and behavior changes at the community level? Is a greater level of program exposure associated with greater programmatic benefit for girls? Can supplemental "booster" activities extend the benefits of a program after it ends? We found evidence to support associations between multicomponent (vs. single component) programs, and longer program exposure (vs. less program exposure), with more favorable outcomes for girls, although both conclusions include methodological limitations. Overall, few studies assessed boosters or program saturation, and evidence on multilevel versus single-level programs was inconclusive. Few studies assessed implementation science questions by design, exposing large gaps in the evidence base. We call for future research to explicitly test such implementation science questions to inform more effective use of resources and to improve outcomes for girls.

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The Influence of Gender Attitudes on Contraceptive Use in Tanzania: New Evidence Using Husbands' and Wives' Survey Data

2013

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SummaryThis paper explores the hypothesis that gender attitude scales (which measure the degree of equity in gender attitudes) are associated with contraceptive use. Four hundred male and female respondents (200 couples) were interviewed using a pre-tested, structured questionnaire. Analyses included comparisons of means and prevalence rates on gender equity indicators, other related factors and socio-demographic characteristics; t-tests to compare mean scores on each gender scale for wives and husbands to identify any significant differences; chi-squared tests to compare associations between individual attributes, attitudes and contraceptive use; and multivariate logistic regression to examine associations between each gender scale and contraceptive use. The findings revealed that, on average, wives endorsed more inequitable gender attitudes compared with husbands on all gender attitude scales. For wives, more equitable gender attitudes were positively associated with contraceptive use. For husbands, the role of gender attitudes had no significant association with wives' reported contraceptive use. Family planning programmes that aim to challenge inegalitarian gender norms should not overlook women in their efforts since both men and women often accept and support inequality in a social system and, in some cases, it may be women's gender attitudes that most influence family planning decisions.

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Empowering married young women and improving their sexual and reproductive health: Effects of the First-time Parents Project

Cited by 32 publications

References 6 publications

Community based reproductive health interventions for young married couples in resource-constrained settings: a systematic review

Community based reproductive health interventions for young married couples in resource-constrained settings: a systematic review

A Systematic Review of Adolescent Girl Program Implementation in Low- and Middle-Income Countries: Evidence Gaps and Insights

The Influence of Gender Attitudes on Contraceptive Use in Tanzania: New Evidence Using Husbands' and Wives' Survey Data

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