How can collective action between government sectors to prevent child marriage be operationalized? Evidence from a post-hoc evaluation of an intervention in Jamui, Bihar and Sawai Madhopur, Rajasthan in India

Abstract

BackgroundAlthough the need for multi-faceted and multi-sectoral approaches to address the multidimensional issue of child marriage is well-acknowledged, there is a dearth of documented experience on the process of implementing and managing such programmes.MethodsWHO evaluated a district-level, government-led multi-sectoral intervention to address child marriage in Jamui, Bihar and Sawai Madhopur, Rajasthan, implemented by MAMTA Health Institute for Mother and Child (MAMTA). We evaluated the intervention’s design, implementation, monitoring, and outputs and identified key challenges and successes.ResultsThrough actions at the state and district levels, the intervention succeeded in creating a cascade effect to stimulate more concerted action at block and village levels, with tangible intersectoral convergence occurring at the village level. The success factors we identified included an experienced partner NGO that was committed to supporting this effort, context-specific design and implementation, and a flexible and responsive approach. However, despite contributing to informal coordination between various stakeholders, the intervention did not succeed in developing a sustained joint-working mechanism at the district level. Shared ownership for prioritization of child marriage across national- and state-level sectors was not established, due in part to lack of directives transcending ministerial/departmental boundaries. Nevertheless, due to its efforts at the district-level, the intervention was able to enlist leadership from the District Magistrates and Child Marriage Prohibition Officers, in line with their duties outlined in the 2006 Prohibition of Child Marriage Act. The challenges we identified included lack of clear directives and institutional support for collaboration, obstacles to monitoring, administrative challenges, differing perspectives on strategy among district leaders, community resistance, and intervention over-commitment.ConclusionsThe findings of this evaluation reveal the potential of multi-sectoral approaches to prevent and respond to child marriage and provide insight into obstacles that affect multi-sectoral coordination. We point to actions that MAMTA could take to strengthen collaboration on this and other initiatives. We also recommend further documentation and evaluation of projects and programmes in this area.

Mapping the patchwork: Exploring the subnational heterogeneity of child marriage in India

“…Effective child marriage programmatic adaptation to local contexts requires both a detailed understanding of those contexts, as well as buy-in and effective, coordinated local partnerships ( Chandra-Mouli, Plesons, Barua, Sreenath, & Mehra, 2018 ; Jha et al., 2016 ; Lo Forte, Plesons, Branson, & Chandra-Mouli, 2019 ). These partnerships are needed at the local district level, but also as a convergence of efforts by neighboring districts and states in order to effectively address the practice of child marriage.…”

Intersectoral actions in decreasing social inequities faced by children and adolescents

“…Figure 2 -Study Selection Flowchart according to PRISMA (26) guidelines. Ribeirão Preto, SP, Brazil, 2019 As for the year of publication, the papers included were published from 2008 to 2019, though most papers were published between 2014 and 2019 (26) , with only one Appleby, et al (27) 2019 Ethiopia -----------5/**** Appleby, et al (28) 2019 New Zealand Qualitative 1/***** Barrett, et al (29) 2016 USA -----------3/***** Chandra-Mouli, et al (30) 2018 India Qualitative and quantitative 5/**** Fabbiani, et al (31) 2016 Uruguay Experience report -Qualitative 1/***** Fabelo-Roche, et al (32) 2016 Cuba Qualitative 1/***** Ferrugem, et al (17) 2015 Brazil Experience report -Qualitative 1/***** Gimenez, et al (33) 2014 Brazil Qualitative 1/***** Jones, et al (34) 2019 Australia Descriptive 1/***** Laurin, et al (35) 2015 Canada Multiple cases study -interpretative 1/***** Leite, et al (36) 2015 Brazil Experience report -Qualitative 1/***** Melo, et al (37) 2016 Brazil Case study -Qualitative 1/***** Milman, et al (38) 2018 Chile Case study 1/***** Mongiovi, et al (39) 2018 Brazil Experience report -Qualitative 1/***** Monteiro, et al (40) 2015 Brazil Action research with a qualitative approach 1/***** Moyano, et al (41) 2018 Argentina Action research with a qualitative approach 1/***** Nunes, et al (42) 2016 Brazil Exploratory descriptive study with qualitative approach 1/***** O'Malley, et al (43) 2017 USA Case study 1/***** Obach, et al (44) 2019 Chile Qualitative ethnographic 1/***** Obach, et al (45) 2017 Chile Qualitative ethnographic 1/***** Pappas, et al (46) 2008 Pakistan -----------5/***** Reader, et al (47) 2017 United States -----------1/***** Shan, et al (48) 2014 Canada Mixed 5/**** Tãno, et al (49) 2019 Brazil Exploratory survey, with triangulation of methods 5/***** Tkac, et al (50) 2017 Brazil Longitudinal, experimental 3/**** Torricelli, et al (51) 2014 Argentina Cross-sectional, descriptive, qualitative and quantitative 5/***** Woodland, et al (52) 2016 Australia Mixed...…”

What can the global movement to end child marriage learn from the implementation of other multi-sectoral initiatives?

“…Evidence shows that single sector interventions have not been effective at ending child marriage, and that coordination between relevant departments/ministries, civil society, and other stakeholders is important to ensure that interventions benefit adolescent girls 23–26…”