For Immediate Release:	July 18, 2008
For More Information:	Sandra Bunch, The International Center for Research on Women (ICRW), sbunch@icrw.org, (202) 742-1240
Sponsor Organization:	International Center for Research on Women
Results show gradual shifts in attitudes on reproductive health and child marriage in two of India’s most impoverished states
WASHINGTON, D.C., July 17, 2008 – Critics contend that a holistic approach to improving youth’s reproductive health – one that focuses on social, economic and cultural systems as well as health care – takes too much time and costs too much money to be practical at a national level. But new findings from the International Center for Research on Women (ICRW) suggest otherwise. A two-year integrated program in 176 villages in Bihar and Jharkhand, India, resulted in significant changes in youth’s actions and decisions, including a nearly 60-percent increase in modern contraceptive use and an increase in age at marriage of nearly two years. The program also showed a gradual shift in attitudes and understanding of sexual and reproductive health among the participants. And some girls experienced greater independence in traveling outside their villages to seek health services. “More than 30 years of ICRW research finds that we will not make progress against poverty and many health problems until we address the inequalities and social restrictions that prevent many young women and men, girls and boys from taking action for themselves,” says Anju Malhotra, ICRW vice president, social and economic development. “Over the years, we’ve learned how to address these realities in an effective way within communities,” she says, “but it’s been less clear how to take these successes to scale to improve national policies and programs. Our results today point a much clearer path to at-scale success for sexual and reproductive health efforts that target youth.” The Program: Development Initiative Supporting Healthy Adolescents (DISHA) ICRW and six local partners implemented the program, Development Initiative Supporting Healthy Adolescents (DISHA), aimed at delaying age at marriage and childbearing among youth – more than 5,000 youth, ages 10 to 24 – in the Indian states of Bihar and Jharkhand, two of the country’s least developed states. Adolescents in India, particularly girls, face significant challenges to their reproductive health. The program, funded by the David and Lucile Packard Foundation, employed multisectoral activities that focused on expanding youth’s access to reproductive health services and information and economic opportunities while addressing the socio-cultural and economic factors that often limit youth’s – especially young women’s and girls’ – choices and actions. The two target states – priority states in India for the Packard Foundation – were marked by high rates of poverty, child marriage and early childbearing; poorly functioning public health systems; and conservative social norms. Despite these challenges, the program revealed remarkable progress. • Age at marriage increased by nearly two years to just shy of 18. • Contraceptive use among youth increased by nearly 60 percent. • Youth exposed to DISHA were 14 percent more likely to know the legal age at marriage for girls than those who were not. • Youth exposed to DISHA were 17 percent more likely to know where to access oral contraceptive pills than those who were not. • Adults exposed to DISHA were 7 percent more likely to feel girls should wait until they are 18 or older to marry than those who were not. • Girls exposed to DISHA were 60 percent more likely to be able to travel unaccompanied outside the village to seek health service than girls who were not. . Community Programs May Be Cost-Effective The DISHA program also offers important insights on how to implement large-scale integrated programs in India and elsewhere, according to ICRW. The research found that the best results stemmed from intensive, individualized activities, which also tend to be the most expensive per capita. The more generalized, community-level activities – which tend to be less expensive per capita – also saw improved sexual and reproductive health outcomes, especially in communities that had few to no prior programs that dealt with these health issues. “The takeaway here is that in villages first grappling with ways to improve the health and well-being of their youth, community-level programs may be a smart strategy, especially when resources are limited,” Malhotra says. Based on its research, ICRW recommends that national policymakers, donors and program designers invest in implementing and evaluating larger-scale integrated programs to improve youth sexual and reproductive health outcomes. “Approaches that seek to improve only one aspect of youth’s lives,” Malhotra says,” are not likely to have a lasting impact on young people.” The International Center for Research on Women (ICRW) is a leading Washington, D.C.-based international research organization that works to advance gender equality, empower women and fight poverty. Learn more about ICRW and its work at http://www.icrw.org. ###