Effectiveness of a community based intervention to delay early marriage, early pregnancy and improve school retention among adolescents in India

摘要

Child marriage is being increasingly recognized globally as a fundamental violation of human rights. Child marriages occur globally in varying degrees across countries and regions. South Asia alone accounted for almost half of the total number of child marriages that have occurred globally. Early marriage can lead to serious ramifications such as school drop-out, early pregnancy, maternal morbidity and mortality. The aim of this study was to assess impact of a multi-pronged community based intervention on early marriage, early pregnancy and school retention among young people in two states of India. Cross-sectional (post-test) was adopted to assess the effect of the intervention. Multi-stage sampling was adopted for the selection of a sample group of young people aged 10–24?years. A total of 1770 respondents participated in the survey, out of which 826 were males, and 944 were females. The assessment was conducted in eight districts in each of the two states. Descriptive statistics, cross-tabulation, chi square and logistic regression methods were used to analyse the data. Youth information centres (YIC) as an intervention strategy showed a significant effect towards decrease in the number of early marriages (Adjusted Odd Ratios [Adj] 2.25, CI 1.28–3.94), of early pregnancies (Adj 3.00, CI 1.06–8.43) and increase in the number of school retentions (Adj 2.96, CI 2.02–4.34). Access to mass media was also associated with reduction in likelihood of early marriages (Adj 1.79, CI 1.15–2.78), and increase in the number of school retentions (Adj 1.49, CI 1.12–1.97). We also found that there was an increase in mean age of marriage (1.2?years), of conception (.85?years) and in the mean years of schooling (1.54?years) among youth surveyed compared to their older siblings. Intervention strategies such as YIC and exposure to mass media, showed an effect in reducing early marriage, early pregnancy and improved school retention. Peer education conducted through the YIC proved to be an effective model. Therefore, this multi-component community based intervention can be a potential model for reducing the number of early marriages and its related consequences in other districts of India with similar socio-economic and cultural settings.