Preventing Early Child Marriage in Nepal
- Conditions
- Child Marriage
- Interventions
- Behavioral: Full TP interventionBehavioral: Light TP intervention
- Registration Number
- NCT04015856
- Lead Sponsor
- Emory University
- Brief Summary
This project evaluates an intervention designed to prevent early child marriage in Nepal. The intervention consists of community dialogues, activist trainings, and community organized activities aimed at transforming social norms around gender. There will be three groups within the study: one exposed to the full program, one exposed to a lighter version of the program, and one that has not been exposed to the program. The impact evaluation will consist of qualitative and quantitative methods that compare these three groups.
- Detailed Description
Each year, child marriage, before age 18 years, affects more than 10 million girls globally. The practice is associated with adverse maternal and child health outcomes and diminished long-term economic empowerment. About half of all child marriages occur in South Asia. A recent study in four high prevalence South Asian countries showed declines in girl-child marriage from 1991-1994 to 2005-2007, however, these declines were concentrated in the youngest ages. Namely, significant relative reductions occurred in the marriage of girls before age 14 years in all countries, however, little or no change was seen in the marriage of 16- to 17-year-old girls for any country except Bangladesh, where the prevalence of such marriages increased.
Tipping Point (TP) is an innovative program developed by Cooperative for Assistance and Relief Everywhere, Inc. (CARE) to change community social norms and build capacity among adolescent girls to become agents of change in their communities, with the ultimate goal of reducing the risk of child marriage.
The quantitative evaluation of the TP package will involve a three arm Cluster Randomized Controlled Trial (CRCT), where the arms are as follows:
* Arm 1: Full TP intervention including emphasized social norms change
* Arm 2: Light TP intervention without emphasized social norms change
* Arm 3: Pure control
The overall evaluation in Nepal will start with the baseline study, followed by eighteen months of interventions. After the intervention phase, there will be a one year 'freeze' period, when no interventions will take place. After that one year, the end-line evaluation study will be conducted in Nepal to assess the impact of the packages.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 2828
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Full TP intervention including emphasized social norms change Full TP intervention Participants in this study arm will receive the full TP intervention, including emphasized social norms change, for 18 months. Light TP intervention without emphasized social norms change Light TP intervention Participants in this study arm will receive the light TP intervention, without emphasized social norms change, for 18 months
- Primary Outcome Measures
Name Time Method Change in proportion of never married adolescents Baseline, Month 30 The proportion of never-married adolescents (aged under 20) in each study arm will be examined.
Change in proportion of married adolescents Baseline, Month 30 The proportion of married adolescents (aged under 20) in each study arm will be examined.
- Secondary Outcome Measures
Name Time Method Change in decision making Baseline, Month 30 Qualitative questions on gender and rights will assess awareness of rights, progressive choices, negotiation skills, and decision making of adolescent girls. Information will be collected during interviews asking open ended questions.
Change in attitudes on ASRHR among community adults Baseline, Month 30 Adults in the intervention communities will complete a 16-item questionnaire about ASRHR attitudes. Responses are given on a scale from 1 to 4 where 1 = fully agree and 4 = fully disagree. Summed scores range from 16 to 64, where higher scores indicate greater change in social norms.
Change in movement building among adolescent girls Baseline, Month 30 Qualitative questions on girl-centered movement building will assess the cohesion, solidarity, leadership and mobilization skills of adolescent girls, as well as the adolescent girls' autonomous engagement with different networks, the community and government and non-government stakeholders. Information will be collected during interviews asking open ended questions.
Change in social norms Baseline, Month 30 Qualitative questions on social norms change will assess to what extent the beliefs have shifted in the community regarding what others do in terms of gender, rights (including ASRHR) and child, early and forced marriage (CEFM) and what others expect them to do in terms of gender, rights (including ASRHR) and CEFM. Information will be collected during interviews asking open ended questions.
Change in Adolescent Sexual and Reproductive Health and Rights (ASRHR) Baseline, Month 30 Qualitative questions on ASRHR will assess the knowledge, progressive attitudes and practice of sexual and reproductive health rights among adolescent girls. Information will be collected during interviews asking open ended questions.
Change in gender attitudes among community adults Baseline, Month 30 Adults in the intervention communities will complete a 42-item questionnaire about gender attitudes. The instrument includes the domains of gender roles, roles of girls and women, manhood and masculinity, controlling behaviors, and attitudes condoning violence against girls. Responses are given on a scale from 1 to 4 where 1 = fully agree and 4 = fully disagree. Summed scores range from 42 to 168, where higher scores indicate greater change in social norms.
Trial Locations
- Locations (1)
Interdisciplinary Analysts
🇳🇵Kathmandu, Nepal