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Life Skills – 1

Life Skills – 1. Impact of Life Skills Education on Age at Marriage of Adolescent Girls Manisha Khale, Ashok Dyalchand, Kathleen Kurz. 31 st Annual GHC Conference: June 1 - 4, 2004. Institute of Health Management, Pachod. in collaboration with.

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Life Skills – 1

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  1. Life Skills – 1 Impact of Life Skills Education on Age at Marriage of Adolescent Girls Manisha Khale, Ashok Dyalchand, Kathleen Kurz 31st Annual GHC Conference: June 1 - 4, 2004 Institute of Health Management, Pachod in collaboration with International Centre for Research on Women

  2. Life Skills – 2 Community Based Intervention Study Conducted in 72 Villages of Rural Maharashtra INDIA Pachod Institute of Health Management, Pachod Institute of Health Management Pachod Project supported by Christian Aid, UK, & ICCO, Netherlands Research supported by Ford Foundation & Rockefeller Foundation

  3. Life Skills – 3 Interventions Outputs Expected Impact Outcome • Life Skills Education • Health Services • BCC: Parents and Community  Cognitive Skills Delayed Age at Marriage •  MMR •  NMR •  Abortions •  LBW •  RTIs /STIs •  TFR  Negotiation and Communication Skills  Self-esteem and Confidence  Social Approval Utilization of Health Services Institute of Health Management, Pachod Preparatory Phase Conceptual Model

  4. Life Skills – 4 Proportion of Girls Married Before Age 18 Years- Rural Aurangabad……… 81 % Source: IHMP, 1997 Proportion of Girls Getting Married Before Age 18 Years, Maharashtra Percent girls married before 18 years Source: RCH District–wise study, IIPS, 2001 Institute of Health Management, Pachod Preparatory Phase Needs Assessment - Quantitative

  5. Life Skills – 5 Reproductive Morbidity Higher in Married Adolescent Girls Compared to Adult women Health Indicator Married Adol. Girls ( 19 years) Adult Women ( 20 years) Abortions 9.2% 2.9% Domestic Violence 25.2% 15.8% Source: Female Sample Survey,IHMP, 1998-99 Prevalence of Anaemia in Adolescent Girls …. 60 % Source: IHMP, 1999 Institute of Health Management, Pachod Preparatory Phase Needs Assessment - Quantitative

  6. Life Skills – 6 Needs Assessment - Quantitative School Attendance Among Adolescent Girls Drops After Age 13 Years Institute of Health Management, Pachod Preparatory Phase Source: IHMP, 1998-99

  7. Life Skills – 7 Institute of Health Management, Pachod Preparatory Phase Needs Assessment - Qualitative • Restriction onmobility after reaching puberty • Girls haveheavy work-loadcompared to boys • Poor menstruation hygiene • Poor communicationbetween mothers and daughters regarding reproduction and sexuality • Low confidence, self esteem, decision making • Married early, attain motherhoodprior to adulthood

  8. Life Skills – 8 • Parents, Village Health Committees, Adol. Girls. • Experts – Lawyers, Social Workers, Doctors, etc. Mothers participating in planning workshop - 1999 Institute of Health Management, Pachod Preparatory Phase Curriculum Developed With Participation of:

  9. Life Skills – 9 • Initiated in: 1999 • Target Group: Adolescent girls age 11-18 years • Duration of Course: One Year • Conducted at: Village level, 1½ hour sessions • Life Skills teacher: Village woman - 7 years educ. Community based Life Skills teachers -1999 Institute of Health Management, Pachod Implementation Phase Life Skills Course

  10. Life Skills – 10 Institute of Health Management, Pachod Implementation Phase Objectives of the Life Skills Course • Delay age at marriage for adolescent girls • Improve social status through skills related to gender, legal literacy, team building, etc. • Improve health status by increasing their cognitive and practical skills in health and nutrition. • Promote self development, increase self-confidence through community and individual projects.

  11. Life Skills – 11 Institute of Health Management, Pachod Implementation Phase Life Skills Course • 225 one-hour sessions • Designed for a grassroots trainer

  12. Implementation Phase Life Skills – 12 Institute of Health Management, Pachod Scope of Life Skills 1. Social Issues and Institutions 2. Local Bodies 3. Life Skills 4. Child Health and Nutrition 5. Reproductive and Sexual Health 6. Legal Literacy / Women’s Rights 7. Vocational Training 8. Gender Sensitization

  13. Life Skills – 13 Institute of Health Management, Pachod Implementation Phase Projects Non-Formal Education Community Nutrition Education • BCC by Adolescent Girls and Life Skills Teachers • School-going Girls Teach Non-school-going Girls

  14. Life Skills – 14 Enrolment Increased From 450 to 2000 Girls Adolescent girls attending certificate distribution function - 2001 Institute of Health Management, Pachod Impact Phase Impact on Community Demand

  15. Life Skills – 15 Source: IHMP, 1997-2001 Institute of Health Management, Pachod Impact Phase Median Age at Marriage and Percent Girls Getting Married Before Age 18, IHMP Project Area

  16. Life Skills – 16 Adjusted odds ratio 95% confidence interval 95% confidence interval Adjusted odds ratio Variables Variables Mothers occupation Working Non-working + Age at the time of enrolment 11-13 Yr. + 14-17 Yr. ( 1.08 - 5.42 ) 2.42* 1 ( 2.13 - 7.08 ) 1 3.89** Adolescent girls from Intervention area + Control area Level of education Upto Primary + Middle & above ( 0.71 - 3.39 ) 1 1.56NS ( 2.09 - 7.51 ) 1 3.96** School going status School going + Non-school going ( 1.35 - 6.09 ) 1 2.87** Socio-economic status Lower + Middle-Lower Middle-Upper Upper ( 0.79 - 4.04 ) ( 0.85 – 3.75 ) ( 0.97 - 5.33 ) 1 1.79NS 1.78NS 2.28NS Mothers education Illiterate Literate + ( 0.84 - 3.31 ) 1.67NS 1 Institute of Health Management, Pachod Impact Phase After Life Skills Education - Girls Less Likely to Marry < 18 Years Logistic regression Pseudo R square = 0.2436 + Reference category * p <0.05 ** p <0.001 NS – Not significant

  17. Life Skills – 17 Institute of Health Management, Pachod Impact Phase Girls Never Attended Course, 2.6 Times More Likely to Marry Before Age 18 Logistic regression Pseudo R square = 0.1543 + Reference category * p <0.05

  18. Life Skills – 18 Learnt about HIV/AIDS during Life Skills course. Insisted that prospective husband gets tested before marriage. She made him undergo test along with herself. Institute of Health Management, Pachod Impact Phase Meera Wagh:

  19. Life Skills – 19 Institute of Health Management, Pachod Impact Phase Manju - 13 Year Old Girl(Name Changed) • Molested by a man on the road while walking home from school • Went straight to police station to lodge complaint & demanded a copy of FIR • Told police inspector she learnt about this in the ‘Life Skills’ course

  20. Life Skills – 20 Institute of Health Management, Pachod Policy Implications Policy Implications • Life Skills course of longer duration needed for empowerment of adolescent girls • Needs to go beyond reproductive / sexual health • Needs to be community based to ensure social support / approval • Programme should engage key decision makers • Replication possible in India through ICDS

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