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					Evidence Review for Delay of Marriage and First Birth
Name of the intervention: Development Initiative on Supporting Healthy Adolescents (DISHA)
Date of Review: May 2007
1. Location and Scale
Number of villages by block, district and state names                        Population covered                                          Comments                                               Time Period (in month & year)
7 districts, 10 Blocks and 200 communities in the states of Bihar and        Approximately 30,000 to 40,000 married and unmarried Through six implementing partners                             2004-2008
Jharkhand                                                                    girls and boys aged 14-24
2. Agencies
Lead agency(ies)                                                             Other Key Agencies (Partners)                                                                  Implementing agencies
ICRW                                                                         1. Rangasutra                                               List                                                   Category of agency
                                                                                                                                         1 Alternative for India Development                    Grassroots organizations/ NGOs in
                                                                                                                                                                                                Bihar and Jharkhand
                                                                             2.DHRIITI                                                   2 Badlao Foundation
                                                                             3. Engender health                                          3 Tribal Cultural Society Social Services and Family
                                                                             (They were technical consultants for different              4. Daudnagar Organization for Rural Development
                                                                                                                                         5. CENSORED
                                                                                                                                         6.Integrated Development Foundation
3. Intervention Description
Goal /Objectives                                                             Key Strategies (5-10)/ Components                           Key Components (3-5)                                   Primary target group
1. Increase access to modern family planning and reproductive health         1. Ensuring access to reproductive health services                                                                 1. Adolescent boys and girls in the age
services for married and unmarried youth;                                    which are youth friendly                                                                                           group of 14-24 yrs
                                                                             - youth depot holders
                                                                             - health service providers trained to provide youth
                                                                             friendly services
                                                                             - referral mechanism

2. Delay marriage and childbearing among youth and strengthen the ability 2. Developing youth capacities and skills through RH
of youth—girls in particular—to make informed decisions about             information, livelihoods training, education and life skills
reproductive health matters;                                              - Peer educators
                                                                          - Youth groups
                                                                          - Livelihood skills and linkages

3. Provide youth with alternatives to early marriage through enhanced        3. Mobilizing community support for young people in
livelihoods skills and options; and                                          accessing information and services
                                                                             - mass media campaign
                                                                             - adult group formation
                                                                             - youth adult partnerships
4. Build the capacity of NGOs in Bihar and Jharkhand to promote the
reproductive health of young people by addressing the interconnected
health, economic, and social issues that are central in their lives

4. Information Sources
Publication Name                                                           Website(s)/on-line                                            Unpublished project documents                               Primary data collection
1. Development Initiative on Supporting Healthy Adolescents (DISHA) -      www.                                                 1 Partners' narrative reports                               Project Team in Delhi
Information Bulletin; November 2004
2. Adolescent Lives in Bihar and Jharkhand, India:                                                                                       2. Annual report to Donor
Insights from the DISHA Baseline Survey; September 2006

3. Improving Adolescent Lives through an Integrated Program                                                                              3. Technical support plans to partners
The DISHA Program in Bihar and Jharkhand, India ; September 2006

4. DISHA Baseline Quantitative Report: Selected Data from Project Sites,                                                                 4. Partners' Annual plan
September 2005
                                                                                                                                         5. Field trip (2004 to till date) reports (Confidential )
5. Results and Data (Part1)
                                                         Methodology                                                                     Key measures/variables                                      Output & outcome level results

Designed                                                                   Implemented                                                   see list of indicators given below                          As an ongoing project, there is only
                                                                                                                                                                                                     output data available.
Pre-post, quasi-experimental                                               Baseline                                                                                                                  1. 720 PEs in DISHA
                                                                                                                                                                                                     2. 212 depot holders
                                                                                                                                                                                                     3. 105 HSPs trained

Project monitoring system                                                  Monitoring system                                                                                                         4. 692 Youth groups
                                                                                                                                                                                                     5. 81 Adult groups (Only 3 partners
                                                                                                                                                                                                     have them)
                                                                                                                                                                                                     6. 125 livelihoods groups/ young people
                                                                                                                                                                                                     trained in livelihoods

5. Results and Data (Part2)
M&E plan (Yes/No)                                                          Internal evaluation (Y/N) & methodology                       External evaluation (Y/N) & methodology                     Key lessons learnt
Yes                                                                        No                                                            None planned
                                                                           End line evaluation will be conducted in Sep-Oct 07.
                                                                           Quantitative and Qualitative survey in control and
                                                                           intervention sites
                                                                           On-going Project monitoring through specific indicators
                                                                           and tools
6. Program Cost
Total per year                                                             Estimated cost per component                                  Estimated cost per beneficiary/unit                         Comments
Approx: 120 lakhs to implementing partners for intervention -- @20 lakhs   While exact costing is difficult to calculate/ obtain, this   NA                                                          As in all interventions which challenge
per partner per year for the 2 intervention years                          kind of intensive project involves costs for staff time,                                                                  social norms, this too required intensive
ICRW costs, baseline and end line costs are not available                  travel, IEC, training NGOs, community and health                                                                          resources for capacity building, staff
                                                                           service providers and monitoring                                                                                          and time
List of Indicators
Community mobilization                                                     Non-reproductive health
Increased community mobilization and support youth access to RH            Improve youth life skills and social capital (networks and capacity to organize, lead, mobilize, and advocate)
information and services                                                   1. Level of education
1.    Increase in adult support for youth access to                        -     Schooling (formal and NFE)
a)    RH information                                                       -     Dropout
b)    RH services                                                          2. Formation of youth groups (what is covered: leadership, networks, communication, structure)
2.    Increase in community support for                                    3. Information about government and non-government education schemes
·     Later marriage                                                       4. Youth involvement in carrying forward RH issues with in the community
·     Later child bearing                                                  5. Number of skilled/trained youth
·     Contraceptive use (spacing)                                          6. Percentage of youth involved in economic activity
·     Other RH services                                                    7. Percent of youth earning money out of economic activity
·     Schooling, life skills                                               8. Percentage of youth who know of specific economic schemes (govt and non-govt)
·     Economic options                                                     Service Providers
3. Increase in community support for adolescent groups (formed and To ensure quality youth friendly RH services
functioning groups)
3. Increase in community support for adolescent groups (formed and
functioning groups)                                                Sensitivity
Reproductive health                                                1. Percentage of youth willing to use RH services from the nearest health service providers
Knowledge level                                                    2. Increased level of sensitization of youth RH needs among service providers (confidentiality/privacy)
1.    Percentage increased among adolescents knowledge on RH       Availability & Affordability
·    Contraception (small family norm)                             3. Availability of RH related materials
·    Pregnancy and child birth                                     4. Mapping of services (who/where/geographical spread/outreach/when/how many youth avail services in a
·    STDs/RTIs/HIV                                                 month/cost of services/distance of nearest health service providers)
·    Age at marriage                                               5. Establishing of a functioning network with RH service providers

2. Increase in knowledge of where they can get RH information      6. Referral mechanism from service provider perspective and youth perspective
3. Increase in Knowledge of availability of services               7. Increase in the supply of RH services (including counseling)
Behavior level                                                     8. Percentage of trained personnel who can deliver RH services (govt./non govt)
1.Youth sharing of knowledge with his /her peer group              Continuity
2. Increase in age at marriage                                     9. Increase in the frequency of visits in a month of RH service provider(s) to the community
3.Increase in child bearing age
4.Increase in use of temporary contraceptive methods
5.Increase in service utilization
Attitudinal level
1. Ability to articulate RH need
2.Ability to identify barriers/challenges/constraints
economic constraints
partner/spousal support
familial support
3.Ability to make decisions/find alternatives
mobilizing household resources

Sponsor/Donor                  Comments
David and Lucile Packard       Bihar and Jharkhand are the
Foundation.                    intervention states for Packard.
                               This is one of several
                               interventions supported by
                               Packard on ARSH in these two

Secondary target group          Targeted the Vulnerable Comments
1. Parents of peer educators   Intervention targeted young girls   Note: The rationale for this
and young people               and boys between 14-24 years of     project evolved from an
                               rural communities, primarily from   earlier ICRW review of linked
                               BPL families of marginalized        programs in ARSH -- mainly
                               communities -- tribals, lower       linking reproductive and
                               castes and Muslims                  livelihoods intervention for
                                                                   young people. This review
2. Private health service      The program aimed at                informed and defined the
providers                      addressing gender inequities        program design conceptual
                               through strategically involving     framework for DISHA
                               boys and older men (fathers,
                               teachers, panchayat leaders) in
                               the community

Its an ongoing project

Impact level results              Quality of data and                   Key lessons learnt
                                  comments                              (share challenges or
                                                                        negative results, if
As an ongoing project, there is   1.M&E Plan is detailed/               1. addressing social taboos
only output data available.       Research rigour is evident.           around issues of gender and
                                  2.Indicators are well defined.        sexuality which influence age
                                  3.Process of data collection is       at marriage for girls -- both at
                                  systematic.                           NGO and community level

                                  4.Baseline data and monitoring        2 Health services which are
                                  data are accurate and of good         not youth friendly; have
                                  quality.                              limited temporary method
                                  5.Inadequate costing data             options -- and practically no
                                  available.                            services for unmarried youth.
                                  6.No MIS exists for quick retrieval
                                  of data
                                                                        3. Public health system is
                                                                        very inadequate in these two


Evidence Review for Delay of Marriage
Name of the intervention: Action for Slum Dwellers Reproductive Health in Allahabad (ASRHA)
Date of Review: May 2007

1. Location and Scale
Number of villages by block, district and state Population covered                                 Time Period (in month & year)
143 notified Urban Slums of Allahabad, UP       30,000 men and women in the reproductive age       April 1999 - March 2004
                                                group and 66,000 adolescents (data about magnitude
                                                of population not available)

2. Agencies
Lead agency(ies)                                   Other Key Agencies (Partners)                                                               Implementing agencies                               Sponsor/Donor
Care India                                         Kamla Nehru Memorial Hospital                             List                                    Category of agency                            USAID
                                                   Population Council                                        1 Care India                            Indian NGO
                                                   TNS mode                                                  2 Local partners

3. Intervention Description
Goal /Objectives                                   Key Strategies (5-10)                                     Key Components (3-5)                    Primary target group                          Secondary target group                        Targeted the Vulnerable
The overall goal was to improve reproductive       1. Mobilization of women, men, adolescent groups          1.Constitution of Advisory committee    Women, men and adolescent boys and girls      District level officials, Yes, it reaches out to adult men and women and adolescents
health status of adolescents and women in city     around awareness of reproductive health                                                                                                         community based           residing in slums
slums of Allahabad in Uttar Pradesh                                                                                                                                                                stakeholders and health
1. To offer a cost effective and sustainable       2. Partnering with men to attain a better involvement     2. Women Health Volunteers                                                            service providers
solution leading to better reproductive health     and results in terms of health of women
living standards for women in the slums
2. To reduce reproductive health related           3. Generate demand for quality services and               3.Male Health Volunteers
morbidity and mortality among adolescents and      improved health practices among women and men
women in slums of the city of Allahabad, Uttar     through customized and proven IEC strategy
                                                   4. Sensitize service providers to ensure accessibility,   4.Adolescent Guides
                                                   availability, and affordability of quality services

                                                   5. Meet the immediate developmental needs of the      5Group formation in the community
                                                   community especially women in order to hold their
                                                   interest in the program
                                                   6. Strengthen the women groups to manage the          6. Women Health Groups/Women
                                                   Women Health Center and to voice their needs for      Health Associations
                                                   quality services and other developmental activities
                                                   7. Proactive demonstration effect the gains of the
                                                   project to be extended to other urban areas with slum

4. Information Sources
Publication Name                                      Website(s)/on-line                                     Unpublished project documents           Primary data collection                          Comments
Integrating adolescent livelihood activities within a                                     Reports are available in soft copies    Conversation with Ex-project Manager - Ms. Geeta
reproductive health programme for Urban Slum                                                                                                         Biswas
Dwellers in India - by Population Council (2004)                                                             1. Process documentation of the
                                                                                                             project/ intervention (2004)
                                                                                                             2. Final Evaluation of ASRHA
                                                                                                             Alllahabad - Qualitative Assessment
                                                                                                             (April 2004)

5. Results and Data (Part1)
                                             Methodology                                                      Key measures/variables                   Output & outcome level results                         Impact level results   Quality of data & Comments                                     Key lessons learnt

Designed                                            Implemented                                               1. Girls’ physical mobility.             Girls in the intervention group were significantly NA                         1. The data on how the results of mid term evaluation were     1. The study report mentions that
A quasi-experimental design, was used. The          1. Using a quasi-experimental pre- and post-test          2. Girls’ skills development.            more likely to have knowledge of safe spaces, be                              2. The study done byprogram intervention is not available of
                                                                                                                                                                                                                                     used to redesign the Population Council only on the effect     while a short-term intervention
study area was divided into an experimental and     design that contrasted the experimental group with a      3. Work aspirations of girls             a member of a group, score higher on the self-                                livelihood component in the project,                           cannot alter the structure of
control area. (Integrating adolescent livelihood    comparison group of adolescents, the project              4. Gender role norms;                    esteem and social skills index, be informed about                                                                                            opportunities available to
activities within a reproductive health programme   investigated whether the intervention increased girls'    5.Reproductive health knowledge          reproductive health, and spend time on leisure                                                                                               adolescent girls, it can raise
for Urban Slum Dwellers in India - by Population    physical mobility and contact with individuals outside    among girls                              activities, than the matched control respondents.                                                                                            awareness, social skills,
Council)                                            the family; enhanced girls' skills development and                                                                                                                                                                                              knowledge of safe spaces and
                                                    sustained use of these skills; altered work aspirations                                                                                                                                                                                         group identification. To reduce
                                                    of girls and encouraged more progressive gender                                                                                                                                                                                                 deeply entrenched gender
                                                    role norms; reduced gender differentials in time use;                                                                                                                                                                                           disparities and enhance girls'
                                                    and increased girls' reproductive health knowledge                                                                                                                                                                                              ability to have a greater voice in
                                                                                                                                                                                                                                                                                                    influencing their lives, the future
                                                                                                                                                                                                                                                                                                    projects need to spend
                                                                                                                                                                                                                                                                                                    considerably more time with
                                                    2. All girls in both experimental and control areas                                                                                                                              3. The report shares the difficulties inherent in fielding
                                                                                                                                                                                                                                                                                                    participants, and with key
                                                    received reproductive health education from peer                                                                                                                                 longitudinal surveys in urban slum areas.
                                                                                                                                                                                                                                                                                                    community members, including
                                                    educators; these group sessions, with approximately
                                                                                                                                                                                                                                                                                                    parents, bank and postal workers,
                                                    20 girls per group, were held weekly for 710 weeks.
                                                                                                                                                                                                                                                                                                    and others.
                                                    Only participants who lived in the experimental area,
                                                    however, were provided with: counseling about
                                                    savings formation and livelihoods; training in
                                                    vocational skills; assistance with opening savings
                                                    accounts; and follow-up counseling and assistance

                                                    3. Livelihoods components were offered to                                                                                                                                                                                                       2. The Study Report shares that no
                                                    participating girls in the experimental areas following                                                                                                                                                                                         programme effect was found on
                                                    completion of the reproductive health sessions. Over                                                                                                                                                                                            gender role attitudes, mobility,
                                                    the course of 10 months, 19 vocational courses were                                                                                                                                                                                             work expectations, time use, or
                                                    offered, each typically lasting 12 weeks, although                                                                                                                                                                                              labor market work, likely because
                                                    some ran for several months. At least one vocational                                                                                                                                                                                            of the short duration of the
                                                    course was completed by 487 girls, and almost 80                                                                                                                                                                                                intervention, as well as the limited
                                                    per cent completed two or more courses                                                                                                                                                                                                          number of times that groups
                                                                                                                                                                                                                                                                                                    convened. (Note that group
Data collected through qualitative methodology      1. The component of the activities conducted in           1. Implementation according to plan      1. Increased awareness among large number of                                                                                                 formation was not a primary goal
(Both Focus Group Discussions and In-depth          schools was entrusted to the organization, Centre for     2. Management Information System         women and adolescents, particularly the latter,                                                                                              of this programme).
Interviews).            (Qualitative Evaluation)    Media Studies (CMS), which was given responsibility       3. NGO partnership                       evident from their visit to the D-Type Health Post,
                                                    for quantitative evaluation. It also conducted Focus      4. Project management, staff and         hospitals and Kamala Nehru Hospital to seek RTI
                                                    group Discussions (FGDs) with students in four            structure                                and other RH services
                                                    schools—two for boys and two for girls. The CMS           5. Effectiveness of the graduation       2. All voluntary workers (Traditional Birth                                                                                                  3. The girls showed interest in
                                                    also conducted Focus Group Discussions in each of         strategy including Community Action      Attendants (TBA), AWW, ANM and even private                                                                                                  opening savings accounts and are
                                                    the four population groups: (i) Adolescent boys (6        Groups (Basti Vikas Samitis-- BVS) and   medical practitioners) knew the Signs and                                                                                                    by law permitted to do so, staff at
                                                    FGDs), (ii) Adolescents Girls (5 FGDs) , (iii) Ever       Adolescent Resource Centers (ARC).       symptoms of high risk pregnancies and deliveries,                                                                                            the post office are male and
                                                    married women of 15-44 years age group (7 FGDs),          6. Key strategies and processes          safe motherhood                                                                                                                              frequently express their reluctance
                                                    and (iv) Married men (6 FGDs). This report is based       created for the project including                                                                                                                                                     to work with adolescent girls; thus
                                                    on the data collected by the qualitative assessment       activities in schools.                                                                                                                                                                programme staff had to act as
                                                    team and results of FGDs conducted by CMS                 7. Effectiveness of conducting Verbal                                                                                                                                                 intermediaries in order for girls to
                                                                                                              Autopsies of maternal deaths in                                                                                                                                                       access savings accounts..
                                                                                                              reducing the maternal deaths
                                                    2. Data collected from the community and the              8. Impact of the program the lives of    3. There was strong working relationship between                                                                                             4. Although the livelihoods
                                                    Project team members                                      people of the communities.               ANM, AWW and WHV leading to the increase of                                                                                                  programme was acceptable to
                                                    a.Project management ( 7)                                                                          regular visits of people to service centers.                                                                                                 parents and feasible to implement,
                                                     b.NGO functionaries (6) [in one meeting]                                                                                                                                                                                                       the project had only a small effect
                                                     c.Women Health Volunteers (5)                                                                                                                                                                                                                  on the behavior and attitudes of
                                                     d.Members of the Women’s Groups (2)                                                               4. A knowledge base was created in the                                                                                                       adolescent girls in the
                                                     e.Women non-members of groups [community                                                          community to support them in RH related issues                                                                                               experimental slums.
                                                    members] (4 7)                                                                                     even after the project ends.
                                                     f.Adolescent Boy Guides(5)
                                                     g.Adolescent Girls Guides( 3)
                                                     h.Members of Adolescents Groups(3)
                                                     i.Adolescents non-members of groups[Community
                                                    members] (2 5)                                                                                     5. 50 percent adolescent girls were found to be                                                                                              5. According to the report of the
                                                     j.Adolescent community members (56)                                                               bold open and confident talking about RH issues.                                                                                             study, the analysis of the
                                                     k.Male community members (66)                                                                                                                                                                                                                  livelihoods intervention indicates
                                                    l.Students (4)                                                                                                                                                                                                                                  that the project had only a minimal
                                                                                                                                                       6. A large force of trained RH programme
                                                    m.Anaganwadi Workers (2)                                                                                                                                                                                                                        impact on adolescent girls in the
                                                                                                                                                       volunteers was developed in the slums .
                                                     n.ANM ( 2)                                                                                                                                                                                                                                     experimental slum areas of
                                                     o.Traditional Birth attendants (3)                                                                                                                                                                                                             Allahabad.
                                                                                                                                                       7. ARCs providing good opportunity for a healthy
                                                     p.Key Government functionaries(11)
                                                                                                                                                       mix between boys and girls.
                                                     q.Private Medical Practitioner (1)
                                                                                                                                                       8. The graduation strategy in the form of Basti
                                                    Besides, three Adolescent Resource Centers (ARC)
                                                                                                                                                       Vikas Samitis and their registration as a
                                                    were visited and several Executive Committee
                                                                                                                                                       Federation is a great asset to the community
                                                    members of Basti Vikas Samitis (BVS) were
                                                    3. Quality of meetings was assessed through                                                        9. In school RH component adolescents could
                                                    discussion with the Women Health Volunteers                                                        clarify a lot of queries on RH
                                                                                                                                                       10. Adolescent Resource Centers gives
                                                                                                                                                       opportunity to adolescents to sit, talk and interact
                                                                                                                                                       with peer group. Besides, this place is also being
                                                                                                                                                       used and would continue to be used for vocational
                                                                                                                                                       and skill training which most of the adolescents in
                                                                                                                                                       slums need

5. Results and Data (Part2)
M&E plan (Yes/No)               Internal evaluation (Y/N) & methodology                                        Comments
                                                                          External evaluation (Y/N) & methodology
Yes                             No                                        Yes

6. Program Cost
Total per year                  Estimated cost per component              Estimated cost per beneficiary/unit   Comments
NA                              NA                                        NA
Training of volunteers
Training on livelihood skills
meetings with stakeholders

Evidence Review for Delay of Marriage
Name of the intervention: Better Life Options Program (BLP) - CEDPA
Date of Review: May 2007

1. Location and Scale
 Number of villages by block, district
         and state names                                      Population covered                                          Comments                               Time Period (in month & year)
11 states (Delhi, Madhya Pradesh, Haryana,     107,384 adolescent girls (since 1987), 60,316         Empowerment model for adolescent girls used: which       1987 - 2004
West Bengal, Assam, Maharastra,                adolescent boys (since 1987), 3000 trained program    emphasized life skills, literacy, vocational training,
Rajasthan, Gujarat, Jharkhand, Uttar           personnel working with over 260 NGOs across 11        support to enter and stay in school, education,
Pradesh and Orissa)                            states                                                leadership training
2. Agencies
             Lead agency(ies)                         Other Key Agencies (Partners)                                                     Implementing agencies                                                                    Sponsor/Donor
                                                                                                                                                                                                        Bill and Melinda Gates Foundation (supported the final impact
CEDPA                                          Aarogya (to conduct impact assessment)                List                                                     Category of agency                        assessment)
                                                                                                     1. Prerana (peri-urban Delhi) since 1989                 NGO in Delhi slums
                                                                                                     2. Bharatiya Grameen Mahila Sangh (BGMS)                 NGO in Madhya Pradesh
                                                                                                      in Madhya Pradesh since 1993                            NGO in Gujarat
                                                                                                     3. Gujarat State Crime Prevention Trust (GSCPT)
                                                                                                      in rural Gujarat since 1995
                                                                                                     These organizations were selected to be part of
                                                                                                     the impact assessment
3. Intervention Description
              Goal /Objectives                               Key Strategies (5-10)                                Key Components (3-5)                               Primary target group                                  Targeted the Vulnerable
Building the self-esteem and self-confidence   1. literacy programs                                   1.CEDPA's non-formal education curriculum is central Adolescent girls (in this study)             Yes, adolescent girls.
of adolescent girls and expanding their
choices related to marriage, and civic
participation fertility, health, vocation                                                                       to the program - two training manuals used
                                               2. post-literacy and linkages with formal education     2.The BLP approach is flexible to enable each NGO to NGO staff                                      Also a specific module for Muslim girls
                                                                                                       tailor it to the local context. It has since added an
                                                                                                       approach to reach adolescent males. This impact
                                                                                                       assessment only reviewed the intervention aimed at
                                               3. family-life education                                Mix of approaches used including:                         NOTE: Adolescent boys were added to       Also, the empowerment model aims to address gender-based
                                                                                                                                                                 later phase though this impact assessment
                                                                                                                                                                 only looked at girls.                     constraints that affect youth reproductive health programs
                                               4. livelihood interventions (vocational training)       1.Long term or integrated approach                        NOTE: BLP has evolved since this impact
                                                                                                                                                                 assessment and continues to use an
                                                                                                                                                                 approach of sub-grants to NGOs, who in
                                                                                                                                                                 turn work with smaller NGOs to implement
                                               5. age-appropriate reproductive health services, social                                                           the empowerment model
                                               mobilization through advocacy and community             2.Short term or camp approach
                                                                                                       3.School approach (classroom based)
                                                                                                       Prerana/Delhi: peri-urban slums; six-more vocational
                                                                                                       program, non-formal education (NFE) and family life
                                                                                                       education (FLE); run through main center,life education
                                                                                                       (FLE); run through main center,sub center and alumnae
                                                                                                       BGMS: Indore/MP; girls' collective, village-based
                                                                                                       center approach, residential program; village centers
                                                                                                       provide vocational training, NFE, FLE in eight-mo
                                                                                                       program; also girls village collectives.Advanced training
                                                                                                       in four-mo residential program in BGMS campus in Rau
                                                                                                       for select group for peer educators and instructional
                                                                                                       assts for village centers
                                                                                                       GSCPT: rural Gujarat: 10-month center approach
                                                                                                       focusing on vocational training and FLE and leadership
4. Information Sources
         Publication Name                                     Website(s)/on-line
Adolescent Girls in India                      CEDPA in India: Program Highlights (undated)
Choose a Better Future: An                     CEDPA: Empowering Adolescents in India: The
Impact Assessment. CEDPA, Sept 2001            Better Life Options Program. March 2006

5. Results and Data (Part1)

                                           Methodology                                                                     Key measures/variables                     Output & outcome level results                            Quality of data & Comments
                 Designed                                            Implemented
Aim of study to measure the impact of the       1.Three NGOs selected for this study. Data collected         1.Age at marriage                                   1.BLP alumnae married after 18 (37%) as       1.Efforts to maintain quality: random sampling, chi-square tests, and
BLP program on unmarried and married            through structured survey questionnaire based on the                                                             compared to control group (26%)               stratified analyses conducted in addition to routine quality data
women (age 15-26) as compared with those
                                                NHFS survey. Sample included girls who had attended the                                                                                                        checks. Also appropriate selection and training of interviewers took
not participating in the BLP.Population was
controlled for age, marital status, religion,   program from 1996-99 and a control group of young women                                                                                                        place and sample size was sufficiently large to permit statistical
residential setting.                            living in comparable areas untouched by program                                                                                                              analysis of results
                                                2.For control group, NGOs selected villages/slums with       2.Engagement in income generating activities        2.Control group are 35 per cent more likely 2.After controlling for effect of education, results indicated thatBLP
                                                approximately equal numbers to those in BLP sample.                                                              to get married under age 18 (RR ratio:      has had a significant impact on the abilities of girls to make decisions
                                                Proportion of married: unmarried girls same in control and                                                       1.35)
                                                intervention area. After sample size determined for each                                                                                                     influencing their lives, to be more mobile,and confident, to earn and
                                                control village/slum, village was divided into four sections                                                                                                   spend the money earned as they desire, and to contribute to the
                                                and one fourth sample selected from each section. Total of
                                                1693 girls (858 controls and 835 alumnae formed the study                                                                                                      community through clubs and groups. No independent external
                                                sample)                                                                                                                                                        evaluation data available
                                                                                                             3.Autonomous decision making                        3. BLP girls are 261per cent more likely to   3.The program was implemented through a large number of NGOs,
                                                4.In each NGO, young women who knew the local language                                                           make decisions on their own or jointly        and each NGO tailored the approaches to their context, so linking the
                                                were recruited and trained in survey techniques. Teams of                                                        regarding to get married
                                                data collectors were not informed that it was an impact                                                                                                        intervention outcomes to the approach is not clear. Data are lacking
                                                evaluation (to reduce bias) but thought it was a survey of                                                                                                     on the capacity building efforts with local partners. Also - not sure
                                                adolescent girls. Control group interviewed by those familiar
                                                with the program interventions. Random sampling and                                                                                                            how much investment ($$) was made to support the local partners
                                                selection done by an external agency to reduce bias                                                                                                            programs -- which has implications for sustainability and scaling up
                                                5.Aarogya (Gujarati NGO) selected to design and pre-test 4.Girls mobility                                          4.BLP girls had 36% higher probability of   4.Not clear why the impact assessment chose the three NGO
                                                the data collection tools, train data collectors, monitor data                                                        using contraceptives than control        intervention areas
                                                collection and analyze the data.6.NGOs provided list of      5.Self esteem/self confidence                        BLP alumnae are 55% more likely to.5         5.No baseline was done, so the intervention and comparison group
                                                contactable alumnae. All 269 included. Study included 2-3                                                        (RR 1.55)discuss FP with husband              were assumed to be similar for the purposes of study, but since
                                                more times unmarried as married girls to obtain the sample                                                                                                     baseline data on comparison of intervention/control characteristics is
                                                                                                                                                                                                               lacking, it limits the interpretation of results
                                                size. A simple random sample drawn from this list. An
                                                                                                             6.Fertility                                         6.BLP alumnae completed secondary             6.Since intervention was comprised of BLP alumni versus non-
                                                attrition rate of 20% was expected during data collection                                                                                                      intervention sites, the data are difficult to interpret due to the
                                                                                                                                                                 school (66%) versus the control(46%)
                                                and considered acceptable.Data collected over 6-8 week                                                                                                         selection bias in the intervention groups (e.g., girls chose to
                                                period                                                                                                                                                         participate in BLP, self-selected compliers)
                                                7.Data entered in Foxbase and analyzed with EpiInfo 6.04b 7.Child spacing                                        7.99 per cent BLP alumnae learned             7.This initiative lasted for 10 years, survey was done by same NGO
                                                software to do tests for statistical significance, and risk                                                      vocational skills compared to 22 per cent     staff - which could introduce bias in data collection despite the fact
                                                ratios, and stratified analysis. Analyses were controlled for                                                    of controls                                   that they were not told that this was a final assessment
                                                girls' education, parents' education, and parents'            8.Use of contraceptives                            8. BLP alumnae are 39 per cent more likely
                                                occupations                                                                                                      to earn than control group
                                                                                                             9.Health seeking behavior                           9.BLP alumnae twice as likely to use public
                                                                                                                                                                 transport (58% vs. 25%)
                                                                                                             10.Educational attainment

5. Results and Data (Part2)
         M&E plan (Yes/No)     Internal Evaluation (Y/N) & methodology    External evaluation (Y/N) & methodology                  Key lessons learnt                Comments
No information available      Yes (see above)                            No external evaluation data available             See above                    See above.

6. Program Cost
          Total per year             Estimated Cost per component             Estimated cost per beneficiary/unit                      Comments
No cost data available

Evidence Review for Delay of Marriage
Name of Intervention: Increasing Low Age At Marriage in Rural Maharashtra
Date of Review: ' May 2007
1. Location and Scale
Number of villages by block, district and                                     Population covered                                          Comments                             Time Period
state names
Pachod, rural Aurangabad District, and Pune Maharashtra 1. Unmarried adolescent girls ages 12-18 with a               Control appears to be a sub-sample of 198 girls          1996 - 2006
including 17 study and 18 control villages              focus on out-of-school and working girls                      that were followed for the study
                                                        2. Estimated total population in intervention and
                                                        control area between 35,000-52,000 people in each
                                                        area (see #5 below for more details)
                                                        3. 1,239 girls in the program area and 894 girls in
                                                        control area
2. Agencies
Lead agency(ies)                                               Other Key Agencies (Partners)                                                                      Implementing agencies                                                     Sponsor/Donor                     Comments
Institute of Health                                            Village Development Committees                         List                                                Category of agency                                                Rockefeller Foundation            Funded program for 10 yrs
Management Pachod                                              Parental involvement in designing the life-skills      ICRW providing technical support on research        NGO, Research
                                                               course and in choosing teachers for program            design, research tools, data analysis
                                                                                                                      dissemination of findings to policy makers in India
                                                                                                                      and in international for a

3. Intervention Description
Goal /Objectives                                               Key Strategies (5-10)                                  Key Components (3-5)                                     Quality of Data                                              Primary target group              Secondary target group
1. Delaying Age of marriage in rural Maharastra                1. Life skills models/training (see below)             1. quantitative and qualitative assessments              1. There were problems with many girls leaving the           Unmarried adolescent girls (11-17) Parents (especially fathers), and other family
                                                                                                                                                                               program and new ones joining between baseline and                                               members as well as the broader slum community
2. Reducing Anemia and Changing Dietary Behaviors              2. Nutritional behavior change communication           2. capacity building workshops                           endline. There may be bais between participating and                                            targeted for the interventions
among Adolescent Girls in Maharastra                           3. community mobilization                              3. data analysis and feedback                            non-participating girls
**Life Skills Program Objectives:                              NOTE: Parents recommended that the module on           4. monitoring systems
1. Improve the social status of adolescent girls by            sexual and reproductive health (SRH) only be offered   5. dissemination of findings at national and             2.No data presented on baseline vs. control
developing skills related to gender, legal literacy and team   to girls who had reached menarche                      international levels                                     characteristics
2. Improve adolescent girls' health status by increasing                                                              For life skills program:                                 3.Criteria for selecting the girls according to degree of
their cognitive and practical skills in health and nutrition                                                                                                                   participation in life skills course provides for selection
3. Promote self-development and increase self-                                                                        1.A year-long life skills course of 225 sessions         bias in intervention group (enrolled, high compliers)
confidence and self-esteem through involvement in a                                                                   spanning one year of five evenings a week;               and limits the interpretation of findings
community project, as well as arts and crafts                                                                         2.Course aimed at developing skills related to           4.Control group appears to be a sub-sample of 198
                                                                                                                      social issues/institutions; local bodies; life skills;   girls and no data given on data verification, drop outs,
                                                                                                                      child health/nutrition; and health                       etc., It is not clear on how age of marriage was
                                                                                                                                                                               determined in this group
4. To delay age at marriage for adolescent girls by                                                                   3.Non-formal education practicum in community            5.The logistic regression comparisons between the
achieving all of the above                                                                                                                                                     subset of girls who fully attended vs a random control
                                                                                                                                                                               probably only measured association, not causality
                                                                                                                      4.Promoting involvement in community projects            6. Selection bais limits interpretation of the data
                                                                                                                      and arts/crafts
                                                                                                                      5.Recruitment/training/placement of teachers with 7. There are not multiple sources of independent
                                                                                                                      eight years of education to teach in their home    evaluation data
                                                                                                                      For nutritional component:                         8. There are no control data on the sexual and
                                                                                                                                                                         reproductive health module
                                                                                                                      1.Monthly home visits by community-based           9. It is not clear that message recall translates into
                                                                                                                      health worker;                                     changed behaviors
                                                                                                                      2.Exhibition and nutrition demonstrations and
                                                                                                                      nutrition-related fun fairs;
                                                                                                                      3.Materials developed including cookbook on iron
                                                                                                                      rich and vitamin rich foods, stickers, flashcards,
                                                                                                                      and posters with key messages

4. Information Sources
Publication Name                                              Website's)/on-line                                              Unpublished project documents                       Comments
1.Improving the Reproductive Health of Married and  
Unmarried Youth in India,
 2.Pande et al., ICRW. 2006
3.Increasing Low Age at Marriage in Rural Maharashtra
India: Can Life Skills Interventions Effectively Raise Age
at Marriage? ICRW Update 1. 2006
4.Delaying Age of Marriage and Meeting Health Needs of
Married Adolescent Women:
Findings from India. Kurtz et al., SCN News #31. 2006

5. Results and Data (Part1)
                                                   Methodology                                                                           Key measures/variables                                    Output/outcome results                                    Impact level results                  Key lessons learnt (share challenges or
                                                                                                                                                                                                                                                                                                         negative results, if possible)
Designed                                                      Implemented                                                     1. Age of marriage for girls                        1.Girls' life skills knowledge in program areas increased            1.Between 1997-2001 median age            1.The proportion of marriages to girls under 18
1. Quasi-experimental design used to study the impact of      1.Data collected at baseline in 1998-99 using both              2.cognitive and practical skills and knowledge      1.5 to three times while insignificant change in control             of marriage rose from 16 to 17 in         dropped within whole program area, not just among
the life skills intervention                                  qualitative and quantitative methods. Bivariate and             about reproductive and sexual health                areas (depending on level of participation in program)               program areas, and proportion of          the girls who had participated fully in the life skills
                                                              multi-variate logistic regression used to examine the                                                                                                                                    marriages to girls under 18               program, suggesting broad community support for
                                                              intervention effect on age of marriage                                                                                                                                                   dropped from 80.7 to 61.8 per cent        delaying marriage
2. The main outcome of interest was the median age of         2.The life skills program was evaluated using a pre-            For the nutritional component (see Section 3        2.There was a significant increase in the probability of             2.No significant change in the age        2.Other determinants of early marriage appear to
marriage                                                      post case control study design, with random selection           above): a.Hemoglobin status b.Economic status       young girls in study getting three meals a day and in the            of marriage in control areas              be being older, being out-of-school, and having a
                                                              of units chosen for the intervention since 1997. Due            c.Consumption of iron-rich foods d.Meals eaten      frequency of eating fruit                                                                                      mother who works
                                                              to lack of birth records, girls' ages established by            in a day e.Use of lemon with meals f.Morbidity in
                                                              recall of life events                                           the past year g.Hours worked in a day h.Onset
                                                                                                                              of menses
Main Hypothesis: that a life skills program of one year       3.Two non-contiguous PHC centers were randomly                                                                      3.Qualitative interviews indicate that after attending life skills   3.Considering only the girls who          3.The studies seem to indicate that addressing
would increase the age of marriage of participants by at      assigned as control and program areas. The girls were                                                               course, girls were more confident, exhibited more self-              had participated fully in the life        gender-based constraints, involving boys and men,
least one year                                                grouped according to their degree of participation in the                                                           discipline, more independence, and influence in decisions in         skills program versus a randomly          and using community-based approaches can
                                                              course. Villages within the two PHCs were divided into                                                              the HH and influence about their own lives/marriage                  selected group from the control           strengthen youth reproductive and sexual health
                                                              smaller geographical units.Each unit comprised a
                                                                                                                                                                                                                                                       area, logistic regression analysis        programs
                                                              population of 1000-1500. The program had 35 of these
                                                              units, the control area had 36. Half of these units were                                                                                                                                 indicates that the control group
                                                              randomly chosen for the intervention (17 and 18                                                                                                                                          was four times more likely to marry
                                                              respectively). About 1200 unmarried girls in the                                                                                                                                         before 18 than girls who had fully
                                                              intervention area and 900 unmarried girls in the control                                                                                                                                 participated in the life skills program
                                                              area were tracked
A pre-post case control design was used by ICRW and           pre-post test on cognitive/practical skills given to girls                                                                                                                                                                         4.Findings suggest that community involvement and
IHMP to evaluate the life skills program                      in intervention and control areas                                                                                                                                                                                                  mobilization is effective in creating a supportive
                                                                                                                                                                                                                                                                                                 environment for youth reproductive health and
                                                                                                                                                                                                                                                                                                 changing attitudes among key decision makers who
                                                                                                                                                                                                                                                                                                 influence youth environments
                                                              IHMP interviewed 10 teachers, 87 parents and 84 girls for                                                                                                                                                                          5.IHMP approaches have been replicated/adapted
                                                              qualitative assessment to evaluate changes in girls (for life                                                                                                                                                                      as follows:
                                                              skills program)
                                                              Census data examined for 1997, 1998, 2000, 2001                                                                                                                                          4.From baseline to end line, blood        a.State government of Maharashtra and the health
                                                              from heads of all households                                                                                                                                                             testing among girls in the                directorate and UNFPA have begun offering a
                                                              To evaluate increase of age at marriage, teachers                                                                                                                                        intervention area showed that the         b.In Pune, the Municipal Corporationstate, for the
                                                                                                                                                                                                                                                                                                 similar course scaled up throughout replicated
                                                              tracked participating girls for one year after life-skills                                                                                                                               mean Hb levels increased from 5.8         nutrition program from IHMP to improve girls'
                                                              course                                                                                                                                                                                   to 9.5 gm/dl for severely anemic          nutrition and health in Pune city slums
                                                              Each study started with quantitative baseline,followed                                                                                                                                   girls, and from 8.9 to 11.2 gm/dl for     6.No data available on lessons learned from these
                                                              by a period of identifying and training field workers;                                                                                                                                                                             replication efforts by the state government.
                                                              putting monitoring systems in place; field-testing and
                                                              modifying intervention modules and finalizing the                                                                                                                                                                                  7.Dietary data was self reported.
                                                              program design                                                                                                                                                                                                                     8.No comparison of baseline vs. control
                                                                                                                                                                                                                                                                                                 characteristics presented
Nutrition intervention designed for unmarried adolescent      1.IHMP implemented a nutrition study as a community-                                                                                                                                                                               9.The effects of community involvement were not
girls (10-19) in slums of Pune city. The project started in   based intervention trial. Then of the 16 slums, with a total                                                                                                                                                                       explicitly measured
16 slums and then expanded to 27 slums in Pune and 72         of 1,000 girls served as intervention areas
villages in rural Maharashtra near Aurangabad.                Six slums with a total of 752 girls constituted the control                                                                                                                                                                        1.Intervention was in place for two years before the end
                                                              areas                                                                                                                                                                                                                              line survey, which meant that many girls had already left
                                                              2.Baseline and endline surveys (two years apart) were                                                                                                                                                                              the program and new girls had since joined, limiting
                                                              conducted to evaluate changes in dietary behavior                                                                                                                                                                                  systematic pre-post follow up of the original sample and
                                                                                                                                                                                                                                                                                                 possibly introducing biases among participating girls vs.
                                                              3.Baseline and endline hemoglobin blood counts were                                                                                                                                                                                girls who were non-participating.
                                                              taken to measure the extent of iron deficiency anemia

                                                              4.Comparisons between baseline-endline changes were
                                                              made between study and control sites

                                                             5.The baseline and endline surveys collected data on
                                                             dietary and morbidity history, anthropometric measures,
                                                             menstrual history, frequency of meals in a day, whether
                                                             lemon consumed with meals (to increase iron absorption),
                                                             consumption of locally available iron-rich foods, and
                                                             workload within the and outside the house. IHMP collected
                                                             blood samples of 803 girls and measured hemoglobin
                                                             using cyanomethemoglobin method. IHMP used logistic
                                                             regression to determine predictors of anemia, with
                                                             hemoglobin status as the dependent variable.
                                                             Independent variables included economic status,
                                                             consumption of iron-rich foods, meals eaten in a day, use
                                                             of lemon with meals, morbidity in the past year, hours
                                                             worked in a day and whether menses had started

5. Results and Data (Part2)
                   M&E plan (Yes/No)                                 Internal eval.(Y/N)/methodology                     External evaluation (Y/N)/methodology                   Key lessons learnt               Comments
Yes. IHMP monitored participant attendance and established   Yes (see above for methodology)                             None available                           See above                           See above

6. Program Cost
Total per year                                               Estimated cost per component                                Estimated cost per beneficiary/unit      Comments

Evidence Review for Delay of Marriage

Name of the intervention: Promoting Change in Reproductive Behavior in Bihar (PRACHAR)
Date of Review: May 2007

1. Location and Scale
 Number of villages by block, district
         and state names                                                  Population covered                                           Comments                                          Time Period
                                                                                                                                                                          July 2001 - June 2005
Three districts in Bihar covering 452 villages in         Total population covered: 686,803 people, 96,241
Nalanda, Nawada and Patna                                 adolescents and young couples and 100,000 parents
                                                          and other adults

                                                          1398 Dais , 447 rural medical practitioners, about 900
                                                          staff of 30 NGOs, 227 cultural team members, and 342
                                                          change agents (one female for every two villages and
                                                          one male for every four villages)
2. Agencies
                Lead agency(ies)                                   Other Key Agencies (Partners)                                                       Implementing agencies                                                     Sponsor/Donor                               Comments
Pathfinder/India                                          30 local NGOs                                               List                                         Category of agency                                      Packard Foundation        PRACHAR grew out of an earlier
                                                                                                                      Pathfinder with local partner NGOs for               19 NGO Implementing Partners (NIPs)                                       Three year project, RHEYA, funded by the
                                                                                                                      capacity building and implementation                11 NGO Training Partners (NTPs)                                            Gates Foundation
                                                                                                                                                                          NIP: hiring/managing local staff and
                                                                                                                                                                          implementing community interventions
                                                                                                                                                                          NTP: training primary target groups and
                                                                                                                                                                          street performers and community health
3. Intervention Description
Goal /Objectives                                                          Key Strategies (5-10)                                 Key Components (3-5)                      Primary target group                             Secondary target group    Target vulnerable
                                                          1. Structuring the Implementation Process                   1. Phased program implementation                    1.NGO partner staff                              Community change agents   Yes
1. Change the beliefs held by young people between        2. Partnering with local NGOs                               2. Selection/training of NGO partners               2.Adolescents and young couples                  Mothers-in-law
the ages of 12-24 regarding RH/FP, challenge              3. Capacity building of NGOs and staff                      3. Recruitment/training of change agents                                                             Fathers-in-law
traditional behavior patterns of early childbearing and   4. Community Engagement/Assessment                          4. Project launch/community mapping                 3.Newly married couples, mothers with one
inadequate spacing between children, and promote                                                                      5. Outreach to targeted populations (e.g., newly-   infant/child, first time pregnant women, first
informed and healthy reproductive behavior                5. Programs with targeted populations                       weds, adolescents)                                  time post-partum women, contraceptive
2. Change beliefs held by parents of adolescents and      6. Cultural teams and folk media                            6. Training cultural performers - folk media        users, and husbands and fathers
influential community adults about RH/FP, provide         7. Training leadership groups                               7. Outreach workshops to community members          4.At least 80 per cent of the members of
them with knowledge and education to discourage           8. Improving access to quality RH services                  8. Efforts to increase access to RH services        primary target group were reached with
early marriage of their daughters, curb the pressure      9. Monitoring, Information & Evaluation systems             through ANMs, dais, and RMP                         messages to maximize chances of changing
that they place on young couples for early                                                                            9. Use of data for program planning/management      beliefs and behavior of at least 20 per cent
childbearing, and encourage adequate spacing of                                                                                                                           of this group
subsequent children                                       Intervention Description
                                                          1. All project staff to be fully educated in RH and
                                                          sexuality and to be comfortable with this subject matter.
3. Increase the use of contraceptives among young
married couples, particularly to delay the first child    Careful screening important for success
until the mother is mature, and to space subsequent       2. All staff working in community are from that
births by at least three to five years                    community, and are known and trusted to others living
4. Enhance the capacity of 30 non-governmental            3. BCC approaches aimed to also reach parents and
organizations in Bihar to design, implement, and          other community leaders
monitor quality RH/FP programs                            4. BCC aimed at covering a critical mass to address the
5. Enhance the quality of basic maternal and child        issue of resistance in the communities
health care, reproductive health, and family planning     5. BCC tested, refined to fully address the felt needs of
services delivered by community-based traditional         the community
birth attendants (dais) and informal rural medical
practitioners (RMPs)

4. Information Sources
               Publication Name                                            Website(s)/on-line                             Unpublished project documents                           Primary data collection                           Comments
Promoting Change in the                                   Promoting Change in Reproductive
Reproductive Behavior of Youth                            Behavior (PRACHAR)
Pathfinder International's PRACHAR                        Project Brief (undated)
Project, Bihar, India,

5. Results and Data (Part1)
                                                Methodology                                                           Key measures/variables                           Output/outcome results                           Impact results                                  Quality of data                                         Key lessons learnt
                    Designed                                            Implemented                          1.Percentage increase in median interval                                                       *contraceptive use rate increased   1.Pathfinder tried to ensure rigor by designing a baseline and     1. Fear that community would be offended
Baseline: 2002; endline: 2004. Surveys             1. Districts chosen due to proximity to Patna             between marriage and first birth                  1.Built management and technical capacity in from 9.7 to 38.1 per cent in        endline KAP survey. The baseline was conducted in                  by open discussion of RH and sexuality
done in representative sample of intervention      and presence of sufficient number of NGO                  2.Percentage of women using contraception for     30 NGOs; 1,398 dais & 447 RMPs trained       three years                         2002 and Endline in 2004. Surveys were done in                     unfounded
villages, as well as one non-intervention          partners. These districts were no less needy              delaying first child
                                                                                                             3.Percentage of newlywed contraceptive            2.342 change agents selected/trained                                             representative samples of intervention villages                    2. Staff did need extensive training and
control area of Nalanda District                   than more remote areas and Pathfinder                     adopters using contraceptives from                3.227 cultural team members trained                                              and in one non-intervention/control area of Nalanda District       role play before they acquired skill and
                                                   anticipated that access and proximity would               consummation of marriage                          4.17,451 girls and 16,136 boys trained                                           Surveyors were trained for three weeks prior to interviews. They   comfort level with intervention
Baseline and endline surveys, project records,     be key to ensuring better management and                  4.Percentage of women using contraception for     5.900 NGO staff trained in RH/FP                                                 also surveyed health facilities, community services, referral      3. More intensive coverage of men
service statistics, longitudinal analysis of       monitoring of the project                                 spacing second child                              6.3022 couples attended newlywed meetings                                        agencies and contraceptive availability. In addition, an endline   should happen at start of project
project records and service statistics, pre-                                                                 5. Percentage of first time mothers using         (64% of all newlyweds)                                                           survey was done to assess the BCC strategies                       through male change agents
                                                                                                             contraception who adopt FP within 90 days of
post training test, survey of BCC effectiveness,   2. Representative samples from intervention               delivery                                          7.96 per cent of the planned beneficiaries                                       2.Other methods of measurement used in the project include:        4. NGO selection process took time:
HH survey (door to door), and assessment           villages and one non-intervention control selected        6.Percentage of youth who believe that FP to      reached with messages                                                            project records and service statistics, longitudinal analysis      desk review followed by field visits. Few
of infrastructure were part of the monitoring                                                                delay first child necessary & safe                8.70 per cent targeted population had                                            of project records and service statistics, and pre-post            organizations had experience in RH/FP
and evaluation systems design                      3. Community based interventions were organized           7.Percentage adults who believe that FP to        undergone some training                                                          training tests                                                     and less in working with adolescents
                                                   around clusters of 20-30 villages, each with a            delay the first child necessary and safe          9.92 per cent of primary target audience                                         3.Major focus on working with local NGOs, but no indicators        5. Progress achieved in just 18 mnths/District
                                                   population of about 35,000. Clusters were                 8.Percentage youth who believe that early child   groups recalled receiving BCC messages                                           on the capacity built in these institutions to continue these      6. NGO selection can be limited due to lack
                                                   subdivided into groups of 100,000 and then                bearing is injurious to health of mother          10.44 per cent could correctly explain all of                                    types of interventions (beyond training numbers)                   of suitable partners
                                                   further sub-divided into units of 2000-2500               9.Percentage of adults who believe that early     the seven issues promoted                                                        4.No external independent evaluation data available                7. Oversight important for selection criteria
                                                   people. Every two to three villages represented a Field   childbearing is injurious to health of mother     11.Percentage of population (all                                                 5.No data on the second phase of PRACHAR to assess                 for the community change agents
                                                   Unit. This allowed for careful planning,                                                                    respondents) who believe that contraception                                      the sustainability of PRACHAR phase 1                              8. Selecting/hiring change agents and
                                                   implementation and follow up of interventions                                                               is both necessary and safe increased from                                        6.No information on the characteristics of the baseline and        building their capacity in RH/FP was
                                                                                                                                                               38 to 81. Among adolescents, this figure                                         control areas                                                      time-intensive and required a lot of input
                                                   4. Surveyors trained for three weeks                                                                        increased from 45 to 91                                                          7.No information on the actual numbers surveyed (n)                and oversight. How sustainable is this?
                                                                                                                                                               11a. Interval between marriage and first birth                                   8.No information on the comparability of the one non-              9. PRACHAR had major focus of broad-based
                                                   5. 311 respondents surveyed on BCC in all                                                                   for newlyweds increased from 21 months to                                        intervention control area of Nalanda District to the other         capacity building of NGO partners, to
                                                   three districts in endline survey                                                                           24 months                                                                        sites in terms of characteristics and also the intervention        strengthen both technical/management
                                                                                                                                                               12.Percentage of newlyweds who use                                               itself (since this evolved over time)                              skills. Data provides information on training
                                                   4. Monthly review of project records to track                                                               contraception to delay their first child went up                                 9.No discussion on the specific methodologies used for the         programs, but none on the sustainability
                                                   planned activities/coverage/staff training                                                                  four times from five to 20                                                       baseline and endline: selection of surveyors, tests                and overall effectiveness of this effort.
                                                                                                                                                               13.Percentage of newlywed adopters who                                           of significance on the findings, populations surveyed,             10. ANMs did not visit villages, and NGOs
                                                   5. A monitoring system tracked frequency and                                                                began to use contraception within three                                          making it difficult to assess data quality                         set up monthly MCH clinics to meet
                                                   effectiveness of project activities and                                                                     months of consummation of marriage                                               10.Effectiveness of the cultural teams not assessed though a       demand for services. At project end, ANM
                                                   interventions, and events such as births,                                                                   increased from 0 to 21                                                           lot of emphasis was placed on this intervention                    would attend about 50 per cent of these clinics,
                                                   deaths, marriages, pregnancies, and                                                                         14.Percentage of first-time parents who used                                     11.For some of the indicators, no information given on the         but limit services to immunization. NGOs
                                                                                                                                                               contraception to space their second child                                        non-intervention/control site, so unable to draw conclusions       provided other health services like
                                                                                                                                                               increased from 14 to 33                                                          for these                                                          pre-post natal care, and FP counseling

5. Results and Data (Part2)
             M&E plan (Yes/No)                     Internal eval (Y/N) & methodology                         External eval (Y/N) & methodology                             Key lessons learnt                             Comments
Yes                                                Yes                                                       No external evaluation available                  See above                                          See above

6. Program Cost
                Total per year                              Estimated cost per component                       Estimated cost per beneficiary/unit                              Comments
                                                                                                                                                               The average annual cost of the
                                                                                                                                                               communication intervention area was
                                                                                                                                                               Rs 8.00 to 9.00 lakhs. Each NGO had 23
                                                                                                                                                               staff, a Project Manager, an Accountant,
                                                                                                                                                               three supervisors, 12 female change agents,
                                                                                                                                                               six male change agents. Pathfinder also
                                                                                                                                                               hired training organizations to travel to the
                                                                                                                                                               field and carry out the training programs.
                                                                                                                                                               This was an extra cost


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