Suchergebnisse

In India, 29% of women aged 15–49 have experienced marital violence. Although crisis centres, known as helplines, exist to support those who experience violence, little is known about the experiences of women who use these services. Two rounds of surveys of 200 women who approached the government-sponsored helplines, conducted about four months apart, reveal that physical and sexual violence perpetrated by husbands and/or family members fell significantly in the inter-survey period. Women were also less likely to report suicidal thoughts and many reported a sense of economic security, happiness, self-confidence, and peace of mind. These findings underscore the importance of facilities offering women a haven in which they may learn about their options, have access to empathetic advocates, and secure support for addressing the violence they face at home.

While there are a growing number of interventions and evaluations of programmes aimed at changing gender norms and violence against women and girls, there remains a dearth of documentation outlining the challenges faced in conducting these interventions and evaluations, particularly in traditional and low literacy settings. The Do Kadam Barabari Ki Ore (Two Steps Towards Equality) programme sought to understand what works to prevent violence against women and girls in Bihar, India. This paper draws insights from process evaluation data. It describes promising features and challenges of implementation, and characteristics which weaken the potential effects of complex, community based, social sector programmes that aim to change deeply entrenched gender power hierarchies. We drew on the Medical Research Council framework for process evaluation in analysing our process evaluation data, and focus on mechanisms of impact, and factors inhibiting programme success, including contextual and implementation challenges. The paper also outlines measures that may help overcome observed challenges and areas that require modifications and/or further investigation. The programme experienced several challenges. These included contextual issues, such as the lack of leadership skills of those delivering the intervention and the gap between expected responsibilities and activities of government platforms and reality. Implementation challenges were encountered in reaching men and boys, younger women and the community at large and ensuring their regular attendance; and in maintaining the fidelity of the intervention activities. Our insights call for an evidence-supported dialogue on these challenges and how best to anticipate and address them.

In recognition of the need to reverse gender disparities, India has instituted numerous policies, laws, and programs intended to empower women and to protect women from violence. However, evidence on what works and what does not work to change notions of masculinity and femininity, reverse the widespread acceptability of marital violence at community level, and reduce women's experience of intimate partner violence remains limited in the country. The Do Kadam Barabari Ki Ore (Two Steps Towards Equality) was implemented among married women who were members of self-help groups (SHGs) and their husbands. The Population Council together with partners implemented the project in one district (Nawada) of Bihar, using the platform of self-help groups that are supported by the Women Development Corporation, Government of Bihar. This brief describes the intervention and presents the effect of exposure to it in transforming attitudes relating to gender roles; reducing marital violence experience; and enhancing agency, financial literacy, and access to social support among SHG members.

This paper reviews the evidence on sexual and reproductive health and rights (SRHR) of adolescent girls in low-income and middle-income countries (LMIC) in light of the policy and programme commitments made at the International Conference on Population and Development (ICPD), analyses progress since 1994, and maps challenges in and opportunities for protecting their health and human rights. Findings indicate that many countries have yet to make significant progress in delaying marriage and childbearing, reducing unintended childbearing, narrowing gender disparities that put girls at risk of poor SRH outcomes, expanding health awareness or enabling access to SRH services. While governments have reaffirmed many commitments, policy development and programme implementation fall far short of realising these commitments. Future success requires increased political will and engagement of young people in the formulation and implementation of policies and programmes, along with increased investments to deliver at scale comprehensive sexuality education, health services that are approachable and not judgemental, safe spaces programmes, especially for vulnerable girls, and programmes that engage families and communities. Stronger policy-making and programming also require expanding the evidence on adolescent health and rights in LMICs for both younger and older adolescents, boys and girls, and relating to a range of key health matters affecting adolescents.

This paper reviews the evidence on sexual and reproductive health and rights (SRHR) of adolescent girls in low-income and middle-income countries (LMIC) in light of the policy and programme commitments made at the International Conference on Population and Development (ICPD), analyses progress since 1994, and maps challenges in and opportunities for protecting their health and human rights. Findings indicate that many countries have yet to make significant progress in delaying marriage and childbearing, reducing unintended childbearing, narrowing gender disparities that put girls at risk of poor SRH outcomes, expanding health awareness or enabling access to SRH services. While governments have reaffirmed many commitments, policy development and programme implementation fall far short of realising these commitments. Future success requires increased political will and engagement of young people in the formulation and implementation of policies and programmes, along with increased investments to deliver at scale comprehensive sexuality education, health services that are approachable and not judgemental, safe spaces programmes, especially for vulnerable girls, and programmes that engage families and communities. Stronger policy-making and programming also require expanding the evidence on adolescent health and rights in LMICs for both younger and older adolescents, boys and girls, and relating to a range of key health matters affecting adolescents.

This paper presents an overview of key policies and government programmes intended to reduce HIV vulnerability and improve sexual and reproductive health among young people in India, and identifies the extent to which these policies and programmes have addressed the gamut of unique sexual and reproductive needs of young women and men. It also explores the extent to which programmes have been adapted to accommodate state-level differences in the sexual and reproductive vulnerability of youth; the review takes the examples of two states, namely, Andhra Pradesh, characterised by both early marriage and high HIV prevalence, and Madhya Pradesh, characterised by early marriage and low rates of HIV. The review focuses on four programme dimensions: awareness building, service provision, reducing gender disparities and developing a supportive environment.

Contraception following delivery or an induced abortion reduces the risk of an early unintended pregnancy and its associated adverse health consequences. Unmet need for contraception during the postpartum period and contraceptive counseling and services following abortion have been the focus of efforts for the last several decades. This article provides an introduction to the more focused contributions that follow in this special issue. We discuss the validity and measurement of the concept of unmet need for family planning during the postpartum period. We then present key findings on postpartum contraceptive protection, use dynamics, and method mix, followed by an assessment of interventions to improve postpartum family planning. The evidence on postabortion contraceptive uptake and continuation of use remains thin, although encouraging results are noted for implementation of comprehensive abortion care and for the impact of post‐abortion contraceptive counseling and services. Drawing on these studies, we outline policy and program implications for improving postpartum and post‐abortion contraceptive use.

Understanding factors that place minor girls at risk of being trafficked for commercial sexual exploitation (CSE) and the consequences of trafficking for their health and life-course trajectories is limited by the scattered evidence available on these issues. The role of various stakeholders in trafficking, namely, families, traffickers, and brothel owners, and the role of law enforcement agencies in preventing it are also poorly understood. Further, adequate data consolidating the responses of government and nongovernmental organizations to issues related to CSE of minor girls are lacking. There is a need, therefore, to consolidate this scattered body of evidence and to identify research and program gaps. This report presents a synthesis of available evidence on trafficking of girls for CSE in India. It sheds light on the magnitude of trafficking of minor girls for CSE, their perspectives and experiences, the factors that place them at risk, and the consequences; the perspectives and experiences of traffickers and brothel owners; and the extent to which laws, policies, and programs in India have helped to prevent trafficking of minor girls for CSE.

Drawing on data collected from a school-based study in India, this paper adds to the scant literature on the relationship between school quality and agency and attitudes of girls and boys in secondary schools; it also explores the better-researched association between school quality and academic competencies. The study was conducted among girls and boys in Class 10 in 30 government-run secondary schools in the state of Bihar. Findings show that classroom dynamics, particularly non-discriminatory treatment by teachers and their expression of gender egalitarian attitudes positively influenced gender role attitudes and awareness of health matters among girls and boys. It also influenced their academic performance.

In India, evidence is sparse regarding the demand for contraception to delay first pregnancy among married young people. Using data drawn from a study conducted in six Indian states among 9,572 women aged 15–24 who were married for five or fewer years, we explore the scope of this demand, the extent to which it has been satisfied, and, using logistic regression analyses, the factors correlated with contraceptive use to delay first pregnancy among those reporting demand. Findings confirm considerable demand for contraception to postpone first pregnancy (51 percent). Of those with demand, only 10 percent had practiced contraception. Contraception was more likely to have been practiced by educated women, those aware of family planning methods before they were married, those exposed to quality sexuality education, and those who participated in marriage‐related decisionmaking. Women who reported feeling pressure to prove their fertility were less likely to have practiced contraception.

India has expressed its commitment to ensuring a healthy, educated, skilled, and employed population through a large number of policies and programmes. Additionally, legislative measures in the area of sexual and reproductive health, youth and gender issues have highlighted the nation's commitment to addressing reproductive rights, as well as the rights of women and young people. Progress has been made: Almost all children are in school, life expectancy has increased, gender disparities in schooling and life expectancy have narrowed, maternal and infant mortality have declined, more and more couples have exercised their right to bear only the children they want, and HIV rates have fallen. At the same time, there remain many areas in which progress has been uneven, and which, if not addressed soon, will affect people's wellbeing and violate their rights. This volume synthesizes available evidence pertaining to the current situation and progress made in improving the health and population situation and realizing rights of women, men and the young, and obstacles that may have impeded progress, and outlines priority areas for action.

The recently launched Rashtriya Kishor Swasthya Karyakram (RKSK) health program seeks to enable all adolescents and youth to realize their full potential by making informed and responsible decisions concerning their health and well-being and by accessing the services and support needed to implement their decisions. To realize this vision, the RKSK framework acknowledges that the strengthening of Adolescent Friendly Health Clinics (AFHCs) and the provision of correct knowledge and information through counseling services are two of its seven critical components. As the government makes efforts to roll out the RKSK program at scale across the country, reviewing the experiences of the AFHCs established under the National Adolescent Reproductive and Sexual Health Strategy (the predecessor of RKSK) can provide useful lessons. With this in view, at the request of the Ministry of Health and Family Welfare, the Population Council conducted an assessment of AFHCs from the perspectives of adolescents and youth, and health care providers in three states in India. This report presents the findings of the assessment conducted among adolescents and youth.