Towards Economic and Sexual Reproductive Health Outcomes for Adolescent Girls (TESFA)

Peer educators met with groups of married adolescent girls to provide information, lead discussions, and support group actions around savings. The girls were organised into four main groups, each receiving a slightly different intervention, in order to test the impact of the project components. One group received economic empowerment (EE) information and guidance based on an adapted VSLA model, while another learned about SRH issues. A third group received programming that combined the two, while a comparison group received a delayed version of the combined curriculum.

The peer educators were selected and trained from the community, and met once a month to discuss how to support girls and receive their own training on gender and health. They also reached out to other community members (five families each) to share their knowledge about various programme topics such as child marriage. These facilitators also led discussion and awareness dialogues in the community, including with the girls' husbands and men in the village.

In the groups, topics covered included skills such as how to stay healthy during their reproductive years, the benefits of family planning, and how to communicate and negotiate with others, including husbands. They also learned about earning and managing money, how to save, and how to make good use of earnings. This was intended to both help them better support themselves and their families, as well as increase their negotiating capacity within the household. The group meetings also provided the young women with the opportunity to develop support networks.

The programme also directly engaged the community. "In particular, community members, including village elders, religious leaders and health workers, were recruited as a part of Social Action and Analyses groups - also called 'gatekeepers.' These adults received training in areas related to the main project goals through a peer education system similar to that used with the girls' groups." The community "gatekeepers" engaged in dialogue around factors that contribute to early and forced marriage, supported the peer educators, and took action in the community. This engagement is cited as critical to the success of the programme.

A post-intervention evaluation was conducted by ICRW (See Related Summaries, below). As part of this process, ICRW and CARE Ethiopia used a Photovoice approach to enable some of the girls to document their perspectives on change. After receiving training in the mechanics and ethics of photography, 10 girls spent 5 days taking photos that reflected what they felt to be the impact of the project. The photographs were organised into 5 categories: education; burden of labour; gender roles; economic and social lives; and SRH. These are part of a travelling photo exhibit and have been published in a Photovoice booklet that includes their reflections on the photos.

Reproductive Health, Child Marriage

According to CARE, child brides have little or no have access to reproductive health information or services, and face many health problems. "They are at greater risk of sexually transmitted infections, including HIV. They face complications - and death - as a result of early pregnancy and childbearing. Further, children born to child brides are more likely to experience death, malnutrition, stunting and ongoing health problems than those born to mothers just a few years older."

Overall, the project sought to provide "opportunities for married adolescent girls - who are among the most marginalized members of society - to participate in the social, economic and political life of their families and communities." The evaluation conducted by ICRW "found that the program helped to greatly better many aspects of the girls' lives and even yielded a few unexpected, positive outcomes."