Impact of the CARE Tipping Point Program in Nepal on adolescent girls’ agency and risk of child, early, or forced marriage: Results from a cluster-randomized controlled trial

Girl child, early, and forced marriage (CEFM) persists in South Asia, with long-term effects on well-being. CARE's Tipping Point Initiative (TPI) sought to address the gender norms and inequalities underlying CEFM by engaging participant groups on programmatic topics and supporting community di...

Full description

Saved in:
Bibliographic Details
Published in:SSM - population health 2023-06, Vol.22, p.101407, Article 101407
Main Authors: Yount, Kathryn M., Durr, Robert L., Bergenfeld, Irina, Sharma, Sudhindra, Clark, Cari Jo, Laterra, Anne, Kalra, Sadhvi, Sprinkel, Anne, Cheong, Yuk Fai
Format: Article
Language:English
Subjects:
Adolescence
Agency
Child, early, forced marriage (CEFM)
Gender and social norms
Girl child
Nepal
Randomized-controlled trial
Regular
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Girl child, early, and forced marriage (CEFM) persists in South Asia, with long-term effects on well-being. CARE's Tipping Point Initiative (TPI) sought to address the gender norms and inequalities underlying CEFM by engaging participant groups on programmatic topics and supporting community dialogue to build girls' agency, shift power relations, and change norms. We assessed impacts of the CARE TPI on girls' multifaceted agency and risk of CEFM in Nepal. The quantitative evaluation was a three-arm, cluster-randomized controlled trial (control; Tipping Point Program [TPP]; Tipping Point Plus Program [TPP+] with emphasized social-norms change). Fifty-four clusters of ∼200 households each were selected from two districts (27:27) with probability proportional to size and randomized evenly to study arms. A pre-baseline census identified unmarried girls 12–16 years (1,242) and adults 25 years or older (540). Questionnaires covered marriage; agency; social networks/norms; and discrimination/violence. Baseline participation was 1,140 girls and 540 adults. Retention was 1,124 girls and 531 adults. Regression-based difference-in-difference models assessed program effects on 15 agency-related secondary outcomes. Cox-proportional hazard models assessed program effects on time to marriage. Sensitivity analyses assessed the robustness of findings. At follow-up, marriage was rare for girls (
ISSN:2352-8273
2352-8273
DOI:10.1016/j.ssmph.2023.101407