Heterogeneous Impacts of Interventions Aiming to Delay Girls' Marriage and Pregnancy Across Girls' Backgrounds and Social Contexts

Purpose: Despite many programs aiming to delay girls' marriage and pregnancy over the last 2 decades, there is no consensus yet concerning the effectiveness of different approaches and the contexts in which they are implemented. We focus on different social contexts within Bangladesh and Zambia and investigate how literacy, poverty, and community characteristics impact the effectiveness of interventions. Methods: We utilize data sets from two randomized controlled trials conducted by the Population Council in Bangladesh and Zambia. Within each respective country, we estimate the impacts of the interventions on marriage and pregnancy among adolescent girls using the analysis of covariance estimator by different social contexts based on community-level variables. Results: In Bangladesh, providing academic skill training had a significant impact on discouraging child marriage in the villages where girls' paid-work participation rate was relatively high, whereas in low paid-work participation villages, providing gender-awareness skill training had an impact. In Zambia, providing empowerment intervention and safe spaces had a significant impact on delaying pregnancy especially for illiterate girls in the communities where premarital sex was relatively common. Conclusions: In Bangladesh, where girls' paid-work participation is limited, premarital sex is uncommon, and marriage is subject to collective decision-making; the effectiveness of a program may depend on girls' agency and the availability of acceptable working opportunities. In Zambia where premarital sex is common, pregnancy may precede marriage, and marriage entails the nature of individual decision-making; empowering the most vulnerable girls seems to be more effective in delaying marriage/pregnancy. (C) 2021 Society for Adolescent Health and Medicine. Published by Elsevier Inc.

Automated summary

Despite various programs aimed at delaying girls' marriage and pregnancy in the past 20 years, there is still no consensus on the effectiveness of different approaches. This study focuses on the impact of interventions in different social contexts in Bangladesh and Zambia, where factors such as literacy, poverty, and community characteristics play a role in determining the effectiveness of the interventions. The results show that the effectiveness of interventions varies depending on the specific social context, such as girls' paid-work participation rate, prevalence of premarital sex, and decision-making processes regarding marriage in the communities.