Published: Wednesday 10th Oct 2012
Dr Ashok Dyalchand works at the Institute of Health Management, Pachod (IHMP) in India. IHMP has found that girls with low self-esteem are particularly vulnerable to child marriage and has been instrumental in developing new and creative ways to identify and supporting at risk children.
With 47% of girls marrying before 18, India has the 15th highest rate of child marriage in the world. Yet due to the size of its population, it is home to the highest number of child brides: of the 10 million girls who marry as children every year, it is estimated that 3 million of them live in India.
Although laws prohibiting child marriage have been in place since the 1920s, India’s size and remote rural regions make it difficult to effectively enforce these laws. High levels of poverty, ingrained traditional practices and rigid gender roles also contribute to the persistence of child marriage.
Yet these obstacles have prompted new and innovative efforts to tackle early marriage. Meet Dr Ashok Dyalchand, Director of the Institute of Health Management, Pachod (IHMP). Since the 1990s, IHMP has been conducting research into why so many adolescents are married early and how best to help them avoid this situation.
IHMP’s work with unmarried adolescent girls centres on the fact that effective ‘Life Skills Education’ and other empowerment programmes should lead to a measurable increase in self-esteem and self-efficacy. That is why the team decided to design a scale, based on the renowned “Rosenberg Scale”, to measure the self-esteem and self-efficacy of girls in rural India.
By making the scale culturally relevant to girls living in a rural setting, IHMP made some interesting findings. Tellingly, the team discovered that those girls with low self-esteem were the same girls who were at high risk of early marriage.
Using the scale means that the team at IHMP are now better able to identify and devote their energy to working with specific groups of at risk girls. They have put in place a series of empowerment projects to support girls in rural India vulnerable to early marriage, including life-skills training, educating girls about their rights, and providing counselling for those with low self-esteem.
Pioneering a similar scale, IHMP has also identified boys with low self-esteem and provided counselling to try to address their negative and often harmful gender-related attitudes and behaviours.
In addition to helping single girls vulnerable to child marriage, IHMP has, with support from MacArthur Foundation, worked with adolescent girls who are already married and their spouses.
Programmes designed by IHMP to help married adolescent girls and to address the particular needs and circumstances in which they live, resulted in a delay in age at first birth, reduction in maternal morbidity and a significant reduction in the prevalence of low birth weight babies.
Apart from the direct health benefits gained by these young brides, IHMP was also able to raise awareness in the communities on the risks of early marriage and conception. Convinced that no child marriage prevention programme can be successful without engaging parents, and that legislation to deter early marriage often results in driving the practice underground, IHMP has established a counselling programme for parents.
IHMP’s programme has proven its success on the small scale. Working in an area of rural India where around 65 % of girls are married before they reach 18, this programme is credited with delaying the median age of marriage, from 14.5 years to 17 years.
The success of approaching the issue from all sides—engaging with parents, addressing girls’ sense of self, empowering and counselling married adolescent girls—is one important lesson to be taken from this work. IHMP’s efforts to address perceptions of gender roles and self-esteem in adolescents is another important piece to the puzzle, illustrating how important it is to tackle the root of the problem as well as the practice of child marriage itself.
The challenge now lies in translating these successes to the large scale. Health programmes in India are executed at the state level, and currently there are many programmes which incorporate different aspects of IHMP’s strategy. Yet no programme provides an all-encompassing approach to deal with child marriage.
IHMP intends to encourage the adoption of this comprehensive approach not only at a local level, but at the state level in India too. IHMP describes their work as a ‘synergistic’ approach to end child marriage, and with the right support networks in place, we hope that such programmes will have the same success rate at the state level that they have had at the local level.