Effectiveness of combined interventions to empower girls and address social norms in reducing child marriage in a rural sub-district of Bangladesh: A Cluster Randomised Controlled Trial of the Tipping Point Initiative
Objectives
The study aimed to assess whether the Tipping Point Initiative, implemented as two packages (TPP and TPP+), reduced the hazard of child marriage among never-married girls aged 12–<16 years in a rural sub-district of Bangladesh. It also sought to determine whether the intensity of girls’ participation in group sessions influenced child marriage risk and to examine effects on girls’ self-efficacy, negotiation skills, gender attitudes, cohesion, collective efficacy, and community social norms related to girls’ rights and decision-making.
Findings
The cluster randomised trial found no statistically significant intention-to-treat effect of either TPP or TPP+ on the overall hazard of child marriage compared with control by endline. However, within both intervention arms there was a strong dose–response pattern: girls in the highest tertile of session attendance had a 54% lower hazard of child marriage in TPP and a 49% lower hazard in TPP+ compared with girls in the lowest attendance tertile, after adjustment for individual, household and village characteristics. High session exposure in TPP and TPP+ was also associated with modest but significant gains in girls’ self-efficacy, negotiation skills, cohesion and collective efficacy and, in TPP+, with reduced endorsement of justifying violence against girls and more positive social norms reported by adults around girls’ participation in decisions about their own marriage. These effects were achieved despite COVID-19 disruptions that reduced the planned intensity and reach of some components.
Recommendations
The authors recommend that norm-change programmes to prevent child marriage ensure high intensity and sustained participation, with designs that enable girls to attend at least 36–40 sessions. Programme implementers should prioritise strategies that support regular attendance, including scheduling, family engagement and community buy-in, because low exposure is unlikely to shift marriage outcomes. Future adaptations of the Tipping Point model should retain and strengthen elements that build girls’ agency and collective efficacy and that target community norms about girls’ decision-making, while addressing implementation challenges such as staffing and pandemic-related disruptions. They also call for further research on the full implementation of revised TPP and TPP+ packages, including cost and sustainability assessments, to inform scale-up of social norm–based approaches to ending child marriage in high-prevalence settings.
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