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
Summary & Objectives
The study aimed to assess whether CARE’s Tipping Point Program and Tipping Point Plus in Nepal reduced adolescent girls’ risk of child, early or forced marriage and strengthened their agency. It tested impacts on time to first marriage and on 15 secondary outcomes capturing girls’ personal assets, intrinsic and instrumental agency, collective agency, perceived social norms and perceived discrimination in the family, using a three-arm cluster-randomized controlled trial in two districts.
Findings
Across all study arms, very few girls married during follow-up, with marriage remaining under 6 percent, and most measures of girls’ agency improved over time. However, difference-in-difference models showed no meaningful program effects on these secondary outcomes, apart from modest gains in sexual and reproductive health knowledge and group membership for the TPP Plus arm compared with control. Cox models found no impact of either program package on time to marriage. The authors suggest that low incident child marriage during the study, sample composition skewed toward less disadvantaged groups, COVID-19 disruptions and concurrent changes and programming in control areas likely diluted detectable program effects.
Recommendations
The authors recommend reassessing the Tipping Point models in contexts and subgroups with higher baseline risk of child marriage and over a longer follow-up period so that effects on marriage timing can be detected more clearly. They call for strengthening implementation fidelity and adapting delivery to shocks such as pandemics, while maintaining the focus on girls’ agency, community norm change and engagement of influential adults. They also highlight the need to pair social norms and agency programming with broader structural interventions that address poverty, schooling and gender inequalities, and to continue mixed-methods evaluations that can unpack how and for whom these approaches work in practice.
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