IMAGINE: Inspiring Married Adolescent Girls to Imagine New Empowered Futures

Adolescent Health

The IMAGINE program was designed and tested to help married girls (ages 15-19) in Niger and Bangladesh delay their first pregnancy. By providing access to alternative life paths, the program aimed to improve health and economic futures for these young women.

Background: Child marriage and adolescent pregnancies

In low-income countries, 90% of adolescent pregnancies occur among married girls. However, development initiatives often fail to reach this group. When girls can delay their first birth until they are older, they are more likely to have healthy pregnancies, finish their education, and find economic stability. Despite these benefits, many girls face restrictive social norms that prevent them from making their own choices around having children.

The IMAGINE approach

The program used a comprehensive method to support girls across different areas of their lives:

  • Strengthening skills and agency: Girls joined collectives to build personal assets and gain self-determination to pursue their own goals.
  • Engaging families and communities: The program worked with husbands and community groups to shift social beliefs that reinforce early childbearing.
  • Creating economic opportunities: Participants received vocational training to make futures outside of early motherhood possible and accessible.
  • Improving health systems: CARE trained healthcare workers to provide high-quality, adolescent-friendly family planning services.

of adolescent pregnancies in low-income countries are to married girls

Program achievements

The final evaluation showed significant progress in how girls accessed health services and engaged their local economies.

  • Health service use: In both Niger and Bangladesh, the program significantly increased the frequency with which girls visited health facilities, their ability to participate in income-generating activities, and the frequency with which they discussed family planning with health workers.
  • Contraceptive use in Niger: Current use of modern contraception was nearly double in the treatment group at 24.7% compared to the control group at 13.6%.
  • Improved knowledge: In Bangladesh, participants showed much greater knowledge of pregnancy risks and income generation, as well as increased awareness of common myths about family planning.
  • Self-determination and agency: In Niger, girls reported greater confidence in visiting health clinics and starting economic activities.
  • Economic results: The program led to substantial improvements in Niger on girls’ savings, asset ownership, and participation in vocational training.

The impact of IMAGINE

Most health programs focus on either preventing child marriage or helping adult women. IMAGINE filled a critical gap by specifically supporting girls who are already married and by addressing social norms that restrict girls’ decision-making. While powerful social pressures to have large families persist, IMAGINE proved that targeted support can increase a girl’s ability to seek healthcare, earn income, and plan her own future.

Resources

Peer-reviewed: Understanding individual, family and community perspectives on delaying early birth among adolescent girls: findings from a formative evaluation in rural Bangladesh

Researchers examined the underlying social, individual and structural factors influencing married girls’ early first birth and participation in alternative opportunities (such as education or economic pursuits) in Bangladesh.

Read the report on BMC Women's Health

Peer-reviewed: “It is a thing that depends on God”: barriers to delaying first birth and pursuing alternative futures among newly married adolescent girls in Niger

In July of 2017, researchers conducted in-depth interviews with a non-probability sample of community members in three communes of Zinder Region, Niger.

Read the report on NCBI