Each year, 12 million girls are married before the age of 18, marking the start of their lives as wives and mothers well before they are...
TESFA’s goal is to improve economic, and sexual and reproductive health outcomes for ever-married adolescent girls in Ethiopia. CARE Ethiopia and its partners implemented the program, and the International Center for Research on Women (ICRW) evaluated it. TESFA relies on peer-education within small group settings modeled on CARE’s village savings and loans (VSLA) approach. Community support is provided by groups of 20 to 30 community members, who meet once a month to discuss how to support girls and receive their own training on gender and health. They also reach out to other community members (five families per SAA member) to share their knowledge about various program topics such as child marriage.
The project works through four programmatic arms: 1) economic empowerment only, teaching saving and loans, negotiation skills, financial literacy and income generation; 2) sexual and reproductive health only, teaching negotiation, anatomy and personal sexual health, which health services are available where, addressing gender-based violence, and the benefits of contraception; 3) economic empowerment with sexual and reproductive health; and 4) a delayed implementation arm that will act as a comparison group. In all four arms, girls are organized into support groups in a structure modeled on CARE’s VSLA model.
The project results were impressive. Program participants stopped 180 child marriages, girls' savings went up by 72 percentage points, girls were more likely to be able to discuss family planning decisions with their husbands, and 96% of participants would recommend the program to a friend.
Many girls at baseline did not even know the mechanics of sex, reproduction and pregnancy. One- quarter reported their husbands had physically forced them to have sex, i.e., engaged in marital rape, in the 12 months prior to the survey. The area faces severe shortages of contraceptive methods as well as a lack of knowledge among girls and others in the community of any contraceptive method except injectables. Condoms are heavily stigmatized, as they are associated with HIV prevention, not contraception, and specifically with sex work and extra-marital sex. Because child marriage is illegal, there was concern about whether married adolescents would participate in the project, but with close collaboration and trust building on the motives of the project with community groups (gate keepers) finding participants and engaging them with project activities was made possible.
Findings indicate increases among project participants in correct knowledge about contraception, use of contraceptives, use of reproductive health services, support for using contraception and ability to negotiate contraceptive use with husbands. Preliminary findings also indicate sharp increases in economic activity, greater confidence in ability to deal with economic crises and increased ability to negotiate with husbands about earning money. Some of the unanticipated benefits that have emerged based on the qualitative and monitoring data include significant increases in couple communication, changed views about women’s roles in society and best age for marriage, girls going back to school and the direct prevention by community members of at least 180 child marriages. Girls, often invisible to the community because they are home doing chores, have gained more recognition and visibility. The SAA groups have resulted in the community’s greater support for girls, and girls with problems seek help from the groups.