Age at marriage, women’s education and mother and child outcomes in Bangladesh

Publication Details

Field, E, Glennerster, R, Nazneen, S, Pimkina, S, Sen, I and Buchmann, N, 2017, Age at marriage, women’s education and mother and child outcomes in Bangladesh, 3ie Grantee Final Report. New Delhi:  International Initiative for Impact Evaluation (3ie).


Link to Source
Author
Erica Field, Rachel Glennerster, Shahana Nazneen, Svetlana Pimkina, Iman Sen, Nina Buchmann
Country
Bangladesh
Region
South Asia
Sector
Health Nutrition and Population
Subsector
Primary Health- including reproductive health
Gender analysis
No
Equity Focus
None specified
Evaluation design
Randomised Control Trials (RCT), Mixed Methods, Others
Status
3ie Final Grantee Report
3ie Funding Window
Open Window Round 1

Synopsis

Adolescent girls in Bangladesh lack the ability to influence key decisions on their marriage and family planning, drop out of school at high rates and experience poor health. This study used a randomised controlled trial design to examine alternative strategies to reduce child marriage and increase girls’ education in rural Bangladesh.

Context

In Bangladesh, as in much of the developing world, early female marriage—defined as marriage before the age of 18—remains widespread despite several efforts taken, including ‘age of consent’ laws banning the practice, government and NGO efforts to curtail it, increasing education levels, and economic growth. Early marriage is highly correlated with low levels of education, access to resources, mobility, and ultimately, poor health outcomes for young women and their children.

Despite the fact that the legal age of marriage is 18, the Bangladesh Demographic and Health Survey shows that 59 per cent of women between the ages of 20–24 were married before 18. About 31 per cent of adolescents aged 15–19 years were giving birth to children. This number is higher in rural areas (32%) than in urban areas (27%). These adolescent mothers face greater health risks associated with lower age of first birth, higher fertility rates, and shorter birth spacing. Against this background, the present study was designed to shed light on the most effective ways to empower adolescents and improve maternal and child health.

Research questions

  1. What are the impacts of girls’ education, age of marriage, and control over resources on adolescent, maternal, and child health, and health service utilisation?
  2. What is the effect of conditional in-kind transfers on female marriage age, marriage outcomes, and health and well-being of girls and their children?
  3. Which elements or combinations of programmes are most effective in empowering adolescent girls?

Methodology

In Bangladesh, as in many developing countries, early female marriage (before age 18) remains widespread. Early marriage is highly correlated with low levels of education, access to resources, mobility and, ultimately, poor health outcomes for young women and their children. This study evaluates a programme implemented by Save the Children (USA) to identify effective and efficient strategies for empowering girls and delaying adolescent marriage. The evaluation employs a cluster-randomised design, in which 460 rural villages spread across five subdistricts in southern Bangladesh were randomly assigned to either one of four treatments or a comparison group. The treatments include (a) a basic literacy package, (b) a livelihood package with additional support to help girls pursue current and future savings, (c) a full package, which includes the livelihood package, along with a direct incentive of 4 litres of cooking oil every 4 months on the condition that the girls remain unmarried; and (d) a delayed marriage package, which provides only a nutritional incentive to delay marriage. Within each village, approximately 20 households will be surveyed. In total, the study involves 45,000 adolescent girls between the ages of 10 and 17. Baseline data, for a subset of girls in the communities, was collected in 2007, and this study will follow the same cohort of adolescent girls at the time of programme completion (2011), as well as 3 years later (2013), as they marry and have children. Data for the midline and endline surveys will be collected in personal interviews. As for the baseline survey, within each household a household head, as well as all adolescent girls (married as well as unmarried) aged 10-17, will be interviewed. If any of the previously unmarried girls have been married off, the head of the in-laws household will also be interviewed.

Intervention design

Researchers evaluated the impact of an empowerment training programme and a financial incentive programme to reduce child marriage in rural Bangladesh. The girls’ empowerment programme, called the Kishoree Kontha (KK) comprised of two interventions for girls aged 10-19 years. The first intervention was made up of three components: community mobilisation, education and social competency. A second intervention, financial and livelihood competencies training, was layered on top of the first intervention in some communities, and aimed to enhance the ability of adolescent girls to generate their own income, take advantage of microcredit opportunities, and manage their own resources effectively.

A random sample of these communities was selected to receive an additional intervention designed to promote savings through savings groups. The savings intervention was introduced approximately halfway through the roll out of the programme.   

The conditional financial incentive programme used the existing setup of another Save the Children programme in the area, Jibon-O-Jibika (a food security and livelihoods programme implemented in the target areas). The incentive was an in-kind transfer designed to encourage parents not to marry their adolescent daughters before the legal age of consent (18). The proposed oil incentive included four litres of cooking oil, delivered to girls three times a year for an approximate value of US$16 per year per girl (2008 USD) or US$18 per household (2008 USD). Cooking oil was chosen because it is valued by households and because of its high monetary value per ounce of weight and the therefore low distribution costs.

Theory of change

Interventions that ensure higher awareness, knowledge, negotiation skills, decision-making power and healthcare utilisation would increase age of marriage, increase education, improve financial resources; with further impacts on income, women and child health.

Evaluation design

A clustered randomised trial was run in collaboration with Save the Children USA’s Bangladesh office between January 2007 and September 2015. Out of a sample of 460 target villages, 307 villages have been randomly selected to receive one of four intervention packages. The remaining villages will serve as the comparison group. The four intervention packages: A basic empowerment package; a financial literacy package which includes components of the basic package; a full package including the oil incentive; and only oil incentive package. In communities randomised to receive the empowerment programme, all girls aged 10-19 were eligible to take part in any of the four cycles that ran between December 2007 and August 2010. In financial incentive communities, girls aged 15-17 at programme launch were eligible to receive the financial incentive every four months from April 2008 to August 2010 until the age of 18 if they remained unmarried. In all study villages all households with girls aged 15-17 at programme launch were resurveyed 1.5 years after programme completion (January 2011 to March 2012) and 4.5 years after programme completion (May to September 2015).

Main findings

The study found that the financial incentive reduced the likelihood of being married under 18 by 21 per cent. Girls who were 15 at programme launch in the incentive only group are 18 per cent more likely to be in school. The incentive to delay marriage also reduces the likelihood of having given birth by 5 per cent  and the likelihood of having given birth before age 18 by 6 per cent. There are no separate or additional effects of the empowerment programme on age at marriage, schooling and reproductive health outcomes. Whereas much of the recent policy focus has been on empowerment programmes for adolescents, the present study shows that non-cash transfers conditional on marriage and targeted to the families of adolescent girls in a setting with a high rate of adolescent marriage are not only more effective but also more cost-efficient in delaying the marriage of participants. In addition, the results suggest that delaying adolescent marriage leads directly to large increases in school enrollment. The evidence provided by the study on intermediate empowerment outcomes is mixed and a further evaluation will be conducted by the study team in 2019.

Policy influence

The research team engaged extensively with key health sector players in Bangladesh to keep them apprised of the study findings.  Team members were recently invited to participate in the technical committee to contribute to the formulation of Bangladesh’s National Adolescent Reproductive Health Strategy. Findings from the evaluation will likely inform the strategy, which will be included in the next health sector plan and target both adolescent health and youth development.

The principal investigators (PIs) on this study are also working with the Copenhagen Consensus Center to make sure that the results from this impact evaluation are incorporated into the recommendations of a high-level panel in Bangladesh. The panel, which includes economists, Bangladeshi policymakers and representatives from prominent research institutions in the country, is seeking evidence-based solutions for Bangladesh’s problems and has focused on child marriage as one of the issues.

Additional publications

About this impact evaluation

Website: http://www.savethechildren.org/countries/asia/bangladesh.html

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