Child Marriage, Secondary School Entry and Completion
Conditions
Keywords
adolescent girls, female sex work, age at marriage, retention in school, sexual debut, India, Karnataka
Brief summary
This cluster Randomised Control Trial is evaluating an intervention to support adolescent girls from marginalised communities in northern Karnataka State, South India to complete secondary school, thereby reducing their vulnerability to HIV infection from early marriage and entry into sex work at young ages. The intervention will test innovations to address both supply and demand side barriers to girls' completion of secondary school, and will have long-term educational and livelihood benefits, in addition to reducing vulnerability to HIV. School-based constraints will be addressed by improving academic outcomes through teacher training and academic support to students; addressing gender-related and skill-based gaps among teachers; training of local female teachers; and increasing the content knowledge of secondary school teachers. Demand side barriers will be addressed by reducing economic pressures that households face to withdraw girls' from school; building appreciation and value of girls' education; building family and community accountability for school attendance; creating safe spaces for girls and strengthening their agency; and engaging boys in promoting and supporting girls' education. Primary stakeholders will include teachers and students, especially adolescent girls in the school (7th to 10 the standard) from marginalized communities. Secondary stakeholders will include school development and management committees (SDMCs), families, boys and the communities that are served by the schools. 80 village clusters (40 intervention; 40 control) were randomly selected from 125 village clusters in Bagalkote and Vijayapura districts. The intervention will be implemented with village communities and high schools in 40 village clusters in Bagalkote and Vijayapura districts. The intervention will be implemented in collaboration with the Department of State Educational Research and Training (DSERT), Karnataka; the Adolescent Education Cell, Government College of Teachers' Education (CTE), Jamkhandi; and the Institute for Advanced Studies in Education (IASE), Gulbarga.
Interventions
BEHAVIORALMulti-level, structural and norms-based intervention
Receive multi-level, structural and norms-based intervention
Sponsors
University of Manitoba
London School of Hygiene and Tropical Medicine
Karnataka Health Promotion Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
13 Years to 15 Years
Healthy volunteers
No
Inclusion criteria
* Adolescent girls in Standard 7
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Completing Secondary School [Sit 10th Standard Exam] | May-August 2016 (cohort one) and May-August 2017 (cohort two) | This outcome will be assessed using data collected from all study participants at end-line, using the face-to-face questionnaire. |
| Number of Participants Married [by Trial End Line] | May-August 2016 (cohort one) and May-August 2017 (cohort two) | This outcome will be assessed using data collected from all study participants at end-line, using the face-to-face questionnaire. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Married and Co-habiting With Husband [by Trial End Line] | May-August 2016 (cohort one) and May-August 2017 (cohort two) | This outcome will be assessed using data collected from all study participants at end-line, using the face-to-face questionnaire. |
| Number of Participants Entering Into 8th Standard [Start Secondary School] | March-May 2014 | Due to delays at the start of the cluster-Randomized Controlled Trial, the intervention had not started when cohort one girls were interviewed. This outcome will be assessed using data from cohort two girls only, using the face-to-face questionnaire. To reduce recall bias, we will use data collected at the first interview (baseline) to measure this outcome. |
| Number of Participants Passing 10th Standard [Pass 10th Standard Exam] | May-August 2016 (cohort one) and May-August 2017 (cohort two) | This outcome will be assessed using data collected from all study participants at end-line, using the face-to-face questionnaire. |
| Number of Participants Having Sexual Debut [by Trial End Line] | May-August 2016 (cohort one) and May-August 2017 (cohort two) | This outcome will be assessed using data collected from all study participants at end-line, using the self-completed questionnaire. |
Countries
India
Participant flow
Recruitment details
80 of 121 village clusters in Vijayapura and Bagalkote districts, Karnataka State, were randomly selected (40 intervention; 40 control). Girls were recruited from two successive academic years (cohorts 1 and 2) to increase study power and achieve required sample size. Analysis was planned by trial arm rather than separately for two study cohorts.
Participants by arm
| Arm | Count |
|---|---|
| Intervention Village Cluster All SC/ST girls in final year of primary school living in intervention villages eligible for study enrolment. | 1,164 |
| Control Village Cluster All SC/ST girls in final year of primary school living in control villages eligible for study enrolment | 1,111 |
| Total | 2,275 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 252 | 235 |
Baseline characteristics
| Characteristic | Intervention Village Cluster | Control Village Cluster | Total |
|---|---|---|---|
| Age, Continuous | 13.0 years | 13.0 years | 13.0 years |
| Caste (ST vs. SC) Schedued Caste | 886 Participants | 902 Participants | 1788 Participants |
| Caste (ST vs. SC) Scheduled Tribe | 278 Participants | 209 Participants | 487 Participants |
| Devadasi Family | 65 Participants | 47 Participants | 112 Participants |
| District Bagalkote | 639 Participants | 620 Participants | 1259 Participants |
| District Vijapura | 525 Participants | 491 Participants | 1016 Participants |
| Household wealth quintile (Poorest) | 228 Participants | 227 Participants | 455 Participants |
| Non-literate Household Head | 748 Participants | 667 Participants | 1415 Participants |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Region of Enrollment India | 1164 participants | 1111 participants | 2275 participants |
| Sex: Female, Male Female | 1164 Participants | 1111 Participants | 2275 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
| Village Type (Feeder vs. Main) Feeder Village | 321 Participants | 346 Participants | 667 Participants |
| Village Type (Feeder vs. Main) Main Village | 843 Participants | 765 Participants | 1608 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 1,265 | 0 / 1,192 |
| other Total, other adverse events | 0 / 1,265 | 0 / 1,192 |
| serious Total, serious adverse events | 0 / 1,265 | 0 / 1,192 |
Outcome results
Primary
Number of Participants Completing Secondary School [Sit 10th Standard Exam]
This outcome will be assessed using data collected from all study participants at end-line, using the face-to-face questionnaire.
Time frame: May-August 2016 (cohort one) and May-August 2017 (cohort two)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| SC/ST Girls in Intervention Village Cluster | Number of Participants Completing Secondary School [Sit 10th Standard Exam] | 680 Participants |
| SC/ST Girls in Control Village Cluster | Number of Participants Completing Secondary School [Sit 10th Standard Exam] | 658 Participants |
p-value: 0.9895% CI: [0.7, 1.38]Regression, Logistic
Primary
Number of Participants Married [by Trial End Line]
This outcome will be assessed using data collected from all study participants at end-line, using the face-to-face questionnaire.
Time frame: May-August 2016 (cohort one) and May-August 2017 (cohort two)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| SC/ST Girls in Intervention Village Cluster | Number of Participants Married [by Trial End Line] | 92 Participants |
| SC/ST Girls in Control Village Cluster | Number of Participants Married [by Trial End Line] | 84 Participants |
p-value: 0.9895% CI: [0.7, 1.4]Regression, Logistic
Secondary
Number of Participants Entering Into 8th Standard [Start Secondary School]
Due to delays at the start of the cluster-Randomized Controlled Trial, the intervention had not started when cohort one girls were interviewed. This outcome will be assessed using data from cohort two girls only, using the face-to-face questionnaire. To reduce recall bias, we will use data collected at the first interview (baseline) to measure this outcome.
Time frame: March-May 2014
Population: outcome assessed using data from cohort two girls only, using the baseline face-to-face questionnaire.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| SC/ST Girls in Intervention Village Cluster | Number of Participants Entering Into 8th Standard [Start Secondary School] | 580 Participants |
| SC/ST Girls in Control Village Cluster | Number of Participants Entering Into 8th Standard [Start Secondary School] | 516 Participants |
p-value: 0.33195% CI: [0.2, 2.31]Regression, Logistic
Secondary
Number of Participants Having Sexual Debut [by Trial End Line]
This outcome will be assessed using data collected from all study participants at end-line, using the self-completed questionnaire.
Time frame: May-August 2016 (cohort one) and May-August 2017 (cohort two)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| SC/ST Girls in Intervention Village Cluster | Number of Participants Having Sexual Debut [by Trial End Line] | 64 Participants |
| SC/ST Girls in Control Village Cluster | Number of Participants Having Sexual Debut [by Trial End Line] | 53 Participants |
p-value: 0.7995% CI: [0.7, 1.55]Regression, Logistic
Secondary
Number of Participants Married and Co-habiting With Husband [by Trial End Line]
This outcome will be assessed using data collected from all study participants at end-line, using the face-to-face questionnaire.
Time frame: May-August 2016 (cohort one) and May-August 2017 (cohort two)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| SC/ST Girls in Intervention Village Cluster | Number of Participants Married and Co-habiting With Husband [by Trial End Line] | 43 Participants |
| SC/ST Girls in Control Village Cluster | Number of Participants Married and Co-habiting With Husband [by Trial End Line] | 46 Participants |
p-value: 0.4595% CI: [0.5, 1.34]Regression, Logistic
Secondary
Number of Participants Passing 10th Standard [Pass 10th Standard Exam]
This outcome will be assessed using data collected from all study participants at end-line, using the face-to-face questionnaire.
Time frame: May-August 2016 (cohort one) and May-August 2017 (cohort two)
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| SC/ST Girls in Intervention Village Cluster | Number of Participants Passing 10th Standard [Pass 10th Standard Exam] | 518 Participants |
| SC/ST Girls in Control Village Cluster | Number of Participants Passing 10th Standard [Pass 10th Standard Exam] | 530 Participants |
p-value: 0.2695% CI: [0.6, 1.15]Regression, Logistic