Adolescent girls in India experience a wide range of disabling gender norms that severely restrict their development. In rural Karnataka, 25 percent of adolescent girls are married before the age of 18 years, while 10 percent of girls between 15-19 years have begun childbearing. In north Karnataka, which ranks low on the Gender Parity Index, and has a high poverty rate and regressive social traditions, adolescent girls are at higher risk for school dropout, early marriage and childbirth, and severe restrictions related to their rights and mobility.

Our Approach

Drawing upon the Integrated Empower Approach, we have developed a peer-led social transformative model called the ‘Sphoorthi’ Role Model Girls’ Empowerment Program. The Sphoorthi program fosters girls’ empowerment across three domains – power within (through self-development), power with (through collective action) and power over (through access to and control over resources). The process consists of two stages:

• Development of a cadre of rural role model adolescent girls (RMAGs) with the knowledge, attitude and skill necessary to challenge gender norms
• In the second stage, RMAGs and their parents work with other girls (peer girls or PGs) and their parents in their villages, to transfer knowledge, attitudes and skills necessary to challenge gender norms, thus leading to community-wide social change.

Life skill education sessions, Samvadas (‘dialogues’), leadership and communication camps and exposure visits are conducted with the girls to develop critical attitudes towards gender equality, self-esteem and confidence to take control of their lives (thus enabling ‘power within’). Parents and community leaders are engaged through the Samvadas to address their roles in sustaining poor gender norms, and to enlist their support for girls, (i.e., enabling ‘power with’). The first two dimensions of empowerment contribute indirectly by allowing girls’ increased access to resources (e.g., nutrition, education) through the support of family and community (i.e., ‘power over’). Once trained, girls and their parents meet regularly and discuss issues affecting girls’ lives, and also participate in public meetings and campaigns, such as International Girl Child Day (IGCD).

Our Achievements

• KHPT is developing a vulnerability framework for adolescents in India through a study commissioned by the Ministry of Health and Family Welfare, Government of India and the WHO.
• In the past five years, more than 15 peer-reviewed publications authored by KHPT staff on different issues around adolescent health have been published in high-impact international journals.
• A high-level committee by Government of Karnataka chaired by Dr Jayamala on understanding the status of female sex workers in Karnataka has recommended two of KHPT’s intervention models, Samata and Sphoorthi, to address the structural drivers of vulnerability among adolescent girls from the most marginalized families.
• The initiatives of role model girls in Koppal have been recognized in different forums at the state and national level. As a part of child parliament initiatives of the state government, one of the Sphoorthi girls had an interaction with the Chief Minister of the Government of Karnataka. Role model girls have also participated in the YUVA challenge organized by UNICEF at the national level.

About the project:

Adequate nutrition is a fundamental right and is part of the Sustainable Development Goals (SDGs). However, nutritional status, among adolescent girls, children, and pregnant and lactating women remains inadequate. Though the Government of India (GoI) has launched a National Nutrition Mission and Poshan Abhiyaan programme to achieve a malnutrition-free India by 2022, the intergenerational cycle of malnutrition affecting adolescent girls, pregnant women and lactating mothers, and children, is yet to be adequately addressed.

KHPT implemented a nutrition project in the Koppal district, supported by the H T Parekh Foundation, between 2021-2024, through a nutrition-specific and nutrition-sensitive approach. The project aimed to address gender norms and develop sustainable nutrition-appropriate behaviours by converging the existing community structures.

Geography: Yelburga, Gangavathi, Kukanoor, Karatagi and Kanakagiri blocks of Koppal district, Karnataka.

Duration: April 2021- March 2024

Funder: HT Parekh Foundation

Key Activities:

• Conducting Life Skills Education sessions for adolescent girls, pregnant women, and lactating mothers on the importance of eating nutritious food, maintaining a healthy lifestyle; influencing their behaviours and empowering them to make informed choices related to eating nutritious foods.
• Working with Gram Panchayat and Frontline workers to undertake joint community monitoring to review, map and track the nutrition status of their community.
• Distributing Fortified Blended Food (FBF) packets – Shakti Vita, the most vulnerable Adolescent Girls, Pregnant and Lactating Mothers and Children up to 36 months to address the immediate concerns of severe malnutrition in the community.

Outcomes:

• 9 % points increase in BMI among Adolescent Girls*
  5% points reduction in underweight among children 6-36 months*
• 13% points reduction in wasting among children 6-36 months*
• 23% points increase in Minimum Dietary Diversity among adolescent girls
• 16% points increase in Minimum Dietary Diversity among lactating mothers
• 16% points increase in exclusive breastfeeding practices#
• 20% points increase in complementary feeding practices#

*As per Anganwadi data
#From project baseline (2022) to project endline (2024)

Context

Adolescent girls who do not complete their education are particularly vulnerable to HIV and other health risks. Structural barriers cut short the education of many adolescent girls belonging to scheduled caste and scheduled tribe families in northern Karnataka, India.

Many girls drop out of school as a result of poverty, early marriage, a tradition of sex work and the under-valuing of girls’ education. Samata , meaning equality, aims to reduce HIV risk among adolescent girls in Bijapur and Bagalkot Districts, in north Karnataka, by increasing their rates of secondary school enrolment and completion.

The likelihood of girls from Scheduled Castes and Tribes (SC/ST) families in northern Karnataka completing secondary school is sharply diminished by family poverty, gender discrimination, the traditions of early marriage and devadasi dedication, boys’ actions and attitudes towards girls, inadequate measures to meet girls’ needs at schools and by community authorities and education officials to enforce girls’ right to education.

The rates of underage marriage are over 30% among girls from SC/ST communities in Bijapur and Bagalkot districts.

Girls who drop out of school are more vulnerable to HIV infection and other health problems, will have a larger, less healthy family, earn less than their better educated peers, and lack voice, agency and are disengaged from larger community issues.

Implementation

Samata was a programme to improve the quality of life of adolescent girls from marginalised communities in northern Karnataka, India, by keeping girls in school, delaying marriage, and reducing entry into sex work.

Reaching 3,600 adolescent girls from 1,800 families in 119 villages and 69 high schools, Samata aimed to increase the proportion of adolescent girls who enter formal secondary education, complete 10th Standard, delay their marriage and sexual debut until after 10th Standard.

To increase the numbers of girls who enroll in and complete high school, Samata:

• Provided special tuition, career counselling and leadership training to improve girls’ academic success and broaden their aspirations
• Established reflection sessions for girls to share experiences and build solidarity and confidence
• Sensitised parents to value girls and recognise the importance of educating them
• Linked families to government schemes that provide incentives for educating girls
• Used sports to encourage boys to respect girls and appreciate their rights
• Trained SDMCs and school staff to institute measures to increase girls’ safety and academic success
• Supported community structures to understand the importance of girls’ education and take action.

KHPT implemented Samata from July 2013 to 2017, in partnership with the Government of Karnataka and the World Bank with the support of UK Aid and ViiV Healthcare.

During this period, STRIVE partners KHPT and the London School of Hygiene and Tropical Medicine (LSHTM) evaluated Samata’s impact on adolescent girls’ high school entry and retention, as well as on their vulnerability to HIV.

Context

KHPT signed an MoU with Mangalore Chemical Fertilizer Ltd. (MCFL) to implement a menstrual health program among adolescent girls in Koppal. As part of their Corporate Social Responsibility efforts, MCFL is providing a small grant to work in five villages of Koppal district and the program aims to address the menstrual health issues among adolescent girls and young women in the rural context. This is an opportunity to develop a comprehensive intervention package and collaborate with other partners in addressing Sexual and Reproductive Health (SRH) issues among adolescent girls. SRH is one of the key areas in the adolescent theme along with Gender-Based Violence (GBV) and Mental Health.

Implementation

Sahaj aimed to improve menstrual hygiene practices and sexual reproductive health among adolescent girls and young women in 5 villages of Koppal Taluk.

The key outcomes expected from this programme were:

• The promotion of equitable gender norms and creation of safe environments for adolescent girls to prevent and address gender-based violence.
• Improvement of the dietary pattern and nutritional status of adolescent girls.
• Improvement in menstrual hygiene practices and sexual health among adolescent girls.

Project Sabala was launched under the Rajiv Gandhi Scheme for Empowerment of Adolescent Girls by the Ministry of Women and Child, Government of India in 2010.

The project aimed to address the multidimensional problems of adolescent girls. Bijapur district in Karnataka was one of the 200 districts chosen from across the country to pilot the scheme.

KHPT implemented Sabala in Mudhol, Jamkhandi and Biligi talukas in the district. The project reached adolescent girls aged 9 to 17 years from Scheduled Castes and Tribes, and devadasi or traditional female sex worker communities.

Sabala primarily focused on giving them health awareness and life skills, and covered 750 adolescent girls and their families from 2010 to 2012.

Context

Adolescence (10-19 years) is a critical period of development. To support this population, the Ministry of Health and Family Welfare (MoHFW), has conceived of the Rashtriya Kishor Swasthya Karykram (RKSK), to address the specific needs of adolescents, covering provisions related to nutrition, sexual and reproductive health, mental health, substance use, accidents, injuries and violence, non-communicable diseases.

However, in order to better address the needs of adolescents, particularly the most vulnerable adolescent groups, the MoHFW in collaboration with the World Health Organization has commissioned a detailed study by the Karnataka Health Promotion Trust (KHPT) to develop a framework to identify the most vulnerable adolescent communities in India, in order to strengthen the implementation of the RKSK program.