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FGM, child marriage and adolescent motherhood: Barriers to girls' wellbeing


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FGM, child marriage and adolescent motherhood: Barriers to girls' wellbeing

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Findings from the GAGE mixed-methods longitudinal study in Ethiopia on prevention strategies and girls' experiences of FGM/C, child marriage and adolescent motherhood, presented to the Parliamentary Standing Committee for Women and Social Affairs, Ethiopia.

Findings from the GAGE mixed-methods longitudinal study in Ethiopia on prevention strategies and girls' experiences of FGM/C, child marriage and adolescent motherhood, presented to the Parliamentary Standing Committee for Women and Social Affairs, Ethiopia.


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FGM, child marriage and adolescent motherhood: Barriers to girls' wellbeing

  1. 1. FGM, child marriage and adolescent motherhood: Barriers to girls’ wellbeing Workneh Yadete, December 2022 Parliamentary Standing Committee for Women and Social Affairs, Ethiopia
  2. 2. Outline of Presentation 1 • GAGE overview 2 •GAGE findings on FGM, child marriage, & SRH 3 •Our validation tools 4 •Conclusions and recommendations 5 •Questions?
  3. 3. GAGE Overview Adolescent girls in East Hararghe, Ethiopia © Nathalie Bertrams / GAGE 2019 Please note that the photographs of adolescents DO NOT capture GAGE research participants and consent was gained from their guardians for the photographs to be used for GAGE communications purposes.
  4. 4. Gender and Adolescence: Global Evidence (GAGE): A longitudinal research programme (2016-2026) By finding out ‘what works,’ for whom, where and why, we can better support adolescent girls and boys to maximise their capabilities now and in the future. We are following 20,000 adolescent girls and boys - the largest cohort of adolescents in the Global South
  5. 5. GAGE 3Cs Conceptual Framework
  6. 6. GAGE’s primary longitudinal research sample
  7. 7. GAGE Ethiopia research sites 3 regions: • Afar, Amhara, Oromia • plus Dire Dawa City Administration Research site selection based on: • Districts with among highest rates of child marriage as proxy for conservative gender norms (MOWCA, UNICEF and ODI, 2015) • Urban and rural sites • Food insecure and pastoralist sites as a proxy for economic poverty • Woreda-based mapping of all kebeles based on infrastructure and service availability (vulnerable/ less vulnerable) • Programming capacities of NGO implementing partners
  8. 8. GAGE’s Irish Aid funded research in pastoralist regions Afar Zone 1 Aysaita Zone 5 Samurobi Hadelella Somali Fafan Harshen Goljano Jarar Daror Quantitative sample  Total of 2,042 households in 36 kebeles  In each household, we surveyed both an adolescent and a caregiver  Approximately 80% of adolesents and caregivers were female  Adolescents were 10-19, but most were young—the average age was 13 Qualitative sample  589 individuals in 8 kebeles in 4 woredas  Purposively selected from the quantitative sample
  9. 9. GAGE findings on FGM
  10. 10. South Gondar, Amhara • 32% were cut • nearly all before their first birthdays Of younger cohort girls whose female caregivers reported: Girls reported more risks than advantages Type 1 is most common ‘They cut the tip of the clitoris.’ (woreda level KI) • 72% reported that FGM has risks • 17% reported that FGM has advantages Few girls believe that FGM is a religious requirement—or should continue • 13% reported that FGM is required by religion • 12% reported that FGM should continue ‘FGM/C helps her vulva to stretch to make birth easier.’ (youth leader)
  11. 11. The dominant narrative is progress Schools spread the word—with cascading impacts ‘They teach us at school about harmful traditional practices …They are working very hard to teach us about FGM.’ (adolescent girl) ‘When there is an educated person in the family, that person tells [the others] that FGM/C is a harmful traditional practice and they need to avoid it. That person convinces the family and stops them from doing it.’ (woreda level KI) Health extension workers target women ‘Health extension workers are active in teaching about FGM … Starting from when they get pregnant, they have a follow-up with health extension workers. They teach them when to go for a check-up.’ (teacher) Religious leaders tailor messages carefully ‘Jesus was baptised with water, not circumcised.’ (Orthodox priest) ‘It is not possible to follow each rule and law provided by the book. This we should not follow.’ (Muslim sheik) Most participants report recent elimination ‘It is totally abolished now.’ (16-year-old girl) Progress is evident in individual families ‘I circumcised my older children. I have two young girls but they are not circumcised.’ (mother)
  12. 12. But subtexts suggest a need for caution • ‘There is no girl who is not cut.’ (adolescent girl) In remote communities, girls are still cut • ‘The practice of FGM/C is very difficult to sanction since it is practised by mothers/ grandmothers in a very private and hidden manner.’ (militia member) Women use ‘hidden practices’ • ‘There is no female genital mutilation … It is prohibited by the government … However, if their families [mother and father] have the skill, they circumcise their female children in a hidden way. … [His daughter] was circumcised by her mother … It was me that ordered my wife to circumcise our daughter.’ (father) Sometimes at men’s order • ‘These days they will be cut in health centres … the clitoris and the side flesh … If it is cut in the health centre, it doesn’t take long to heal … In the hospital they give painkillers and they apply ointments on the wound, that is why it recovers quickly.’ (mother) There is some evidence of medicalisation • ‘According to our criminal code of conduct, female genital mutilation is a criminal act … We are not seriously working on this aspect.’ (teacher) Kebele level officials are often not engaged
  13. 13. East Hararghe, Oromia Of older girls who self-reported: • 73% had been cut • 62% had wanted to be cut at the time Girls are excused from housework and pampered by their mothers. • ‘They gave me milk and egg … They prepared for me rice and macaroni with sauce.’ (12-year-old girl cut at age 10) • ‘We prepared food and chicken and then the people come and give you money.’ (14-year-old girl cut at 12) Girls want to fit in with their peers • ‘There is an insult for girls who are not circumcised.’ (married 11-year-old girl) Girls want to show their peers they are old enough to attend shegoye dances • ‘They have to be first circumcised. It is after circumcision that a girl attends shegoye.’ (17-year-old girl) Why do girls want to be cut? Girls were cut just before age 10 Types 1 and 2 are most common Girls slightly more likely to report that FGM has advantages than risks: 39% vs 34% 76% of girls believe FGM is required by religion 49% of girls believe FGM should continue
  14. 14. Drivers are rooted in girls’ reproductive roles ‘I didn’t find girls who got married without being circumcised. It is shameful here not to be.’ (HEW) Girls cannot marry without FGM/C ‘During intercourse there is no way to insert the penis if the clitoris is not removed.’ (father) It is believed that sex is not possible without FGM/C ‘If the girl is not circumcised, she will not get pregnant.’ (younger boy) It is believed that pregnancy is not possible without FGM/C ‘The sexual desire of women who haven’t had FGM is inflated… We are farmers and engage in tiresome activities of farming… We cannot handle another responsibility of satisfying our wives because their sexual desire is heightened if they are not circumcised.’ (father) It is believed that FGM/C is required to lower girls’ and women’s sex drive
  15. 15. Backsliding is increasing—and set to increase more ‘If we see it and hear about it, we will put them in jail.’ Officials proclaim progress ‘In the past, during our mothers’ time, they were prohibited to practice circumcision … Now, it’s open.’ (13-year-old girl) But girls report the reverse ‘You go to a health facility. You can deliver through an operation, for instance.’ (17-year-old girl) Awareness raising is falling flat ‘The kebele administrator takes money from people who circumcise their girls. He takes (for instance) up to 200 birr (~$4)… The administrator stopped now. People don’t even give him [the money] even if he asks now. They don’t listen to him now. They do the circumcision freely.’ (young woman) Fines are ignored ‘Girls do not listen to their families … They just go with boys … They go with boys to get married. In the past, we didn’t go after boys unless we were asked for marriage because we were circumcised.’ (grandmother) There are calls to resume more invasive types ‘There was a female teacher that used to register the names of parents who allowed girls to undergo FGM/C, but since there is no school, they cut girls and there is no one to question them.’(kebele level KI) Covid has complicated protection ‘Previously it was forbidden, but now they allow it.’
  16. 16. Afar Of younger cohort GAGE girls whose mothers are reporting: • 88% have been cut Girls were cut at an average age of 1.5 ‘Though we know that female genital cutting harms our daughters, we are still practising it.’ (religious leader) Irish Aid research finds even higher prevalence: • 97% of girls have been cut • 85% of girls were infibulated with scar tissue And more nuance regarding drivers: • 65% report the main driver is cultural identity • 21% report the main driver is religion And that legal knowledge is rare: • 42% of caregivers had heard of a law re FGM • 19% of those had accurate knowledge Girls are more likely to report advantages than risks  53% of girls report that FGM has advantages  49% of girls report that FGM has risks Girls support continuation: • 72% of girls believe that FGM is required by religion • 74% of girls believe it should continue ‘It is difficult to have sex with uncircumcised girls since the clitoris prevents the penis penetrating deep in the girl’s vagina.’ (14-year-old boy) ‘Girls would misbehave and be disobedient to their parents unless they were circumcised.’ (mother)
  17. 17. Location determines type ‘Currently people cut only the tip of the girl’s clitoris, people stopped cutting the entire part of the inner of the girl’s genital organ from three directions.‘ (clan elder) Infibulation is being replaced ‘We work with women doing it and give them alternative income opportunities. And we also organised a reward programme for champions who stopped doing it.’ (Justice KI) Because of officials’ efforts ‘Especially, the Sharia persons and religious leaders taught us to change the type of cutting and to use the ‘sunna’ type.’ (clan elder) And most especially because of religious leaders’ efforts Type is (probably) shifting in more central communities ‘What we are practising now is what we were practising previously.’ (clan elder) In more remote communities, there is only stasis
  18. 18. Elimination will require local ownership PRESENTATION NAME AND DATE Girls comply to avoid exclusion ‘If a girl is not cut, she will be isolated by the people. So, the girls themselves agree to circumcision. They prepare themselves and ask the mother to do it. It is done based on family interest and the girl’s willingness.’ (mother) Caregivers comply to avoid exclusion ‘We are also told that a father who didn’t circumcise his daughter is considered as lazy and we are also ordered not to get in the house of a man who didn’t circumcise his daughter because having a daughter who is not circumcised is considered haram.’ (clan elder) ‘It becomes risky to speak about stopping FGM among rural communities and they are afraid to teach about FGM as a bad practice because it has been a long-held traditional practice … For instance, there is a midwife working at Community B and she told us that the community laugh when she teaches about avoiding FGM.’ (woreda level KI) Champions are silenced by exclusion ‘We can change the practice only if we heard it from religious leaders. We do not stop because of meetings.’ (grandmother) Work with religious leaders is key ‘They taught us that it became a big sin if a female child died without being circumcised.’ (mother)
  19. 19. Somali Only 78% of girls had heard of FGM/C. Of those: • 72% had been cut • girls were cut at age 9 • 33% had some input into the timing of FGM/C • 100% of girls were infibulated • Infibulated girls are preferred for marriage. ‘Boys want to marry a circumcised girl and no one will marry an uncircumcised girl because of our religious views. Girls who are sewed are good, boys want them, believe that her dignity is protected and that of her family since it is closed. We disregard sunna types.’ (FGD unmarried boys, Somali region) • Families are shamed if daughters are not cut by marriage. • The age of cutting is dropping as adolescent-driven marriage becomes more common.  54% of girls reported that the main driver of FGM is cultural identity  33% of girls reported religion as the main driver  34% of caregivers had heard of a law re FGM  80% believe Type 1 is legal  16% understand that cutters and parents are liable  22% of girls believe FGM has risks  55% of girls believe FGM has benefits  68% of girls believe FGM should continue
  20. 20. Infibulation and life-course trauma in Afar and Somali  Qualitative findings underscore that FGMC is not a one-off painful experience but ongoing pain and suffering – urination and menstruation hurt and girls dehydrate themselves and suffer frequent infections. • In Afar, the defibulation process at marriage is brutal and often involves rape and sometimes Viagra. Women are resewn nearly closed after their first four pregnancies. • In Somali, defibulation is increasingly medicalised—an unintended consequence of NGO efforts. ‘During the time of their first sex girls face severe pain when the boy/man struggle to dis-virgin her… Newly married grooms have also been suffering a lot when they dis-virgin girls, because the hole is too narrow, and the scar is also very strong to dis-virgin, bride grooms were limping for three or four days after they dis- virgin their wives, because of the pain due to the friction while struggling to dis-virgin girls.’ (older boy, Afar)
  21. 21. Girls from a pastoralist community in Afar. © Natasha Bertrams / GAGE 2018 GAGE findings on child marriage
  22. 22. ‘My soul agitated me to get married right way when I reached puberty... While experiencing this feeling, I came across a gorgeous girl and wanted to seize the opportunity to marry her… We competed with a lot of males for the girl… The competition was fierce... Our rivals beat us with stones… I beat them and married her finally.’ (17-year-old boy, who at 14 married a 12-year-old girl, East Hararghe) Child Marriage ‘Families are afraid that girls might get pregnant and can have children out of wedlock and for that reason they are married early. A boy can have whatever girlfriend that he may wish to have even when he is in school. But it is a taboo for a girl.’ (15-year-old divorced girl, Aquashmoch) ‘Unless we die, it is our absuma that we are going to marry.’ (adolescent girl)
  23. 23. South Gondar--progress, from a low base Nearly all marriages are arranged, and two-thirds of married girls would have rather married later. The age of marriage is increasing— and girls have some space to argue for delay—but most girls are still married as children. ‘My first marriage proposal was at the age of 13 but my father refused as I was a teenager and then I got married at age 15.’ (married 17-year-old girl) Parents’ interest in child marriage is driven by needs to prevent premarital sex. ‘We are afraid that they will start a sexual relationship before marriage.’ (mother of married girl) Girls often feel they must say ‘yes’ to their parents—even when they do not want to marry yet. ‘I would have been cursed and my parents would feel sad.’ (married 15- year-old girl)
  24. 24. South Gondar– the youngest girls are at risk of forced marriage  Girls who are to be married to priests are made to marry especially early—because there must be no doubt of virginity. ‘To be the wife of a priest she will be engaged at 7 or 8 years. To be the wife of a farmer she will be engaged when she is older than that.’ (12-year-old boy) ‘I had no idea that I was going to get married. And then the day approached and they told me... I said no way. I was even tempted to flee. But I had nowhere to go. So I got married not to disobey my parents.’ (married 12-year-old)  The youngest girls have the least input.  Parents report that they are sometimes forced—by the broader community-- to marry their daughters. ‘If I refused to marry my daughter the cow would be looted, crops and house would be burnt and people would be beaten.‘ (father of a married girl) At baseline, 2% of 10–12- year-old girls were already married. At midline, 4% of 12–14- year-old girls were already married.
  25. 25. East Hararghe--complicated and shifting patterns ‘They get married because it is in their interest. You can’t enforce them not to marry if they want to marry.’ (12-year-old girl) Respondents report that child marriage is increasingly adolescent- driven. ‘If a girl is able to carry a 20 litre jerry can, they (the parents) think she is ready for marriage. They assume she can also manage a man if she is capable of lifting and carrying a 20 litre jerry can.’ (KI) But child marriage has always been common. ‘For the child, it is husband and wife decide together for the child. Father and mother construct house for the boy and the boy searches a girl who is suitable for him. Then after he marries.’ (19-year-old boy married to a 12- year-old girl) The “old” and the “new” are mixing to increase incidence and decrease the age at marriage. Parents suggest to boys that they marry—and boys choose the youngest girl they can find to say yes. At baseline, 2% of 10–12-year- old girls were already married. At midline, 8% of 12–14-year-old girls were already married.
  26. 26. East Hararghe--why do girls choose marriage? Girls “choose” to marry because they have few other options, to escape violence, and are pressured by both older boys/young men and their female peers. This narratives about girls’ ‘choice’ are more complex than they first appear. ‘I got married because they [referring to friends] got married’. (married 13 year old girl) ‘Girls prefer marriage than to simply sit idle.’ (father of a married 12 year old girl) ‘I beat the elder girl when she played with boys…Then she went to Boko town again and started living with a boy. She was 11 years old.’ (father of a girl married at 11) Melke) ‘Boys try to lure her to go out and then beat her… with sticks and the leaves of a plant that makes you itch.’ (local youth leader, East Hararghe) ‘The reality of what is being done in shegoye place is that the boy gives 1,000 birr for a person who plays a role of mediating between the girl and the boy. Girls can be easily deceived by the money.’ (teacher) ‘According to our culture that males better marry with their younger females. Males are not interested in females who are older.’ (younger cohort boy)
  27. 27. Zone 5—largely static, due to absuma traditions • Nearly all marriages are arranged, and two-thirds of married girls would have rather married later. • Girls have no say in who or when they will marry. ‘I cannot refuse. If I refuse the man who was going to marry me, he would be given permission to take me by force.’ (17-year-old girl) ‘We have our own peculiar culture and tradition with regard to marriage practice… It is the absuma marriage tradition.’ (father of a married girl) ‘If my daughter married to someone outside of our kinship, our family line would discontinue.’ (father) ‘If we teach them directly to stop early marriage and cross-cousin marriage, we will provoke conflict.’ (teacher) At baseline, 1% of 10–12-year- old girls were already married. At midline, 3% of 12–14-year- old girls were already married.
  28. 28. Zone 5—glimmers of progress Irish Aid sample • 62% of girls would prefer to marry at 18+ • Some adults are supporting ‘choice’ marriage to reduce IPV and divorce • Some girls are reporting planned marriages to BOWSA offices at woreda level or to teachers ‘Nowadays, absuma marriage culture is declining….The process is like if a girl reach’s puberty, then the parent will start looking for a guy that can marry their child. They support (the groom and bride if they are first cousins but if it is marriage by love it will be arranged between the girl and the guy who wants her.’ (16-year-old girl, Afar) Married girl, Afar, Ethiopia © Nathalie Bertrams / GAGE 2020
  29. 29. Somali--old norms drive new practices  4% of adolescent girls have ever married. Of these:  Girls married at age 15.6  22% of girls married before age 15  21% of girls were married by parental arrangement  97% of girls reported that they were ready to marry  Only 2% of adolescents reported knowing that 18 is the legal age for marriage  Female caregivers married at an average age of 17.4 years ‘Every girl want to marry in that age category as most other females also do the same. The female would not be happy to stay beyond the age of 16.’ (younger girl, FGD) ‘In the past, parents were arranging the marriage but now adolescents choose and decide when and who to marry.’ (older boy, FGD) Risk factors are evolving in ways that are encouraging child marriage:  Drought means that grooms and their families cannot provide bride price—so adolescents choose one another and have no reason to delay marriage  Mobile phones and education are leading to more adolescent interaction—and marriage is the only sanctioned place for sex ‘Previously, child marriage was not that much practiced in real life, and the community believed that they should wait till they are responsible and old enough.’ (school director)
  30. 30. Marriage marks the end of most girls’ educational careers ‘In this area, I haven’t seen any person who continues to go to school after getting married.’ (15-year-old girl, EH) ‘It is difficult [to combine marriage and school]; you can’t concentrate since your thoughts are divided thinking about [other] issues.’ (15-year- old girl, SG)  In S. Gondar, 40% of ever married girls are enrolled in school.  In East Hararghe and Zone 5, however, fewer than one in ten married girls is enrolled.  Most married girls report that their husbands will not allow them to attend school.  Even in S. Gondar, few girls are able to combine school and marriage once they begin living with their husbands—because work loads are too high. Now I have given birth to children and I am raising them. My morale has been broken by them.’ (18-year-old mother, EH) In Somali, 43% of girls in our sample had NEVER been to school.
  31. 31. Child marriage often leads to IPV Can begin on the wedding night • ‘When I hugged her, she refused and shouted and then tried to leave the room… I forcefully had sex at first as she refused to do so.’ (19-year-old married to a 12-year-old, S. Gondar) Is seen by men as their ‘right’ • ‘I don’t beat [my wife] with something that hurts. I beat her with electric wire.’ ( 19-year-old husband, East Hararghe) •Is meted out for infractions large and small • ‘If I go to someone’s home or if I visit my friends, my husband beats me.’ (married 17-year-old, East Hararghe) 48% of adolescents agree that a man’s violence towards his wife is private 84% of adolescents agree that a woman should obey her husband in all things
  32. 32. Child marriage leaves girls lonely and distressed ‘Hahahahaha ! We don’t talk much… I didn’t count how many times I beat her.’ (18-year- old married boy, Z5) ‘The only thing that I am worried about is fear of getting married and interrupting my education.’ (12-year-old girl, SG) In South Gondar and Zone 5, girls are afraid of being forced into marriage. Many married girls lose access to friends. ‘I used to spend more time with my peers before I got married… We used to meet at school and in our neighbourhood s.’ (15-year-old girl, EH) ‘I miss my family very much.’ (19-year- old girl, Zone 5) Some married girls lose access to family. Many married girls are distressed— some are suicidal. Few married girls are in supportive relationships ‘‘I was not happy that I was married… I wanted to kill myself .’ (14- year-old girl, Z5)
  33. 33. GAGE findings on sexual and reproductive health and adolescent motherhood Young girl, Ethiopia © Nathalie Bertrams /GAGE 2019
  34. 34. Adolescents’ access to puberty education varies • Boys mostly feel pride at growing up. • Girls are more conflicted—because menarche is stigmatized and, in some communities, means that girls must soon marry. ‘I saw blood on their cloth when we played together and when I asked them what it was, they warned me not to tell.’ (12-year-old girl, Zone 5) • Three-fourths of adolescents have a source of information about puberty. “I didn’t know anything about menstruation and when my sister said she saw her period for the first time; I told her not to give me with her hand and considered her as a prostitute.” (Mid adolescent girl, Debre Tabor) ‘I know the name, but they don’t tell us about that. I heard it from children in this neighbourhood. When they have headache, they say “I am on menstruation”. But I don’t know what it means.’ (12-year-old girl, East Hararghe)
  35. 35. Adolescents’ SRH knowledge is often inaccurate PRESENTATION NAME AND DATE ‘If a girl wears the pants of a male person and if there is sperm on the pants of that person, that girl can become pregnant.’ (11-year-old girl, EH) ‘The educators teach that adolescents shouldn’t begin to have sexual intercourse before getting married…..He taught us that our life span will decrease otherwise.’ (12-year-old boy, EH) ‘We learned that there is an egg in our uterus and the egg will break when men have intercourse with us. After the egg breaks, blood will emanate from it and the blood will grow into a child. I don’t remember anything else.’ (16-year-old girl, Zone 5) Girl in East Hararghe © Nathalie Bertrams / GAGE 2020
  36. 36. Adolescents’ contraceptive knowledge varies • Health Extension Workers are central to disseminating information in urban areas and S. Gondar. They teach in the community and in schools. ‘Health extension workers are doing great in this regard. They are creating awareness in each school.’ (educator, Debre Tabor) ‘All these things you are talking about are new for us. We don’t know these things in our locality, because as you know there is no school or health institution here.’ (older boy, Zone 5) • Services and education are more limited in E. Hararghe and Zone 5. • Misinformation is common—even in S. Gondar. ‘If you take penicillin, then there's no problem.’ (older girl, Aquashmoch)
  37. 37. Adolescents' contraceptive uptake differs across locations ‘We have to teach young girls to use contraceptives …I took my daughter to the health centre and made her use contraceptives. She has no [boy]friends but I did it for safety.’ (Father) In S. Gondar, even unmarried girls often use contraception. ‘There are no people using contraception… It is because people do not want to use contraception because it is regarded as haram’. (17-year-old married girl) In Zone 5, girls often emphasized that contraception is forbidden by religion. ‘They fear their husbands. They are discouraged to use it for their husbands expect that they will give birth.‘ (13-year-old girl) In E. Hararghe, girls are afraid of being branded infertile. • Of sexually active girls (nearly all of whom are married)—only 42% have ever used conception. • Uptake is higher in urban areas (42%) versus rural areas (23%). • Uptake is higher in S. Gondar (54%) versus Zone 5 (9%) and E. Hararghe (4%).
  38. 38. Adolescent motherhood is linked to contraceptive uptake • In S. Gondar, 25% of married girls have been pregnant…despite 62% of older girls having been married by age 18. • In Zone 5, 43% of married girls have been pregnant… 57% of older girls were married by age 18. • In E. Hararghe, 38% of married girls have been pregnant… 49% of older girls were married by age 18. ‘Now I have given birth to children and I am raising them. My morale has been broken by them.’ (18-year-old girl, EH) An adolescent mother, Ethiopia © Nathalie Bertrams /GAGE 2020
  39. 39. Adolescent girls, Oromia © Nathalie Bertrams / GAGE 2020 Our validation tools
  40. 40. Purpose of the validation tools Verify woredas’ and kebeles’ readiness to eliminate child marriage and FGM. Inform tailored action plans to accelerate progress. •Tools have been developed and piloted by GAGE. Tools build on previous evidence from MOWCY and MoH. Tools triangulate perspectives from different stakeholders at different levels. Tools are engaging for participants.
  41. 41. Three level sample Woreda level: WCYA Education Justice Police Health Religious Council Kebele level: administrators educators HEWs Women’s Association militia/security religious leaders youth leaders parents adolescents Regional level: WCYA Education Health Justice
  42. 42. Tablet-based surveys….  Surveys will be completed on tablets or phones.  Interviewers will read questions to respondents in the local language.  Respondents will choose their answers based on picture cards.  Interviewers will enter respondents’ answers into the survey.  Interviewers will collect administrative data related to child marriage, FGM/C, and school enrolment from kebele administrators, HEWs, and school officials.
  43. 43. ….Paired with easy to “read” cards How common? How fast?
  44. 44. Ready set go! Health worker, Amhara © Nathalie Bertrams /GAGE 2020 Entrenched—will take significant effort to begin making progress First signs of change—but from a low base and slow Gradual progress over time Significant progress thus far— need to maintain trajectory Eradicated/abandoned
  45. 45. Recommendations for policy and programming
  46. 46. Recommendations for strengthening sector policies 1 • Strengthen coordination and collaboration among sector offices at federal, regional and woreda levels to protect girls from harmful practices and to expedite generational change. 2 • Work with religious leaders to promote abandonment of FGM/C and CM and to shift gender norms that lead to SGBV 3 • Allocate sufficient human and budget resources to tackle these widespread norms and practices that jeopardise girls’ and women’s empowerment and enjoyment of their rights 4 • Invest in evidence-based monitoring and evaluation of programme interventions and the impacts they are having over time on child marriage and FGM with a particular focus on remote communities where prevalence is highest 5 • Promote a coalition to advocate for and to ratify the Family Law, especially in Afar and Somali regions (on age of marriage) and the Criminal Code (which bans undertaking or procuring FGM) 6 • Strengthen SGBV rehabilitation centres (one stop centres) by involving key stakeholders and work with health officials to ensure girls and women whose health is compromised by FGM/C have access to appropriate and affordable medical care 7 • The social and women standing committee of the parliament to provide supportive supervision on the implementation of the laws and polices. 8 • The social and women standing committee of the parliament to support the sector Ministries to secure sufficient budget approval for activities related to eliminating child marriage, FGM and SGBV .
  47. 47. Recommendations regarding FGM 1 • Address underlying gender norms through context-tailored approaches incl. working with religious leaders, parents, and adolescents—and addressing risks and perceived advantages. 2 • Raise awareness of the criminalization of FGM/C—considering transparently levied and bottom-up fines on a community-by-community basis and providing girls with uncut role models to counter peer pressure. 3 • Engage with health care providers to encourage their work with new mothers, prevent medicalization, and ensure that cut girls are treated sensitively. 4 • Adopt a long-term lens that recognizes that change is non-linear and that continuous pressure is required over time to prevent hidden practices and resurgence.
  48. 48. Recommendations regarding child marriage 1 • Invest in approaches to support girls 2 • Tailor child marriage programming to local drivers. 3 • Empower girls with knowledge and skills –developing broader aspirations and strengthening voice and agency. 4 • Build—and publicise-- reporting mechanisms to have marriages canceled. 5 • Work with parents and communities to shift gender norms that favour child marriage over education. 6 • Work with traditional and religious leaders to develop messaging. 7 • Step up enforcement and prosecute adults involved in child marriage.
  49. 49. Recommendations to improve married girls’ wellbeing 1 • Use the HEW programme to spread awareness to married girls and women of their right to be free of violence--and when and how to seek help. 2 • Work with religious and traditional leaders to develop messages—for boys and men— about alternative ways to demonstrate masculinity (rather than violence). 3 • Establish safe house for girls and women experiencing IPV. 4 • Ensure that formal justice mechanism are brought into play—and that perpetrators face consequences for their actions. 5 • Develop opportunities and venues for married girls to get together with one another—and access near peer mentors—for guidance, support, and recreation.
  50. 50. Recommendations regarding SRH and adolescent motherhood 1 • Provide school- and community-based age-appropriate, comprehensive sexuality education to adolescents—ensuring information is detailed, accurate, and tailored to local concerns about the effects of contraception 2 • Ensure that adolescents are aware of the health and economic risks of early parenthood—and how adult parenthood benefits themselves and their children. 3 • Ensure adolescents have confidential access to SRH information and services. 4 • Work with religious and traditional leaders—including both women and men—to build support for family planning. This should include attention to delaying first pregnancies as well as spacing subsequent pregnancies. 5 • Address underlying gender norms that value girls and women for the children they produce and leave them with limited control over their own fertility.
  51. 51. About GAGE WEBSITE: TWITTER: @GAGE_programme FACEBOOK: GenderandAdolescence  Gender and Adolescence: Global Evidence (GAGE) is a nine-year (2015-2024) mixed- methods longitudinal research programme focused on what works to support adolescent girls’ and boys’ capabilities in the second decade of life and beyond.  We are following the lives of 20,000 adolescents in six focal countries in Africa, Asia and the Middle East. Download the report: