Consolidated notes of the one-day event on "What Lies Beneath Women’s and Girls’ Wellbeing as a Critical Underpinning of India’s Nutritional Challenge", December 10, 2018,

1. What Lies Beneath
Women’s and Girls’ Wellbeing as a Critical Underpinning of India’s Nutritional Challenge
Monday, December 10, 2018, 9:00 – 18:00 hrs
Opening session (Session 1): What aspects of women’s and girl’s wellbeing are critical for India’s
nutritional challenge?
Chair: Thingnganing Longvah, National Institute of Nutrition & Purnima Menon, IFPRI
Session 1: Presentation 1
Overview and structure of the conference - Purnima Menon, IFPRI
What lies beneath: Why worry about women’s and girl’s wellbeing in the context of India’s
malnutrition challenge?
• Why at this point in the juncture of India’s battle against malnutrition we should worry about
women’s and girl’s wellbeing?
• Our work: three buckets - 1) documenting and understanding the nutrition challenge, 2)
understanding determinants and drivers of change in nutrition outcomes, and 3) possible
solutions (impact of new solutions and platform.
• This event focusses on bucket (2), emphasizing women’s well-being as a critical determinant of
nutrition status.
• Recent NFHS survey data provides opportunity to understand these determinants and drivers of
change.
• For me (Purnima), biggest surprise in data is prevalence of overweight and obesity among
women (20-25%), movement in stunting less surprising.
• The nutrition challenge has taken a different shape in the last 10 years, where the
improvements/changes on average hides the considerable variability across the country.
Stunting is concentrated in northern states, anemia more widespread, and overweight is an
emerging challenge which is more prevalent within states that have been doing better on
stunting. Therefore, there are different issues to worry about for different regions.
• IFPRI research on factors which account for high and low stunting: among 4 factors which
contribute to 50% of change in stunting are women’s education, nutrition status during
pregnancy, age at marriage, and access to health and nutrition services. Therefore, we need to
think of investment in girl’s wellbeing early in the life cycle, after pregnancy/child is born is “too
little too late”.
• IFPRI research on changes in anemia over time: among important factors which contribute to
changes in anemia over time are women’s diet, poverty, sanitation, women’s education, health
and nutrition interventions, and low BMI. All critical determinants are related to women’s well-
being.
• Time to ask from the perspective-are we doing enough to address what lies beneath India’s
nutrition challenge?
• Objective of the event to firstly acknowledge the importance the role of women’s well-being for
nutritional outcomes as well as understand what works to improve women’s well-being, globally
and in India.
Session 1: Presentation 2
From mother to child: Pathways from early marriage to poor child growth in India
Samuel Scott, IFPRI

2. • We are examining the link between women who become a mother at an early age and their
child’ nutrition. This is a new topic being presented the first time and expecting feedback on how
to improve this paper.
• Examining the following pathway:
Early marriage – early childbearing – change in women’s wellbeing – influence on child’s health
and nutrition outcomes
• Outline of the talk
- Prevalence of early marriage and early child bearing globally and in South Asia and India
a. India is in 40-60% range when it comes to prevalence of early marriage. Although it has
decreased, still 41% get married early even though it is illegal
b. 50% of the burden occurs in south Asia although Africa is also heavily burdened.
c. Prevalence in India has fallen from NFHS3 to NFHS4 but remains high. This trend is seen in
India and Pakistan but not in Bangladesh where it still is very high.
d. In India, the prevalence of early marriage varies across states but is the worst in north
eastern states. Nevertheless, the situation has improved over time. A similar distribution is
also seen for early child bearing.
e. Also, we have seen that Child HAZ is better for kids born to older mothers and is lower for
adolescent mothers.
- Conceptual Framework: We are linking early marriage to child nutrition and the coefficients
have been obtained through the structural equation models.
a. Conceptual framework: We came up with 5 pathways i.e. living condition, maternal
nutrition, health services, educational and bargaining power and IYCF  leading to
undernutrition in child<5y.
b. If we look at the direct path from adolescent pregnancy to child HAZ we see significant
coefficients for adolescent pregnancy; Also, significant coefficients seen for SES and
improved sanitation under living conditions.
c. Prenatal services: Adolescent pregnant women are less likely to receive prenatal services
i.e. have worse delivery services and receive poorer childhood services.
- Policy implications: Major policy barrier is that this practice is deeply entrenched in cultural
beliefs. That is why it is difficult to enforce bans and laws. Involving men is critical. Also,
somehow hitting a single policy target can have huge benefits on nutrition and well-being of
women.
- Policy landscape analysis: Also did a policy landscape analysis outlining how Indian policies
to prevent early marriages have undergone changes over the years. We had a national policy
prohibiting early child marriage, but nothing really happened for the next 60 years.
However, in the 1990s different state government launched various schemes and programs
(Apni Beti and Apna Dhan) to encourage families to delay marriage but it was a failure.
Session 1: Q&A / Discussion
• Purnima puzzled by why such high prevalence of early marriages among well doing south Indian
states. Also, in Indian context single policy targets are not really going to work.
• Chair’s comments - Thought provoking presentation but we haven’t really gone into the depth
of the problem. Meghalaya has a matriarchical society, so women are empowered but if you
look at the nutrition outcomes it has one of the worst performances. So how do we explain this
– This is happening because early marriage is a problem in Meghalaya also. Moreover, repeated
pregnancy without giving women’s body time to recover is also responsible for poor nutrition
outcomes and micronutrient deficiencies. In addition, the dietary intake is also not adequate due
to various reasons. That is why maternal and infant mortality is so high. All these are interlinked.

3. How do you deal with this issue? Sam gave a good presentation on how early marriage affects
nutrition outcomes, but the big question is how to resolve it. Government is not doing enough to
deal with this problem. Will open the floor to audience so that we can get diverse perspectives
and feedback on how to take this issue forward.
• Smith- Would be good to know age-wise or cohort-wise breakup so that we get a better picture.
• Shruti from WFP – Lack of security forces parents to marry their child early even if they don’t
believe in early marriage.
• Would be good to know how many or what percentage conceived within the 1st year of
marriage – PHRN.
• Poonam - Even though early marriage has come down, the biggest challenge is the social norm.
What we see as a problem, community sees as a solution. As a result, it is difficult to bring
change. Family planning is also an issue and needs to be considered by the nutrition community.
Spacing of child is important. Improper spacing has resulted in high MMR and IMR – the cost of
inaction in family planning is very high.
• Sam’s response - Haven’t covered the drivers of early marriage – There are a lot of drivers – We
need to acknowledge them – difficult to change social norms – need to think how we can change
it – to get a better idea we can show a district or a state level map--- some programs have used a
broader approach of building life skills – However what works and what doesn’t is likely to vary
by place and hence same approach may not work everywhere – Monitoring of newly married
makes sense but not sure how it works. Can unpack the 41% age-wise.
• Purnima - Our work in Bangladesh has highlighted that even if there is economic progress in
some communities, it is usually not enough to prevent early marriage – Also, the challenges are
highly hyper local i.e. in some areas driver of early marriage is security but in some other place in
Bangladesh the barriers are different. We need to understand that the barriers are going to vary
by location. Also, the question of family planning is very important and is a serious problem in
India, although this kind of thing is rarely encountered in Bangladesh due to the BCC work being
done there.
Session 2: What do we know about women’s and girls’ wellbeing globally? What works?
Chair: Aswathy Sivadas, National Gender Centre, LBSNAA & Poonam Muttreja, Population
Foundation of India
Session 2: Presentation 1
Global interventions to improve women's and girls' wellbeing and implications for India
Rohini Pande, Harvard University and EPoD
• Puzzle 1: Even though sub-Saharan countries have a lower GDP on average than India, India has
a higher stunting rate. Even reasonably rich states like Gujarat are performing worse than
African countries on the height for age z-score. Improvements in economic growth have led to
improvements but are not enough to solve the problem of stunting in India.
• Puzzle 2: Usually, when countries are poor, most people work in agriculture. As incomes rise,
women drop out of the workforce, but after incomes rise further, returns to education rise and
women then enter the workforce. In India, we are not seeing this; labor force participation is
decreasing and not increasing.
• Structure:
- Linking son preference and child stunting
- The economic rationale for son preference:

4. o Role of gender norms around women’s work which limit women’s participation in
the labour force and further increase son preference
- Change power dynamics through public policy: nutrition interventions are not enough, and
affirmative action is needed
o Women as political actors (quotas)
o Improving financial independence
• Puzzle 1: Linking son preference and child stunting [Jayachadran Pande (2017)]
This paper looks at two rounds of DHS surveys across 27 African countries and India to try to
decompose Puzzle 1.
Findings: Indian height deficit was driven by higher-parity children; second, third and so on
children were contributing to the problem. This provides a bound on how much genetics is
causing the problem. Second, parent’s allocation across children integral to height puzzle. This
means that investing in the first child’s nutrition has a lower impact than investing in the second
or third child’s nutrition. Further, if allocation of nutritional resources is higher for earlier
children, this may have consequences for overweight as India gets richer.
In the first round of surveys, for the first child, India and Africa performed roughly the same with
respect to HAZ scores, with India perhaps performing slightly better. By the second child,
however, India is performing worse, and this gap widens significantly if we compare the third
child across the two countries instead.
The second round looks at post-2010 DHS surveys and NFHS-4. Stunting on average has reduced
between the first and second round of surveys, but the same patterns are clear. The average
stunting rate has reduced in both Africa and India, and the average height gap has gone down,
but this gap remains significant and negative. This ‘birth order effect’ is still driven not by the
first child, but by the second and third children.
Possible drivers: Birth order effects in health inputs (both pre and post-natal) may be driving the
HAZ gap. For example, the third-born child is less likely to get vaccinations than the first-born
child. Between the two survey rounds, the reach of interventions has increased. Areas where
total child vaccinations and institutional delivery rates have risen are areas where the effect of
birth order has increased. On the other hand, since the number of pre-natal visits has not
changed much, significant birth order effects continue to persist.
Explanation: First-son preference driven by patrilocality and patrilineality, thus affecting
resource allocation among children. This manifests through two paths. First, the girl is directly
worse off because she was not born a boy. Second, son preference means that if the first child is
a girl, parents will keep having children until they have a boy, meaning that girls are more likely
to come from larger families, meaning that they get allocated fewer resources.
The India-Africa height gap continues to exist only for girls, and this is not being affected by
economic growth. While earlier, third-born girls and third-born boys were equally worse off,
third-born girls are now worse off than third-born boys. Preferences could be driving this effect:
girls are doing better in states with matrilineal preferences, and areas with low sex ratios (boys
to girls) also do better in terms of girls’ height.
Summary and conclusion: Economic growth in itself has not been enough to change these social
norms. But what are norms? They are standards describing typical or desirable behavior, and
sanctions or rewards incentivize a certain behavior. How can we change these power dynamics?
• Puzzle 2: The economic rationale for son preference
Female LFP in India is low and declining; India scores 121 out of 131 countries in the best-case
scenario. GDP is growing fast, as is female education, and fertility has fallen, but this has not
translated to higher female LFP. Comparing wives’ work by husbands’ income quintile, the
authors find that work has fallen dramatically among wives of poorer men, but there is no

5. corresponding rise for the top income groups. This does not seem to be driven by women’s own
preference to opt out of the labor force; surveys indicate that women do seem to want to work!
In India, the problem seems to be a lack of entry rather than exit; they may be getting educated,
but they may not have the power of mobility to travel to where the jobs are, especially if they
live in rural areas where the jobs are not. If marriage is universal and/or early marriage is
prevalent, then women know that they may have to relocate again after their marriage; there
may be less incentive to find a job that they cannot continue for long.
Gender norms are linked to marital norms and intra-caste marriage. There are restrictions on
women’s movement within and outside the village, thus restricting access to jobs. Since fewer
and fewer jobs are agricultural, women cannot get to where the jobs are if they do not have the
freedom of mobility. This has a cyclical effect: Lower labor market outcomes for girls makes
parents less likely to think of daughters as being financial support in their old age, this affects the
preference to have a son, as well as allocate resources to the son, which further reduces the
prospects of women.
Men also assign a higher social cost to husbands of working women than the women
themselves! We need to bring men into the conversation, but that may be a hard thing to do. In
terms of social reputation, men may think that non-working women are better off. There are
safety concerns too, leading to a vicious cycle: fewer women working means they are working in
male-dominated workplaces and industries, reducing their safety and increasing the risk of
discrimination and sexual harassment. This in turn makes these workplaces less attractive to
women and reduces the women working.
Implications for women’s well-bring: Parents in South Africa value children providing old-age
support, and patrilineal and patrilocal norms means that they value sons more than daughters in
this respect. Daughters are less likely to enter the labor force, and then son preference is
magnified by these economic concerns. There is evidence on how to counteract this effect.
Jensen (2012) found that providing villagers information about job market opportunities in BPOs
led to improvements in young women’s labor market outcomes as well as education. Knowing
about these opportunities may change perceptions of working women and make it more
acceptable for women to work; making women’s employment viable may improve their
educational outcomes as well.
• Policy Opportunities
The policy discussion right now is being framed as gender-neutral, but this misallocation of
talent has implications for the economy as well as intergenerational effects. A way of dealing
with this is affirmative action.
1. Gender quotas in politics
Currently operating at the panchayat level, but planned at the state and national level as well.
Can transfer power to women by providing them political positions. Seeing women in positions
of power can change beliefs and aspirations of young girls. Women leaders may also alter
spending decisions that can directly impact the outcomes of women and children.
Changes to policies with implications for health: Women are more likely to invest in policies
that have huge effects on nutrition and health. For example, women are more likely to invest in
drinking water (Chattopadhyay-Duflo, Beaman et al). Another study uses close elections to look
at the effect of having a woman leader as opposed to man leader. Women politicians are more
likely to invest in village health infrastructure; this has implications for neonatal mortality.
Effects of quotas: Quotas have improved election outcomes for female candidates. Areas that
were never reserved are less likely to have female politicians than those that were reserved
once or twice. Reservations may also reduce gender gaps in aspirations, in terms of parents
aspirations for their daughters, and reduce time spent by girls on household chore

6. Extend affirmative action? If not implemented properly, this could lead to ceilings;
implementers could just try to hit targets without understanding the underlying norms that they
are trying to change. Understanding causal channels is needed for these programs to work.
2. Enabling financial independence for women
- Alleviating the impact of norms requires intervening within the household
- Can strengthening women’s control over earnings strengthen their bargaining position when it
comes to work?
- If it increases work, is it also increasing empowerment?
Female bank accounts and linked earnings – Status quo: women’s earnings deposited into
husband’s bank account. The intervention provides bank accounts to these women. Therefore, it
is incentivizing a certain group of women to work who did not work before.
Findings: Changed women’s decisions to work. 2 years after linking accounts, women who had
not been working were seen to enter the labor force. The program changed beliefs of what was
appropriate in women who had been influenced to work by the program. There were also
changes in empowerment among those who did not work in baseline; they more likely to make
purchases with their resources. There was not much change in beliefs of husbands, but there’s
also not a lot of effect on gender-based violence. However, there were higher rates of anxiety
and stress, either by increased conflict or strain of working and managing a bank account.
Economic empowerment and well-being: Intergenerational persistence of health disadvantages
for women. If parents do not see girls as economically valuable, they will not invest in them, and
this cycle will continue. Economic growth and direct health interventions can reduce this
disadvantage, but we need to directly influence women’s economic empowerment as well,
especially in settings where women actually say they want to work. Otherwise, we risk seeing
greater gender gaps. We need to understand how norms influence the allocation of labor
market returns; broad policies are easier than looking at addressing power dynamics, but at the
same time are less effective.
Session 2: Presentation 2
Global evidence on agriculture and rural development interventions to improve wellbeing of
women
Agnes Quisumbing, IFPRI
• The presentation touched upon the topics of empowerment as an aspect of wellbeing and its
defining characters, lessons learnt from GAAP1, measurement of agency through WEAI, and
learning from GAAP2.
• Empowerment was described as a process closely related with well-being. Presenter elucidated
empowerment as an interlinkage of resources (material, human and social resources that
enhance one’s ability), agency (capacity to define one’s own goals and make strategic choices in
pursuit of these goals) and achievements.
• Next, presenter discussed about GAAP1 project, which stands for Gender Agriculture and Assets
Project Phase 1. The objective of this project is to reduce the gap between men’s and women’s
use, control and ownership of assets, broadly defined, by evaluating how and how well
agricultural development programs build women’s assets. It is a four-year project supported by
the Bill & Melinda Gates Foundation (mid 2010-mid 2014), jointly led by IFPRI and ILRI, including
8 core project collaborators working in Sub-Saharan Africa and South Asia.
• The focus of this project is on assets and gender because firstly, increasing control/ownership of
assets help create pathways out of poverty more than measures that aim to increase incomes or
consumption alone, and secondly, who receives or control these assets matter. There is

7. evidence from many countries that increasing resources controlled by women improves child
health and nutrition, agricultural productivity, income growth. Under GAAP1, about 8
agricultural development projects were evaluated to:
- Identify the impacts on men’s and women’s assets
- Clarify which strategies reduce gender gaps in asset access and ownership (Johnson et al.
2016)
- Use a participatory process between implementers, evaluation partners, and GAAP team, to
add a gender perspective to existing impact evaluation
- Use existing baseline surveys and add-on targeted studies (qual and quant)
- Also included training and technical assistance to program staff
- Developed a toolkit and practitioners guide (gaap.ifpri.info)
• The main findings of GAAP1 include:
- Gendered use, control, and ownership of assets affect the take-up of agricultural
interventions
- Agricultural interventions affect the gendered use, control, and ownership of assets
- Gendered use, control and ownership of assets is more nuanced than simple male or female
individual ownership: jointness is also important
• Discussion on two key development projects under GAAP1:
(a) Enhanced -Homestead Food Production program in Burkina Faso
The project is targeted at women with children 3-12 months of age at baseline. Coverage
locations include eastern region, gourma province and fada district. Water shortages inhibit
having a second cultivation season in these areas, and there is a high prevalence of malnutrition
(stunting 30%, underweight 30%, wasting 14%, anemia 92%). Overall goal is to improve women’s
and children’s nutritional status. Impact evaluation design included a cluster RCT trial,
longitudinal survey design, quantitative household survey along with children’s growth and
haemoglobin measures. There were two rounds of process evaluation including specific
qualitative research on gender related topics including ownership and control over agricultural
assets.
Findings of E-HFP Burkina Faso Study:
- Program had positive impacts on dietary diversity, anemia and wasting among children, and
thinness among women; positive impacts were limited to Health committee villages vs
control villages.
o Greater increase in children’s hemoglobin both among children 3-12 mo and a larger
impact among children 3-5.9 mo at baseline
o 14% greater decrease in the prevalence of anemia among children 3-5.9 months of age
at baseline
o 9% greater decrease in the prevalence of wasting
o 11% greater decrease in the prevalence of thinness among women
- Women’s participation in the E-HFP program increases their ownership and control over
agriculture assets, has a positive influence on changing perceptions related to women’s
ability to own and use land for agriculture purposes and improves their health and nutrition-
related knowledge.
- These positive changes in women’s ownership and control of assets likely related to positive
changes in nutritional outcomes
(b) BRAC-Targeting the Ultra Poor Program, Bangladesh
It is “TUP Phase 2” – running from 2007-2011, allocated using a randomized controlled trial
design. Mixed quantitative and qualitative methods are used to explore TUP’s impacts on the
targeted women themselves.

8. Key findings of the project include:
- CFPR-TUP increased asset ownership at household level
- In terms of “tangibles” assets, mixed effects on targeted women:
o Increased women’s ownership and control over transferred livestock
o However, greater increase in men’s sole ownership over other forms of new investment
in assets
o Reduced women’s mobility outside the home due to transferred asset requiring
maintenance inside the homestead
o Reduced women’s voice in a range of decisions
- In terms of “intangible assets”, effect on targeted women appear more favourable.
o Women’s social capital increased (having better clothing meant they were no longer
ashamed to be seen by others)
o Given sociocultural stigma of working outside home, women preferred working at home
even with reduced mobility
o Women themselves framed project impacts more in terms of intangibles (self-esteem,
satisfaction in contributing to household and children’s well-being, status in the
household and community, etc) than individual rights or material gains. If increasing
women’s asset ownership and decision-making power are explicit goals, a targeted asset
transfer may not be sufficient; local sociocultural norms may themselves need to be
changed.
• Presenter highlighted that a lot of interest in women’s empowerment is witnessed among both
donors and implementors. Implementing agencies design and implement “women’s
empowerment projects”. However, an important question is if projects actually “empower”
women, or just “reach” or “benefit” them? To measure empowerment, a credible indicator is
required. For example, in a maternal nutrition program, if the objective is to deliver nutrition
intervention to women, the monitoring indicators could be number of women attending
nutrition training and receiving intervention. For a program trying to improve women nutritional
status, sex disaggregated data for nutrition and time use can be considered for monitoring
purpose. However, if a program’s objective is to increase women’s agency over health and
nutrition decisions, empowerment related indicators such as decision-making power over
income, food consumption and health can be evaluated.
• Lastly, presenter discussed about ongoing work under GAAP2, which is a learning and capacity-
development initiative working with a portfolio of 13 development projects in the Gender,
Agriculture, and Assets Project Phase 2 (GAAP2). In GAAP2, a portfolio approach has been
employed to measure empowerment using WEAI (Women Empowerment in Agriculture India).
Project strategies to empower women include direct provision of goods and services to
beneficiaries and an indirect provision by supporting availability or access, strengthening groups
or organizations such as enterprise, build knowledge and skills via agricultural training and
extension, nutrition education, business and finance training etc., and community conversations
to identify community solutions to gender issues.
Session 2: Q&A / Discussion
• Question 1
Dr. Priyanka Chatterjee (PHRN): Have you focused on the effect of sending girl children to their
relatives instead of keeping them at home on nutrition and other outcomes?
Rohini: We don’t know a lot about this, or about women’s movement in terms of going to the
natal home after delivery which affects post-birth and post-pregnancy care.
• Question 2

9. Neelam: Gender quotas in politics. In the Indian context, there are many women who are
panchayat leaders, but what is their preparedness in these roles and their impact on nutritional
and health outcomes? Furthermore, how do we deal with women as proxies for men?
Rohini: Even in a place where there may not have been training, having a woman leader makes
women more likely to vote for women, so they must be doing something right! And yes, women
may be running with their husband’s support, but this may be because they don’t want to
• Question 3
Unknown: What are we doing about men’s empowerment?
Rohini: The existing society provides rents to some groups. Brothers and not parents are the
gatekeepers of these norms in many families. Male attitudes need to be changes, not specifically
male empowerment.
Agnes: What is men’s empowerment and how do we measure it? In fact, most indices also
measure men’s empowerment. Men and women are disempowered in many areas, but women
are more disempowered in India as well as global.
• Question 4
Rohini (Nandi Foundation): We’re looking at women who would use NREGA; the bottom most
quintile. What about quintiles 3 and 4?
Rohini (EPoD): People who don’t want agricultural jobs anyway: maybe looking at movement
into jobs at CCD and so on.
• Question 5
Dr. Siddharth (Project Concern International): Dealing with social, cultural and agricultural
issues. How has the SHG platform affect women’s empowerment and activity?
Rohini: A lot of the focus of SHGs is focused on married women; we need to start focusing on
single women too.
Agnes: Positive impact on empowerment; reduced gap between men and women. We do not
want to disempower men, we want to close the gap.
• Question 6
Unknown: M shaped graph for women in LFP. What is it like for men? Second, sustainable
female empowerment models that keep the fabric of the country intact? For many, marriage for
women means relocation and displacement in India. But there’s an in-between workforce, that
prefers home-based work like teaching and entrepreneurship. We need to stratify and
understand cultural context.
Rohini: A lot of women want to go where the jobs are; they are bored at home. They do not
necessarily want to work within the home.
Agnes: Women themselves as empowerment in the context of their family and society. They
think of power of the group and power of the community. They feel that if they are empowered,
they will be able to help others and bring people along. If we see the social norms are a barrier
to progress, we need to bring men along too. Putting the entire burden of empowerment on
women is not sustainable! Example: program in Bangladesh that is trying to change these
cultural attitudes and norms.
Session 2: Closing remarks from the chairs
Aswathy: The Ministry of Rural Development is in charge of training Panchayat leaders, and the
modules that they use for training needs to be improved. The National Centre for Gender developed
modules to be used by these institutions, especially in terms of creating plans for Gram Panchayat
programs. More information from Sarojini Thakur. Political representation of women has also shown
us that we need to have a long-term view, and not expect quick results. We need to acknowledge
the intangible benefits of these quotas: youngsters are getting more used to seeing women in

10. powerful positions. Similarly, even though SHGs were started as thrift groups, they have gone so
much further than that.
Poonam: Son preference is not the only reason; daughter aversion is also playing a part. Unwanted
fertility has a role to play; there is a huge unmet need for fertility, and the desired fertility rate is far
lower than the actual fertility rate! This has huge implications for education and nutrition across
society, but especially in poorer families, who are definitely more resource constrained. Investing in
increasing access to resources and assets will increase empowerment, but civil society has a role to
play. Changing social norms is critical, but changing norms around gender is one of the most difficult
to change. Entertainment education, however, can change social norms very quickly, and there are
many success stories, including decreasing fertility in Brazil. Indian story – After 52 episodes of Mein
Kuch Bhi Kar Sakti Hoon women were more likely to negotiate family planning with their husbands,
and men and women were more likely to say that domestic violence is not acceptable. Changing the
social norms and attitudes of men is the biggest thing we can do, we do not want to disempower
them. Both men and women watched Mein Kuch Bhi Kar Sakti Hoon, and they watched it together. It
led to conversations between women and men, and between parents and child. Women and girls
have very different aspirations, and there are huge opportunities to make things better. Season 3
name: Desh badlega jab mard badlega. We ought not to worry that much about men’s
empowerment and worry more about the 30% of girls who do not have mobile phones in this age of
digital disruption.
Session 3: Reshaping the world for India’s girls and women: What does the evidence tell us?
Chair: Subhalakshmi Nandi, ICRW
Session 3: Presentation 1
Evidence review on women’s group platforms and pathways to improved nutrition
Neha Kumar, IFPRI
• The presentation’s aim was to review and synthesize evidence on impacts of women’s group
interventions on maternal and child nutrition outcomes in South Asia.
• In the absence of a comprehensive conceptual framework, Kumar et al. (2018) published an
article in Global Food Security which identified pathways from women’s group-based programs
to nutrition change in South Asia. The conceptual framework identified 4 distinct pathways to
impact for women’s group programs. These are:
1. Income pathway
2. Agriculture pathway
3. Health and nutrition behavior change pathway
4. Rights pathway
• Additionally, 3 cross-cutting pathways were also identified
1. Building social capital
2. Acting collectively
3. Promoting women’s empowerment
• While the preceding literature showed linkages between women’s group and health outcomes
and women’s empowerment, it lacked clarity on the role of women’s Group(WGs) in improving
nutrition and which was the most important factors along the WGs to nutrition impact
pathways. To understand this missing link, Neha et. al searched databases and gray literature for
the time period 1980 to 2016. Starting with more than 18,500 articles, they were finally left with
34 articles that met the criteria of being grounded in women’s groups and measuring nutritional
outcomes in South Asia.

11. • The presentation highlighted that women’s group programs have the potential to improve
nutrition but often these pathways to nutrition are long and complex. Most importantly which
pathways are triggered depends on the nature of the women’s group program. For example,
Microfinance group- operating on the joint-liability of women’s groups that receive loans or
grants from financial intermediaries trigger Income pathway and also have some indirect effects
through agriculture and rights pathways. On the other side, Multi-sectoral group- operating on
several bundled programs to improve financial access, livelihoods, entitlements and health and
nutrition in women while keeping savings and credit the core group activity, trigger all the
pathways. Among the Cross-cutting pathways identified, it was noticed that these pathways are
always triggered irrespective of group type. Also, each pathway triggers a specific set of
intermediate outcomes.
• Looking at results and the significance of maternal and child nutrition outcomes by women’s
group intervention type and outcome category, most studies suggested null or non-significant
impacts. These were attributed to lack of rigorous study designs (of 34 studies identified for
review, only 12 were RCTs), lack of focus on potential pathways to impact, and/or not assessing
whether programs were adequate to trigger change in desired outcomes. Also, few studies
targeted nutritionally-vulnerable age groups.
• Overall the review showed that the existing evidence base is limited and that most studies do
not provide insights on pathways that lead to changes in nutritional outcomes. The WINGS
program of work at IFPRI aims to strengthen this evidence base by mapping evidence to
conceptual framework and identifying gaps. A study of evaluating an SHG-agriculture-nutrition
intervention implemented by PRADAN to strengthen the conceptual and empirical
understanding of the pathways through which SHGs can improve nutrition is already underway.
• Key takeaways from the presentation for designing successful programs included:
- Including explicit nutrition goals and actions in programs for success in delivering on
improved nutrition outcomes
- Targeting vulnerable groups that have the greatest potential for improvement
- Designing multisectoral programs to address the multiple determinants of undernutrition in
South Asia
- Collecting data on intermediate outcomes, such as women’s empowerment and carrying out
process evaluation to help understand pathways to impact.
Session 3: Presentation 2
Evidence review on strategies to address educational attainment, early marriage and other
empowerment outcomes in India
Shireen Jejeebhoy, AKSHA Centre for Equity and Wellbeing
• This video presentation focussed on evidence on supporting investment for transitions from
adolescence to adulthood.
• Entitlements for school going adolescents keep in school, reduce discontinuation and enhance
learning outcomes, reduce discontinuation and enhance learning outcomes.
• Evidences from Malawi, Pakistan, and Mexico show that conditional cash transfer programmes
promote school completion and have other indirect benefits, e.g. delay marriage.
• Evidences from Liberia, Uganda, India, and Nepal show that comprehensive skilling programmes
(not just provision of vocational skills) are associated with a successful transition to work.
Comprehensive skilling programmes blend vocational training with soft skills and life skills
training, career counselling, job search support and job-related mentoring.

12. • Global evidence review shows that school-based comprehensive sexuality education (knowledge
plus human rights, skills to make informed decisions, critical thinking and sense of self efficacy) is
skills to make informed decisions, critical thinking and sense of self efficacy) is imperative for
healthy development.
• There is global evidence to support that non-formal group-based gender transformative life skills
education develops agency, awareness and new notions of masculinity and femininity. While
many programmes have been implemented, few have been evaluated.
• Evidence review from India, Malawi, Ethiopia and Nepal shows that focused programmes for
married girls build their agency and improve reproductive health outcomes.
• Evidences from high-income countries as well as low and middle-income countries show that
programmes to engage parents improve adolescent outcomes - agency, school performance and
safe sex.
• In the case of India, investment is needed to support the Rashtriya Kishor Swasthya Karyakram
(RKSK) for implementing adolescent-friendly health clinics (AFHCs) and strengthening peer
educator programmes in different settings.
Session 3: Presentation 3
A social movement to end child marriage & dowry in Bihar, India
Mona Sinha, UNICEF
• SHG members are getting more and more politically engaged; this is especially clear in Bihar. In
Bihar, an unmarried girl is called a Kumari, a virgin. As soon as she gets married, she is called a
Devi, a goddess. Suddenly, she has achieved a respectable status in society: this is the premium
we place on marriage. Bihar is the second highest reporter of dowry deaths and torture. It also
has the highest child marriage rate, even despite programs to improve women’s agency. There
has been a drop in the child marriage rate, but a great deal of work remains to be done. A host
of schemes have been initiated by the government since 2005, such as Kanya Vivah Yojana and
so on. Some of these schemes have changed the rural landscape of Bihar – these days, you can
see girls, in uniforms, on bicycles, cycling to school. The Mahila Samakhya Yojana has been
discontinued by the government, but has been taken over by the Jeevika SHG group. 1 lakh
functional groups with 1 million members are functional in Bihar, engaging with the government
of Bihar and making demands such as banning liquor; domestic violence is reported to have
decreased in rural Bihar.
• The government of Bihar has taken up the challenge in a big way, by implementing women-
friendly social protection schemes and launching schemes that focus on gender mainstreaming
and promote responsible parenthood. The launch of the Mukhyamantri Balika Cycle Yojana was
instrumental in helping girls transition from primary to secondary school.
• A zero-tolerance approach to crime and making police departments accountable led to crime
coming down and the perceptions of safety going up. Women became more mobile, as through
girls. The prohibition of the sale of alcohol in 2015 was another step. Jeevika members asked the
government to end child marriage and dowry, leading the government to make it a policy
priority. More recently, the Integrated Conditional Cash Transfer gives girls a certain amount for
every milestone crossed. Even though there are implementation issues, it is a promising scheme.
The Bandhan Tod platform offers a peer-support network as a protective measure against child
marriage.
• 3 Phased Implementation Plan
- Reducing prevalence of child marriage below the national average

13. - Bring down atrocities related to dowry by at least 50%
- Use media advocacy to build opinion, created awareness and champions from communities
The value of this program is that while child marriage used to be the norm in Bihar, but for the
first time, people started talking about it and questioning it.
• Strategy 1: Leading from the top with Planning, Review and Commitment
This was done by generating the highest level of political commitment, as well as s
comprehensive SBCC and advocacy package. Another part of this strategy was a state-wide
multi-media initiative, A huge human chain with 15 crore participants attempted to bring focus
onto child marriage and created awareness around it. UNICEF supported the government of
Bihar in developing in a package of interventions, as well as a multimedia initiative with a variety
of activities including media fellowships. This led to TV spots and radio jingles going viral in Bihar.
• Strategy 2: Developed a costed State Plan of Action
This included mapping and reviewing existing schemes, as well as conducting budgetary analysis.
With the Women Development Corporation, a plan was rolled out in 5 districts in Bihar and used
to put together the state plan of action. A working group was constituted and chaired by the
Chief Secretary, and the government commitment went from that high level right down to the
Gram Panchayat level. Roles and responsibility for all concerned groups and departments,
including WDC, CPCs, Gender Resource Centre, UN agencies, state departments, NGO partners
and community stakeholders were finalized. Each official was assigned specific rules on what to
do, and whom to contact to prevent child marriage.
• Strategy 3: Large scale capacity of line departments
Following a cascade system of training, 600,000 government officials and functionaries were
trained. Standard operating procedures and capacity development tools were finalized, modules
for training district administration, block development officers and civil society organizations
were developed. 8.8 million USD was leveraged so that the program could be rolled out state-
wide in 2018. At the district level, 400 trainers were trained from 7 key line departments.
• Strategy 4: Re-designed a consolidated ‘Cash Transfer Plus’ programme
The CCT in Haryana (Ladli) was used as a template to learn from; learnings were also drawn from
various global examples. The strong implementation structure was intended to support the new
CCT program, with panchayats, teachers and school management committees all playing a role
to mentor young beneficiaries. The program provides scholarships for higher education and
vocational training and micro-credit; it is linked to government programmes and aims to develop
safe spaces through community-based platforms.
• Multi-media SBCC Initiative
This was a three-phased initiative, of which the first was the development of a multimedia SBCC
package to create knowledge and awareness. This package include TV spots, radio jingles,
hoardings, banners, print media and social media. The performance of kala jathas and nukkad
nataks was instrumental in reaching 8400 gram panchayats. Phase 2 was undertaking capacity
development of key functionaries on child marriage and dowry, specifically by emphasizing the
roles and responsibilities of stakeholders and mobilization of local groups with the objective of
prevention and monitoring. Third, interpersonal communication was used to ensure reiteration
of key messages, specifically a systematic follow-up of state-run adolescent schemes and
monitoring and evaluation of the impact of campaign activities.
• Results of the Program
At the individual and household level, the issue of child marriage and dowry has more visibility
and more dialogue is being generated around it. The connection between early marriage and
outcomes such as poor nutrition as well as maternal and infant mortality has been established.

14. People now have more access to information on legal structures and lawful rights. Finally, the
campaign has engaged men and boys in the dialogue as well.
At the community level, reporting of incidents has increased, and groups and coalitions have
been formed. Monthly meetings of these groups are more and more accepted by the
committees. The campaign has given a boost to existing government programs and community
initiatives, and has also led to increased conviction on the need to educate adolescents.
The strong SBCC package has led to the visibility, reinforcement and retention of key messages
at the key influencer level. Finally, at the systems and political level, the campaign has seen a
high level of political commitment, the mainstreaming of key messages, sustained momentum,
multisectoral convergence, and cooperation between departments, agencies and civil society
organizations.
• The Kanya Uthhan Yojana aims to encourage girls who have discontinued school to come back to
school. The first phase of this campaign focused on building an enabling environment, making it
a topic of conversation in households. The second phase is focused on sustaining the campaign,
addressing the gaps, increasing media engagement, and streamlining the process to achieve the
desired effect. Impact: 972 cases of child marriage have been reported to have been averted.
This is a good sign, and hopefully we will see more good news from Bihar.
Session 3: Q&A / Discussion
• Question 1
Sam (IFPRI): Could you explain the specific conditions for receiving cash, and the timing, and any
plans for a rigorous impact evaluation?
Mona: The Kanya Uthhan Yojana looks at 10 milestones, 1) birth to 3 months, 2) one year of age,
3) two years of age, 4) full immunization, 5) class one admission (for uniform), 6) class 3-5 (for
uniform), 7) class 6-8 (for uniform), 8) class 9-12, 9) unmarried girls who pass 10th grade, 10)
passes 12th grade.
Rs. 54000 spent on each girl if she crosses all these milestones. The JSY will also be subsumed
into this.
(Note from Priyanjana: There is some confusion between what Mona said and what the internet
says about these milestones. For example, a milestone listed online is Aadhar card preparation,
but I don’t remember her saying that (though I could have missed it). Second, she specifically
mentioned money being given to girls in class 9-12 for menstrual hygiene, but online it says that
one is also for uniforms.)
• Question 2
Priya Das (OPM): The first presentation was how group activities serve as a platform, and
Mona’s was interesting in terms of how they’ve taken learnings from different cash transfer
schemes. What’s interesting is that now in Bihar, with RMNCH, we seem to be working in
different silos. How does it tie up with the transition to adulthood mentioned by Shireen? How
does each program, be it nutrition, transition to adulthood, and child marriage, tie in with the
other?
Neha: We’ve been talking about multisectoral convergence for a while. With Jeevika, we’ve
been trying to do this. We need to identify target households and make sure the interventions
converge at the household level. While evaluating, we realized that it is extremely difficult to
develop a program like that, but we should not give up because that is the way to go.
• Question 3
Neelam (UP): How have you involved child protection committees at various levels to address
this issue? For example, in UP the gram panchayat is very involved. My question involves
operationalization of the program.

15. Mona: The sarpanch is held directly responsible if a child marriage takes place in his/her gram
panchayat. CPCs have been formed under ICPS, and while they were not very active before, they
are now. They know what to do and whom to contact.
• Question 4
Sarojini Thakur: A lot of work in terms of IEC have taken place. Is there any linkage between the
initiatives you mentioned and the funding available? The issue of targeting men and boys to
change gender norms has not really come up.
Mona: We started off the girl groups, but we are starting work on adolescent boy groups as well.
• Question 5
Shonali Khan: the state of Bihar has the highest fertility rate and the highest mobility rate to
other parts of India. How does this factor into the well-being of women and child marriage?
Context: Behaviour around social norms and dowry aren’t changing, so this could explain why
how much remains to be done – demographic factors could be playing up, and causal factors
could be shifting.
Mona: The fertility rate in Bihar is 3.4. The CM is clear on the fact that if you increase years of
schooling for girls and keep them in school, this will lower fertility. Education is going to move
indicators of fertility as girls marry later and bear children later. He has talked about the link
between child marriage, education and malnutrition. A robust family planning program is going
on (Jan Sankhya Tirthya Khosh), as well the family planning fortnight. The numbers on fertility is
not encouraging, and unmet need for FP has not really changed (NFHS). In 2010, a lot of FP work
was being done, but since then things have stagnated. In our program, IEC engagement was
huge, including outdoor media, newspapers, talk shows, radio. Media personnel were trained on
how to talk about and report on child marriage with sensitivity to the issue. Proactive journalists
were given awards. Every official is made responsible and held accountable.
Session 3: Closing Remarks from the chair
• We’re talking about reshaping the world and making it better for women. It’s not just about how
we define empowerment, but also about how we think about those pathways. Do we have
enough evidence, and how do we generate discourse and public discussion about what works?
Targeting also has to be intentional; what is the intent of targeting, and what is the design that
corresponds to this intent? Does this line up with costing and the investment? Third, all these
programs seem to be focused on adolescents’ outcomes, just as SHGs focus on certain
outcomes. It is also important to think of building the learnings – these things are important for
themselves as well.
• CCTs might be shifting the age at marriage, but don’t seem to be changing norms. Are our
programs doing enough to change the underlying determinants? Addressing control over
sexuality on the one hand, reducing violence on the other hand are two parts of this. We need to
talk more about violence: at the household level, how women are negotiating or entering the
public space, and domestic violence are all key questions.
Session 4: Facing the future: Evidence on the lives and aspirations of adolescents in India
Moderator: Purnima Menon
Session 4: Presentation 1
The Teenage Girls’ (TAG) Survey
Rohini Mukherjee, Naandi Foundation

16. • Teenage Girl (TAG) Survey - India’s first teen age girls survey was done by Project Nanhi Kali for
girls in the age range of 13-19 years. Currently there’s no large-scale data for teenage girls to
enrich our programs. It’s necessary to work with adolescent girls today to avoid malnutrition
tomorrow.
• Shared the journey of developing the tool for survey – a 2-min audio-visual presentation.
• Key findings of the latest TAG survey (age range 13-19 years):
- 80.6% of girls are currently studying in schools/colleges
- 95.8% girls are unmarried
- 73.3% girls want to marry after the age of 21
- 70% girls wish to pursue higher pursue
- 74.3% girls want to work after studies and have a specific career in mind
- 87.8% girls want to learn English
- 87.6% girls want to learn how to use a computer
- 51.8% girls are anaemic
- 46.3% girls have adequate BMI
- 39.8% girls defecate in the open
- 45.6% girls follow unhygienic menstrual practices.
• Anaemia and low BMI are still areas of problem among teenage girls – across all age groups and
wealth quintiles.
• In terms of new age skills, mobility restrictions are still prevalent among teenage girls, both for
education and work.
• A TAG index was built using the following indicators
- Currently enrolled in educational institution
- Never married
- No open defecation
- Hygienic menstrual protection
- Normal haemoglobin levels
- Normal Body Mass Index
- Five or more New Age Skills
- Own mobile phone
- Age appropriate schooling
• Top five states in TAG index are as follows:
1 Kerala
2 Mizoram
3 Sikkim
4 Manipur
5 Himachal Pradesh
Session 4: Presentation 2
The UDAYA survey in Uttar Pradesh and Bihar
Sachin Shinde, Population Council
• The presenter started with a brief introduction of UDAYA survey conducted by Population
Council for the states of Bihar and Uttar Pradesh. The objective of UDAYA survey is to profile the
situation of adolescents and change in their situation over time, and to assess the quality of
transitions from adolescence to adulthood. The survey design is both cross sectional (2016) and

17. longitudinal (2007 and 2016). The cross-sectional surveys covered about 20,000 plus adolescents
in ages 10-19 (boys & girls, unmarried & married, rural & urban). The longitudinal survey
included 3000 plus young adults in ages 23-27.
• Findings:
- School to work transitions over time in Bihar: An increase was observed in the educational
indicators from 2007 to 2016 such as ever enrolled, completed class 8 and 10 education
among older adolescent boys, older unmarried and married adolescent girls (age bracket 15-
19).There was a decrease in reported engagement in paid work or in child labour among
older boys and older unmarried and married adolescent girls.
- Gender quality in schooling experience (Bihar and UP): Almost similar percentage of older
adolescent boys and girls reported being ever enrolled in school, regularly attending school
and completing at least class 8 education.
- Agency and attitude of adolescents over time in Bihar: Ownership of bank account and
operation of the account independently, increased among the adolescents over time. More
number of adolescent boys than unmarried and married adolescent girls were allowed to
visit selected locations unescorted. An improvement in pro-social attitude was also observed
among the adolescents.
- Immediate future plans among older adolescents in UP and Bihar: In 2015-16, more than
half of boys and unmarried girls reported that they wish to continue studies. More boys than
married and unmarried girls wish to work for pay or acquire a vocational skill. Not
surprisingly, married adolescent girls reported of assuming the role of spouse, parent or
homemaker.
- Transition to marriage and motherhood over time in Bihar (2007-2016) and UP (2005-06 &
2015-16): A decreased observed in the marriage before 18 and adolescent pregnancy.
• Challenges:
- Although the enrollment in the school has increased over time, the quality of education is a
big concern. This is more so among girls.
- There is a huge unmet need among adolescents for vocational skills training. A very few boys
and girls reported of attending a vocation course. For example, among 15-19 years boys,
78% wanted to attend vocational training, but only 6% attended a course. In case of older
married women (15-19 years), 78% wanted to attend training, but only 16% attended a
course.
- Limited awareness of sexual and reproductive matters among older adolescents in Bihar and
UP (2016). Knowledge regarding getting pregnant at first sex, consumption of oral pills on
daily or weekly basis, requirement of atleast 4 ANC check-ups, and feeding new born on
breast milk within an hour of birth.
- There are also missed opportunities to promote maternal health care. Of the 100 pregnant
married girls, only one-third received PNC in these two states.
- Missed opportunity to provide comprehensive health information by frontline workers,
married girls. Only around one-third married adolescent girls reported of having interacted
with ASHAs in the last year.
- A high number of adolescents reported experiencing or perpetration of physical and sexual
violence.
- Mild depression cases were more prominent in males than in females. About 12% unmarried
women, 19% married women and 8% men showed symptoms of mild depression. Married
older girls were more likely than all the others to display symptoms of moderate to
severe depressive disorders.

18. Session 4: Q&A / Discussion
• Question 1
Santosh Malhotra: We’ve done very well in the last ten years in increasing secondary enrolment,
and with gender parity. Two things about your presentation were heartening to me. Girls are
getting educated, but what after that? For the last 4-5 years, the LFP of girls and women has
continued to drop. A major reason for that is that non-agrarian jobs are not growing, and many
youth do not want to work in agriculture. The fact that girls want to marry after 21, that they
want to learn English, get jobs and learn how to use a computer is amazing. Having talked to
parents or to kids themselves, what do you think can be done to encourage vocational skills and
create jobs for these kids closer to home?
Rohini: Naandi Foundation partners in many programs on skilling and placing youth, both boys
and girls, in formal sector jobs. They are enrolled in a three-month course that helps make youth
more employable. These courses focus on learning English, using computers, and also job-
focused skills based on where they will be placed (CCDs, McDonalds, etc.). Employers are coming
back to use for more recruits. Moving jobs to rural areas may not be feasible, but we can
improve digital and physical mobility. Industry needs people, but it needs certain qualities in
people, and if we can generate these qualities, then we have more jobs. However,
entrepreneurship is also needed. The definition of vocational skills is changing: today, the major
skill is coding, and that needs to be encouraged.
Sachin: Enrolment is high in the schools, but studies in Bihar and Delhi (RCTs) suggest that
though enrolment is high, daily attendance is low; only 40-50% of students are attending on any
given day. Acer surveys talk about literacy and numeracy skills, as well as life skills that kids are
getting through their education – adolescents do not necessarily feel that school is preparing
them for life, in which case high enrolments will not be enough.
• Question 2
Vani: One, a lot of analysis takes place with NFHS because it is easily available. Now, we have
data from urban slums and so on. Would be great if TAG made this data available too. Two,
methodologies do make a difference when we project the data; we use BMI z-score as the gold
standard. Maybe you could consider recalculating in terms of z-scores. Third, how you measure
anemia makes a difference, so maybe talk about how you took the blood samples. How do we
compare between surveys that measure these in different ways? For example, earlier versions
used the capillary method. How do we screen malnourished women or adolescents? There’s the
screening method, and the care method. Finally, we’d like to collaborate with researchers on
nested evaluations; we have a lot of data and program officers have a lot to offer researchers.
Rohini: We do plan to put data out in the open; the report just came out, and the data will be
out in the next few months for researchers who want to do better research. On the BMI
methodology, as long as the data is there, other researchers can use their own methods. This
can be used to develop interventions for government programs. For anemia, we used the
HemoQ machine, and did the analysis then and there. Collaborations: yes!
• Question 3
Unknown: We have an aspirational India, and kids do not want to be left behind. What’s on their
mind is what is trending. Nutrition is not necessarily trending. We have great academic
discussions, but these need to be brought to the centre stage so it becomes the kind of thing
that middle-class families discuss at social events. Also, age at marriage has moved a lot, but
anemia does not seem to have changed at all. Which variable does it most closely relate to? Is it
wealth, or something else? Can we work on shifting that?

19. Rohini: No correlation between anemia with age, rural/urban or wealth. My view is that it goes
back to the status of women. Our major question is, why are all these good things happening?
We need to find out more about what’s working.
• Question 4
Neha: It’s great that you looked for data, didn’t find it, and created a dataset yourself. You talked
about girls’ aspirations, and an enabling environment outside the home. Did you interview the
parents, what were their perceptions, and will you follow these same girls five years from now?
Rohini: We did talk to parents, but not in a structured way. We got their consent. There was a
diverse range of responses: some were ambivalent, others were very excited and interested; we
definitely saw a lot of engagement. It would be great to follow these girls 5 years later, but we
don’t know if that feasible. However, we will definitely be looking at the Nanhi Kalis as we move
forward, even though that’s not exactly a random sample.
• Question 5
Shonali: Violence, other forms of discrimination, and nutritional outcomes are all forms of
discrimination that women face. If girls are not marrying early, how does that effect these other
forms of discrimination? We’re not seeing a lot of movement towards gender equality, with girls
having lower skilled jobs, and education not really meaning equality. When we think of future
for the girls, using both these sets of data, what do we need to plan for? Do we just run anemia
programs, or, if girls are in schools, will that affect anemia outcomes? We need to stop thinking
in silos, and we need real strategies to empower girls. Are things like being able to use Google
really signs of empowerment?
Sachin: Life skills education is very important, be it bullying or agency. We need to think about
what skills they need, and also provide them with platforms to use those skills, be it
communication, negotiation, or relationship building.
Rohini: Status of women, what’s being decided in the home, and who’s deciding it all factor into
empowerment. Shireen talked about some of the markers of a successful transition into
adulthood, and what the data is telling us is that we’re better off than we were before with
respect to some of these markers, and that should give us hope. Girls say they want to work and
earn their own money, but if you ask what they want to do, their usual answers are teacher and
nurse, because those are the only role models they have – they need more exposure, maybe to
success stories of girls from humble backgrounds in sports. We have female police officers come
talk to our Nanhi Kalis, but maybe we need bigger policy approaches to this too.
• Question 6
Unknown: Rohini: Is the age at menstruation going down? Why are 30% of girls not going into
secondary education? To Sachin: There’s a lot of data, and I think you just touched the surface.
Rohini: They didn’t always remember when they had their period, and required conversation.
Due to time constraints, we didn’t have that question. Only 65% are going into secondary
education, and that’s a major question in our mind. The answers are a) can’t afford it and b)
can’t travel so far. That tells us what we need to do about it.
• Question 7
Shivani K: 95% of girls are unmarried; do you know what that looks like across the age window,
and the wealth quintiles, and so on? Even if only 5% of girls were married, how did nutrition
status and education look like for that 5%?
Rohini: We’ll write to you about this later.
• Question 8
Neeraj: Have you thought about sharing the results back to the communities you got them
from? For example, sharing the aspirations of these girls with their parents and sarpanches and

20. create a buzz around them? Hopefully some of what you’ve done gets embedded in NFHS, but
getting the voices of the boys could be valuable too.
Rohini: This data is definitely going back to those 5000 villages that we collected data from, and
we’ll also be having state-level dissemination events.
• Question 9
Shonali: Ending child marriage and FGM is a huge policy priority. I saw your data and something
worried me. WHO said India was not at high risk of HIV, and the resources coming towards that
disappeared. While I’m heartened by this data, up to now early marriage has been the Holy
Grail, with all these other things centred around it. If what you’re saying about early marriage is
true, what will that do to the funding? And now what? What is the empowerment narrative
going to be now?
Rohini: It’s a valid concern, but it’s up to us to make sure this won’t fall through the cracks so
that this remains a policy prerogative.
Sheetal (program funder): We were extremely surprised by this 95% figure. We track the girls
we support, and when they drop out we know why. Early marriage is a reason for drop outs, but
that is extremely rare. That gives me hope that what we’re seeing could really be happening.
• Question 10
Purnima: What was the sampling method? What if married girls have not been representatively
surveyed? What if they were not reached, either because people don’t consider them to be
girls? What if you got the daughters and not the daughters in law? The NFHS data on ever
married children does continue to show a lot of early marriages, so we need to think about why
this is different.
Rohini: When we did the household listing, we did run into this issue. We asked for ladki, and
ladki was interpreted as the unmarried daughters of the household. We then started asking for
mahila between 13 and 19. So we know that bias has been avoided. We did compare our data to
NFHS to see what was going. As for this difference, maybe it’s because our result is more
contemporary. NFHS-4 happened a few years ago, and the 15-19-year-old women who were
surveyed are older now; those are not the women that our data is capturing.
Session 4: Closing remarks from the chair
We looked at what underpins women’s ability to take care of themselves and their children, and that
covered a lot of these. How do we force and create these conversations and taken them back to
these critical underpinnings? The data keeps telling us that we have a huge problem, and nutrition is
not enough to tackle that. CCTs are a popular way of dealing with things, but no one has really
identified a central issue that is at the core of all this and should be dealt with. We have the data to
look at the determinants that can drive the change, and these convening is a good start. We will
come back to you to tell us what the next steps are and who we need to reach out to make this
happen. I saw a lot of great ideas, but we saw that the Indian program community does not seem to
be doing enough impact evaluations, whether it’s in nutrition or in SHGs or in transitions to
adulthood. Programs are being rolled out, but we need evidence from them. Finally, the last
presentation was especially powerful for me. Teenagers often look you in the eye and tell you what
they want, and thinking about the data, it makes me wonder what the parents of those teenagers
think, and how they think they can deliver on those hopes and dreams? There are resource
constraints, but how do public and private actors help these parents make that happen?