A presentation by Professor Sarah Baird to '11th Annual CUGH Global Health Conference', Washington DC, US, April 2020

1. Adolescent girl at a recycling plant in Dhaka, Bangladesh © Nathalie Bertrams / GAGE 2019
What works to Improve the Lives of Adolescents?
Preliminary findings from Gender and Adolescence: Global Evidence (GAGE)

2. Outline of Presentation
1
• Introducing GAGE
2
•Early findings from Bangladesh, Ethiopia, and
Jordan
3
•Implications for programming and policy
solutions

3. 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.
GAGE overview
12 year old Syrian girl in Mafraq @ Natalie Bertrams / GAGE 2019

4. Adolescence: Age of opportunity
Adolescence
10-19 years
Rapid neuro-
development
changes Growing
adoption of
adult-like
roles, e.g.
work, intimate
relationships
Increased
salience of
gender norms
in daily life
Increased
interaction
with peers vs
parents
Psycho-
emotional
and self-
identity
changes
Physical and
reproductive
changes

5. Adolescence: The demographic imperative
% total population 10-24 years in 2013
Source: Accelerating adolescent girls’ education and empowerment:
G7 Whistler Meeting 2018 | May 2018
Globally, 1/6 of the
world’s population is
an adolescent.
In Ethiopia, it’s 1:4.
In Jordan and
Bangladesh, it’s 1:5.
Multi-dimensional
poverty affects:
42% in Bangladesh
84% in Ethiopia
40% in Jordan
Multi-dimensional
poverty affects:
42% in Bangladesh
84% in Ethiopia
40% in Jordan

6. Gender and Adolescence: Global Evidence (GAGE):
A longitudinal research programme (2015-2024)
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 the largest cohort of adolescents in the Global South

7. GAGE 3Cs Conceptual Framework

8. Quantitative survey:
• Adolescent girls and boys + their
caregivers
• 2 age cohorts: 10-12 yrs + 15-17 yrs in
rural and urban locales, in programme
intervention and non-intervention
sites
• Sub-sample of adolescents with
disabilities
Qualitative and participatory
research:
• Nodal adolescents, their siblings,
caregivers, community leaders
• Nested sample of adolescents with
disabilities
• Key informant interviews and historical
process tracing with officials, service
providers and donors
Annual participatory research:
• Nodal adolescents, their
caregivers and peer networks to
better pinpoint shifts in
adolescent capabilities over time
• Social network analysis to
understand evolving influence of
peer groups
GAGE research sample
8

9. Stemming from our conceptual framework, GAGE addresses three core sets of questions:
GAGE Core Research Questions
1
• How do adolescent girls and boys in diverse low- and middle-income
countries (LMICs) experience transitions from childhood to adulthood? How do
these differ by age, gender, disability, geographic location?
2
• What effects do adolescent-focused programme interventions have on
adolescent capabilities in the short and longer-term?
3
• What programme design and implementation characteristics matter for
effective delivery and scalability?

10. Early findings on
Violence,
Child Marriage
and Psychosocial
Well-being
Adolescent girl with her children in Dhaka © Nathalie Bertrams/GAGE 2019

11. Violence comes from all directions
‘I have no solution
except beating them…
it is like emptying and
a release’.
(Syrian mother, host
community)
‘Our community is
unmerciful … If anyone
violates any girls, the
community thinks that the
girl likes to do that, and she
wanted this action’.
(15-year-old Syrian girl)
Home
In Jordan, 37% of mothers
admit to beating their teens
School
In Ethiopia, 72% of
teens have been
violently punished by
a teacher
Peers
In Bangladesh, 45% of
teens in camps and
host communities have
been bullied
‘When boys try to create
problem to me, I beat them. I
am aggressive and I can beat
everyone who has tried to
create problems with me’.
(11-year-old boy, Ethiopia)

12. Boys’ and girls’ risk factors differ
Boys
 Boys are more likely than girls to
experience violence at home, at
school, and from peers.
 Boys often ‘invite’ violence, to prove
that they are ‘manly’—and rarely
seek help, for the same reason.
Girls
 Girls are usually punished not for
misbehaving, but for violating
standards of femininity.
 Sexual violence is endemic—and girls
are blamed.
Boys from Afar, Ethiopia © Nathalie Bertrams / GAGE 2019

13. Child marriage: mostly girls
 In Jordan, many girls did not know about
sex before their wedding day.
 Girls’ contraception uptake is limited by a
preference for early childbearing.
 In Jordan, girls often mentioned
receiving fertility treatments
(e.g. clomid).
 Where marriage signals adulthood, girls
often want to marry.
 Intimate partner violence is “normal”:
‘Some husbands torture their wives. This
is very common here.’
(Rohingya girl)
A group of girls talking in Zaatari camp ©Herwig/
UNICEF/2018

14. Child marriage: mostly girls
In Jordan, married girls are:
 54% less likely to leave home daily
 17% less likely to have a trusted
friend
 44% less likely to have talked about
a community problem
‘When I got married my psychological
state was completely destroyed. I
would feel like I want to die, I want to
do suicide… it was like very bad, I could
not tell anyone.’
(19-year-old Syrian girl)
 In Ethiopia, 40% of girls marry
before adulthood.
 In Jordan, 18% of GAGE’s 15-17
year old girls were already
married.
Consanguineous marriages are
common—and usually forced—in
Jordan and parts of Ethiopia.
‘Unless we die, it is our absuma that
we are going to marry.’
(Younger girl, Afar, Ethiopia)

15. Psychosocial wellbeing
•In Jordan, 1/3 of teens are emotionally distressed (on the GHQ-12).
In Ethiopia, 75% of younger teens have a trusted friend.
Teens are closer to mothers than fathers—and girls are closer than boys.
Teens are worried about doing well in school.
Teens are worried about conflict.
Many girls are worried about child marriage.

16. Psychosocial wellbeing
Teens are worried
about poverty.
‘Depression… comes from very
severe poverty… It has a high
effect on adolescents as all their
needs aren’t complete… They
spend their time in the street or
the girls in the home in their
room… Where can they go? They
have no place… and we know of
suicide attempts … her family
may try to hide it but it’s
happening.’ (Social worker, Gaza
camp, Jordan)
Older girls lose access to
peers.
‘Girls stay home and do
household work. We can’t
communicate with friends
as we wish, we stay at
home and cook while
crying’.
(Rohingya older girl)
Teens are worried
about unemployment.
‘I worry about the
scarcity of job
opportunity after I
graduate because there
are a number of
adolescents who sit idle
after graduation.’
(11-year-old boy,
Ethiopia)

17. ART
PRESENTATION NAME AND DATE
Links to solutions
An adolescent girl with her child, Afar, Ethiopia @ Nathalie Bertrams / GAGE 2020
Links to solutions

18. Implications for policy and practice
•Continue to expand access to affordable health care, accounting for the cost
of transport and medications.
•Expand school- and community-based health education for children--
including sexuality education-- explicitly targeting engaged and married girls
•Support mental health by providing adolescents with opportunities to
connect with one another and caring adults, parents with classes and
support groups that address gender norms and develop parenting capacity,
and the promotion of national efforts to expand psychosocial support
services, beginning with those who have experienced violence.
SDG 3:
Good health
•Provide girls, including those who are married, with programming that
supports aspiration, emotional connections, self-confidence, voice, and skill
development.
•Work with adolescents’ families and broader communities (including boys
and men) to shift the social norms that limit girls’ lives and leave them at
risk of gender-based violence.
•Invest in more tailored approaches to eliminating child marriage,
incentivising adolescents (girls and their partners), parents, and communities
to wait till adulthood.
SDG 5:
Gender
equality

19. Implications for policy and practice
• Enhance social cohesion by providing adolescents with opportunities
to interact with those of different nationalities to solve community
problems.
• Scale up school- and community-based programming, including
through participatory classroom activities, to develop adolescents’
cognitive, personal and interpersonal skills.
• Scale up parenting classes and support groups, including for fathers,
to teach parents about gender norms and develop their capacities for
supporting their adolescents.
SDG 11:
Sustainable
communities
• Establish initiatives to ensure safe and anonymous reporting of
violence and timely follow-up (particularly for married/ divorced girls
and those with disabilities).
• Expand investments in community-based safe spaces where
adolescents can develop inter-personal and communication skills and
grow friendships across nationalities.
• Promote opportunities for adolescents vulnerable to social isolation,
including girls and those with disabilities, to have greater access to
internet connectivity.
SDG 16:
Peaceful and
inclusive
societies

20. Contact Us
WEBSITE
www.gage.odi.org
TWITTER
@GAGE_programme
FACEBOOK
GenderandAdolescence
About GAGE:
 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 18,000
adolescents in six focal countries in Africa,
Asia and the Middle East.