A new Population Council study finds that the PRACHAR project in India to improve the sexual and reproductive health of married women and increase contraceptive knowledge and use, continued to have an effect on participants' behavior long after the program concluded. This finding is groundbreaking because while most programs demonstrate promising changes in the knowledge, skills, and attitudes of participants at their immediate end, the long-term impact on reproductive health behavior has seldom been assessed. Additionally, the new study finds that this program not only had a positive long-term effect on women who had been directly exposed to program activities, but also on those indirectly exposed.
Background on the PRACHAR project
Pathfinder International implemented the Promoting Change in Reproductive Behavior of Adolescents (PRACHAR) project in three phases from July 2001 to August 2012 in Bihar, one of Northern India's least developed states. Bihar has the highest total fertility rate of any state, and a high proportion of child marriage and early childbearing.
The goals of the PRACHAR project were to delay the age of marriage, delay the birth of the first child, and promote healthy timing and spacing of pregnancy among adolescents and young couples. The intervention included multiple components: individual counseling for young women and women's group discussions about sexual and reproductive health issues; group meetings with married men, fathers, and fathers-in-law led by male counselors; "infotainment" programs for newlywed couples; and cultural programs for the broader communities. Additionally, the project displayed murals, which conveyed contraceptive information to the community, and educated health service providers about reproductive health matters, specifically focusing on how to discuss these issues with young women.
Evaluation of longer-term effects
The Population Council evaluated the longer-term effects of the PRACHAR project's Phases 1 and 2. Council researchers sought to determine whether the improvements in contraceptive awareness and use following implementation of the project were still evident four to eight years after its completion, and whether women who were having families in areas where the PRACHAR project had been implemented reported different contraceptive experiences than women in comparison areas where the program had not been implemented.
From March to April 2013, Population Council researchers...