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PARTNERSHIPS FOR ENHANCED ENGAGEMENT IN RESEARCH (PEER)
Cycle 9 (2020 Deadline)


Young wives: an exploratory study of married women below twenty and the socio-cultural determinants of their contraceptive behavior in low resource settings in India

PI: Sudipta Mondal (smondal@pciglobal.in), Project Concern International, India
U.S. Partner: Cristine Legare, The University of Texas at Austin
Project Dates: March 2022 -  April 2024

Project Overview 
9-440_Mondal_US visit
Group photograph with Prof. Legare and the team.  
 9-440_Mondal_interview in progress
 Interviewer explains the study to a household in Dharmoshala (Dhubri)
 9-440_Mondal_woman in Godda
 Woman busy with daily chores in a Muslim household in Dighi (Godda)
9-440_Mondal_Santhal-dominated village of Baghmara (Godda)
Village of Baghmara (Godda)


Family planning (FP) is a public health priority in India, with a target fertility rate of 2.1% by 2025. However, FP in India has focused more on female sterilization than delaying births, despite the fact that delaying births is more relevant for young women who are in the process of building a family. More than 30 million women in India who want to avoid pregnancy are not using modern FP methods. Despite the fact that the general determinants of family planning behaviors of Indian couples are broadly known, this is not an adequate basis for governments to plan effective interventions. Most national surveys do not provide a thorough understanding of the complex social norms and gender roles concerning fertility that people navigate and that ultimately lead to higher incidences of early marriage and conception.

This PEER project sought to generate knowledge required for designing interventions to achieve this behavior and enable young couples to successfully navigate complex socio-cultural norms and make good FP decisions that protect their well-being. The researchers focused on women aged 15-19 years who have been married at least a year in states with high rates of marriage and pregnancy before the age of 18. While interventions and policies are in place, it is important to focus simultaneously on understanding and addressing the socio-cultural norms and gender roles at work in order to effectively delay the first pregnancies of young already married women. The project sought to identify the extent to which FP beliefs and behaviors vary among adopters and non-adopters of modern FP methods.

Final Summary of Project Activities

The researchers developed questionnaires and structured interviews for young wives, husbands, mothers-in-law, frontline healthcare workers, and community influencers, as well as household and community observation guides. The PEER team undertook field work in several villages across five districts (Godda, Jharkhand, Dhubri, Assam, and Ujjain), sending appropriate research leads based on cultural expectations and collaborations within each area. These surveys and interviews focused on understanding family planning behaviors and choices of young couples and the role of social norms in determining both.

While there were significant differences between districts and even within villages, the researchers in general found challenges and gaps in family planning among young wives and their husbands, including restrictions on their mobility and decision-making power. Communication about family planning between spouses is lacking, with husbands often making the final decision on contraceptive methods. Misconceptions about family planning methods are common, and access to information and counseling is limited for both young wives and husbands. Regressive social norms related to fertility are a hindrance to higher uptake of contraceptives among newly married young couples in rural areas.

The researchers identified social norms and gender roles are two critical elements that need immediate attention from the FP programs targeted at young wives. They recommended programs break the “silence” around topics related to FP usage by promoting increased discourse at the family and community level, tailoring programming to local norms. The team also identified the importance of engaging not only young wives but also family members, community influencers, and frontline healthcare workers. Family members play significant roles in decision-making regarding reproductive health, so engaging them in discussions and education can lead to more informed choices. The PEER team also recommended that FP initiatives should extend their focus beyond solely measuring the total fertility rate. Instead, they should prioritize timing and spacing on the family-building journey, especially programs that actively contribute to the increasing social and economic ambitions of young women in India.

The PEER team has several papers forthcoming and will use data collected for future research. The PI Dr. Mondal also presented their findings at the Population Research Center at the University of Texas at Austin and several state-level dissemination workshops, as well as collaborated with local and international NGOs. As of May 2024, the researchers had also received three additional grants for this work, for a total of $97,000.


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