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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 (, Project Concern International, India
U.S. Partner: Cristine Legare, The University of Texas at Austin
Project Dates: March 2022 - February 2024

Project Overview:
Research Team Meeting chaired by the Principal Investigator, PCI New Delhi, Sept. 22, 2022
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 [Muttreja & Singh, 2018]. This is especially true for states that lag behind in demographic transitioning and other development indices. This project will focus on two such states, namely Jharkhand and Assam, known for higher proportions of underage marriage and tribal populations. More than 30% of women aged 20-24 in Assam and 37% in Jharkhand got married before the age of 18. Moreover, 33% of young married women (15-19) in Assam and 27% in Jharkhand became pregnant within a year of marriage (Indian National Family Health Survey 4). 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 team will focus on women aged 15-19 years who have been married for at least a year and separate them into two groups: (1) those who have delayed the first pregnancy a year or more after marriage using modern methods (adopters); and (2) those who conceived prior to a year of marriage, or conceived later but did not use any modern method (non-adopters). The intent is to identify the extent to which the FP beliefs and behaviors of these two groups vary, despite navigating similar complex and diverse socio-cultural environments. The main project objective is to identify predictors of FP adoption by studying the complex cultural ecologies of health, particularly fertility-related beliefs and gender norms, and how they interact with the FP decisions of young couples. This study will draw complementary insights from both qualitative and quantitative methods to address data gaps, since these constructs often elude large-scale surveys. The merit of the study lies in its ability to generate context-specific evidence crucial for designing better interventions which will enable young couples to successfully navigate complex socio-cultural norms and make good FP decisions that protect their well-being. The research team will proceed on the basis of their central hypothesis that without an attention to the prevailing socio-cultural values and norms, and without viewing the issue from a family systems perspective, conventional approaches to FP programming will continue to falter.

Despite the fact that the general determinants of family planning behaviors of Indian couples are broadly known, this is not adequate 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. More than 30 million women in India who want to avoid pregnancy are not using modern FP methods. The proposed research will generate knowledge required for designing interventions to achieve this desired behavior.

Project updates

During July-September 2022 the project team prepared Questionnaires, and Observation Guides, and researched literature which can contribute to the strengthening of PEER research tools. By mid-Sep. 2022, the first review of all draft tools was completed by IIPS team and following the review by PCI, the tools are now with Prof Christin Legare and her team at University of Texas at Austin for the second review with particular focus on the ethnographic tools, as the qualitative research will take place first. After this review is completed, the tools will be sent for translation and digitization.
On Sep.22, 2022, a meeting of members of both partner teams (PCI and IIPS) took place at PCI Office in New Delhi. The meeting was also attended by Prof. T.K. Roy, Senior Statistician and member, Technical Advisory Group formed by the research team working on this project. He advises the team on the subject of family planning and sampling. At the meeting, the team discussed Census of India data available for the Project Districts, the plan for the next quarter (Oct-Dec 2022) and target dates for completing various tasks In September, the Research Team also had 2 tele-conferences with the USG partner team at University of Texas at Austin to share observations on the draft tools.
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