Impact Evaluation of Türkiye's Adolescent Girls' and Boys' Empowerment Programme for Elimination of Child Marriage

Overview

Low income, refugee, displaced and disaster affected populations face a variety of protection risks, including higher risk of child, early and forced marriage and unions (CEFMU). This is the case in Türkiye, where low income, refugee populations and those affected by the 2023 earthquake in Southern and Central Türkiye face elevated risk of child marriage. As part of the UNICEF Türkiye Country Office (TCO) commitment to implement comprehensive interventions that aim to contribute to a change in social norms and attitudes towards gender equality, the CO and partners have developed the "Adolescent Girls' and Boys' Empowerment for Elimination of Child Marriage" program (hereafter "the program"). The program is an 8-week group-based empowerment and life skills training for adolescent girls aged 12 - 18 years old, a 4-session adolescent boys awareness training, and a one-time awareness raising seminar for caregivers. The current trial has the overall objective of evaluating the short-term causal impact of the program with respect to CEFMU and related outcomes for adolescent girls. The trial design is an individual randomized control trial, allocating 820 households with adolescent girls to either treatment or control on a 1:1 basis. The primary data collection includes a pre- and post-intervention caregiver and adolescent face-to-face survey, as well as a one-time qualitative data collection. The trial results will inform the future operation and scale-up of the program, as well as contribute to the broader evidence base on what works to increase the empowerment of adolescent girls and reduce CEFMU.

Detailed description

Low income, refugee, displaced and disaster affected populations face a variety of protection risks, including higher risk of child, early and forced marriage and unions (CEFMU). This is the case in Türkiye, where low income, refugee populations and those affected by the 2023 earthquake in Southern and Central Türkiye face elevated risk of child marriage. As part of the UNICEF Türkiye Country Office (TCO) commitment to implement comprehensive interventions that aim to contribute to a change in social norms and attitudes towards gender equality, the CO and partners have developed the "Adolescent Girls' and Boys' Empowerment for Elimination of Child Marriage" program (hereafter "the program"). The program is an 8-week group-based empowerment and life skills training for adolescent girls aged 12 - 18 years old, a 4-session adolescent boys awareness training and a one-time awareness raising seminar for caregivers. The current trial has the overall objective of evaluating the short-term causal impact of the program with respect to CEFMU and related outcomes for adolescent girls. The trial seeks to answer the following evaluation questions:

* 1\) Does the program improve participant adolescent girls' agency, self-confidence, and gender-equitable attitudes (including for CEFMU), and to what extent? * 2\) Does the program improve the household enabling environment, including gender-equitable attitudes (including CEFMU), social support, protective behaviors against CEFMU, and use of social services among participating caregivers and in the broader community, and to what extent? * 3\) Does the program reduce CEFMU for adolescent girls, and to what extent? * 4\) Through which pathways (or combination of pathways) do potential impacts occur? * 5\) Was the program implemented in a manner to maximize potential impacts? and * 6\) What is the return-on-investment (cost-benefit calculation) for the program? The trial design is an individual randomized control trial, allocating 820 households with adolescent girls to either treatment or control on a 1:1 basis. The primary data collection includes a pre- and post-intervention caregiver and adolescent face-to-face survey, as well as a one-time qualitative data collection. The trial results will inform the future operation and scale-up of the program, as well as contribute to the broader evidence base on what works to increase the empowerment of adolescent girls and reduce CEFMU.

Interventions

• Behavioral Adolescent Girls' and Boys' Empowerment Program
  The program was developed based on a social behavioural change (SBC) approach in order to change attitudes and behaviours of the participants, consisting of the following main activities on a 6 - 8 week cycle. * Girls' Empowerment Training: Workshops comprise six sessions of approximately 80 minutes each, held separately with girls aged 12-15 and 16-18 years in groups of approximately 12-20 adolescents on a range of life skill themes. * Boys' Awareness Raising Training: Similar to the girls' tr

Primary outcome measures

• Proportion of girls married or cohabiting [Time frame: Baseline and 8-weeks post-intervention]
• Score on new general self-efficacy scale (short form, higher is better) [Time frame: Baseline and 8-weeks post-intervention]
• Score on decision-making scale (higher is better) [Time frame: Baseline and 8-weeks post-intervention]
• Score on voice scale (higher is better) [Time frame: Baseline and 8-weeks post-intervention]
• Score on child marriage attitudes scale (higher is better) [Time frame: Baseline and 8-weeks post-intervention]

Secondary outcome measures (5)

• Scale of perceived social support (higher is better). [Time frame: Baseline and 8-weeks post-intervention]
• The Balanced Cohesion subscale of the Family Adaptability and Cohesion Evaluation Scale (higher is better) [Time frame: Baseline and 8-weeks post-intervention]
• The Revised Family Communication Pattern Instrument Conversation Orientation Sub-scale (higher is better) [Time frame: Baseline and 8-weeks post-intervention]
• Score on willingness to intervene and speak out for girls' scale (higher is better) [Time frame: Baseline and 8-weeks post-intervention]
• Linkages to services scale (higher is better) [Time frame: 8-weeks post-intervention]

Eligibility criteria

Inclusion criteria (primary study participant, however note that primary female caregivers and siblings will be invited to participate in the study pending inclusion of primary study participant):

• Adolescent girls aged 12 - 17 years
• Unmarried girls
• Have never previously been exposed to the intervention
• Live in a family or household with at least one adult caregiver
• Live in a family who are social service clients of the implementing partner
• Live in a family who are risk-assessed as 'low' or 'medium' on the family risk assessment tool
• Live in a family which is planning on staying in the catchment area of the intervention in the subsequent 6-months

Exclusion criteria

• Adolescent girls younger than 12 or older than 17 years
• Girls who are married or cohabiting
• Previously been exposed to the intervention
• Are in institutionalized or non-family-based care
• Live in a family who are not social service clients of the implementing partner
• Live in a family who are risk-assessed as 'high' or 'highest' on the family risk assessment tool
• Live in a family which is planning on moving outside the catchment area of the intervention in the subsequent 6-months

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Prevention

Study locations

Turkey (Türkiye) · 1 center

• UNICEF Türkiye — Ankara

Identifiers

NCT: NCT06947018 · HML2855

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗