Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.
CARE USA, Atlanta, Georgia, USA.
Glob Health Action. 2022 Dec 31;15(1):2057644. doi: 10.1080/16549716.2022.2057644.
Child Marriage (CM) is one of the major developmental concerns in Bangladesh, reporting one of the highest rates of CM (59%) globally. To date, interventions to address CM in Bangladesh have failed to seriously engage with social norms that are important contributors to CM. This paper describes the evaluation design of the Tipping Point Initiative that aims to reduce CM through social norm change and increasing adolescent girls' agency to voice their rights. The Tipping Point Initiative evaluation trial employs a mixed method design. The quantitative component includes a three-arm Cluster Randomized Controlled Trial design, where Arm 1 receives Tipping Point Program (TPP); Arm 2 receives Tipping Point Program Plus (TPP+), a social norms-enhanced version of TPP; and Arm 3 is the Control. The trial covers 51 clusters (villages) in , in Rangpur district, randomized into three study arms (17 per arms). From each cluster, a cohort of 25 adolescent girls aged 12-<16 years were selected randomly for participation in the survey and intervention. Further, a cross-section of adults (six males and six females) were randomly selected from each cluster for survey. Qualitative baseline data were collected from two purposively selected intervention villages in each intervention arm. Thirty In-Depth Interviews, eight Key Informant Interviews and 16 Focus Group Discussion were conducted with adolescent girls, boys, adult women and men. Same strategies have been followed at endline. The intervention was implemented from April 2019 to December 2020. The endline was conducted 10 months after the end of intervention. Intention-to-treat analysis approach will be used for impact assessment. Both narrative analysis and Grounded Theory approach will be employed in analysing qualitative data. The learnings are expected to inform programs and policies regarding what works and does not work to address CM in such social norms intervention in Bangladesh.
童婚(CM)是孟加拉国主要的发展关切之一,报告称其童婚率(59%)居全球最高。迄今为止,孟加拉国为解决童婚问题而采取的干预措施未能认真应对对童婚有重要影响的社会规范。本文描述了“临界点倡议”的评估设计,该倡议旨在通过改变社会规范和增强少女表达权利的能力来减少童婚。“临界点倡议”评估试验采用混合方法设计。定量部分包括一项三臂群组随机对照试验设计,其中第 1 组接受“临界点倡议方案”(TPP);第 2 组接受 TPP+,即 TPP 的社会规范增强版本;第 3 组为对照组。试验覆盖孟加拉国朗布尔区的 51 个集群(村庄),随机分为三个研究组(每组 17 个)。从每个集群中,随机选择一组 25 名年龄在 12-<16 岁的青春期少女参与调查和干预。此外,从每个集群中随机选择六名男性和六名女性成年人进行调查。在基线阶段,从每个干预组中选择两个有针对性的干预村庄收集定性数据。与青春期少女、男孩、成年女性和男性进行了 30 次深入访谈、8 次关键知情人访谈和 16 次焦点小组讨论。在终点线也采用了同样的策略。干预措施于 2019 年 4 月至 2020 年 12 月实施。在干预结束后 10 个月进行了终点线调查。将采用意向治疗分析方法评估影响。将采用叙述分析和扎根理论方法分析定性数据。预期这些经验教训将为在孟加拉国这种社会规范干预措施中解决童婚问题的方案和政策提供信息,了解哪些措施有效,哪些无效。