Improving the health of adolescent girls

What we found

First, we found that offering male partners a soccer-based health programme that educated and inspired them to make better choices regarding sexual and reproductive health reduced female reports of intimate partner violence. Together with BRAC, we offered that intervention by partnering with Grassroot Soccer. This is a nonprofit adolescent health organisation that uses soccer to educate, inspire, and mobilise young people in developing countries.

Reductions in intimate partner violence associated with the soccer-based health intervention appear to be driven by a change in male attitudes towards intimate partner violence in communities where Grassroot Soccer operated. In addition we observed a reduction in sexual activity in these communities. Females reported fewer partners and spent less time with male partners.

Second, we found that female adolescents who participated in the goal-setting activity reported decreases in intimate partner violence. We asked the female adolescents to set two or three specific strategies to achieve the goal of staying healthy and free of sexually transmitted infections and HIV.

Reductions in intimate partner violence due to the goal-setting activity were driven by improvements in the reported quality of partners, as well as an increase in the young women’s sense of personal agency. We measured the quality of partners by partner age, educational attainment, and use of contraception. These are all factors which are correlated with risky sexual activity.

In both the goal-setting and soccer treatment arms, we found that impacts were larger among females who were already sexually active at the beginning of the study.

Third, we found that mere access to free contraceptives had no significant impact on sexual and reproductive health outcomes. This might be because providing access to modern contraceptives without altering the norm via education is not effective – but further study is needed on this issue.

Key lessons

We drew a number of key lessons from our findings. First, engaging adolescent boys and young men reduces intimate partner violence and shifts male attitudes around violence against women.

Second, adolescents benefited from participating in an activity that encouraged forward-looking behaviour. This increased their sense of personal agency to make better choices in the present around sexual relationships.

Third, offering contraception alone, without focusing on behaviour change for females and males, won’t necessarily improve sexual and reproductive health for adolescents.

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Manisha Shah is Professor of Public Policy and Director of Global Lab for Research in Action, UCLA Luskin School of Public Affairs