“In the past I didn’t even want to be seen by other people, let alone talk to them. Nowadays, I am not scared of anyone. I speak up. I say what is on my mind.” – Mesobua Kassaw, 20, South Gondar, Amhara, Ethiopia

By April Houston

In the Amhara region of Ethiopia, as in other areas of the world with strong patriarchal traditions, women and girls are expected to be quiet and obedient to the men in their lives. Their own needs and desires are less valued than instructions handed down by religious leaders, government officials, their fathers, or husbands. It is not uncommon in these cultures for girls (and sometimes boys) to be married as teenagers. Once married, they often drop out of school and begin having children of their own, although adolescent pregnancy and childbirth comes with high risk of complications and death for these girls and their babies.

Fortunately, rates of early marriage in Ethiopia are on the decline, and the change is coming from members of the communities most impacted by these harmful traditions. CARE launched the TESFA program in the Amhara region in 2010 (“TESFA” stands for Towards Improved Economic/Sexual Reproductive Health Outcomes and means “hope” in Amharic) to unlock the power and secure the future of ever-married adolescent girls. We came back four years after the program ended to see what has changed for the original participants.

What was accomplished?

• Physical, social, and economic wellbeing improved: Findings from the initial program evaluation conducted by the International Center for Research on Women identified gains in communication between girls and their husbands, decreased levels of gender-based violence, improved mental health, improved knowledge and use of sexual and reproductive health services (including family planning), and increased social capital and support.
• Girls spread the word (without CARE’s help): A 2017 ex-post evaluation found that all the girls groups in two implementation districts (Farta and Lay Gayint) continued to meet, without any assistance from CARE.
• Financial benefits led to increased independence and empowerment: Inspired by the financial education they received during TESFA, participants created their own income-generating activities, ranging from fattening cattle, poultry feeding, growing vegetables, and selling baked goods and coffee. The proportion of participants with their own savings grew by 23 percent (compared to 3 percent in comparison groups) from the beginning of the program to the end. As their financial situation improved and they were able to buy things for themselves, they also started having meaningful conversations with their husbands about spending (which most had never done before TESFA). One participant told us “spending without planning is now considered ‘old fashioned’.”
• Girls are exercising their sexual and reproductive health rights: TESFA not only increased participants’ knowledge about sexual and reproductive health, but also the skills, confidence, and mobility necessary to gain access to health services. Girls reported that they feel comfortable discussing family planning with their husbands and decide jointly on how many children they will have and when, and whether to use contraception. The number of girls using a family planning method increased 15 percent over the life of the program.

How did we get there?

• Start with savings groups: Although CARE had been using Village Savings and Loan Association (VSLA) groups to help marginalized women and communities save money and access loans, they had not been tried exclusively with adolescent girls or used to deliver health-related curriculum before TESFA. Many of the girls surveyed in the ex-post evaluation reported “saving money” as one of the top reasons for their participation in the program. (Learn more about CARE’s advocacy work on women’s economic empowerment)
• Get community leaders on board: To complement the work of the girls’ groups and support their efforts to improve their lives and environment, CARE staff worked with community “gatekeepers” to identify and recruit individuals to participate in Social Analysis and Action (SAA) groups. SAA is a process by which participants explore and challenge social norms, beliefs, and practices around gender and sexuality. Adult members of these groups acted as liaisons between the program and the community and assisted the girls as allies – taking their needs and concerns to individuals with power to address them.
• Train peers to be educators: Girls’ groups were facilitated and led by peer educators – girls from the community who received training on TESFA content, including sexual and reproductive health and economic empowerment/financial literacy.
• Work for gender-transformative change: Four years after the conclusion of this phase of the TESFA program, community members have noticed sustained transformative change at the individual, family, and community levels. Acceptance of early marriage has decreased, leading to the interruption of 180 planned child marriages, and freedom of movement for girls has improved to a level they described as “ground-breaking” (aided by supportive government policies and better access to technology).