New Delhi: Findings from the Safe Adolescent Transition and Health Initiative (SATHI), a pilot intervention for married adolescent girls made in 2003-06 in ten districts of Maharashtra has seen a significant drop in maternal mortality and post-natal morbidity. The project will now be scaled up to other districts in the state and replicated in the rest of the country.
Amarjit Sinha, joint secretary, Ministry of Health said, “the ministry would be happy to scale up the intervention, even though health was a state subject. Guidelines would be issued to ensure that the married adolescent programme is implemented within the existing health system, especially within the National Rural Health Mission (NRHM).
The SATHI project was undertaken by the Institute for Health Management, Pachod (IHMP) in 50 villages and 27 urban slums in ten districts of Mahahrashtra where there was a high prevalence of early marriage. A baseline survey in 2003 and an endline survey in 2006 assessed the impact of various interventions. Findings included a drop in percentage of low birth babies from 35% to 25% in rural areas and 27% to 18% in urban areas. Contraceptive use went up from 10.9% to 23% in rural areas and 8% to 30% in urban areas. New born babies were found healthier, maternal health was better and there was a reduction in reproductive tract infections.
According to the National Family Health Survey –3, 2006, 45% women in the 20-24 age group in India are married before 18 years of age. In rural Maharashtra, 48.9% girls are married early and in urban areas it is 28.9%. Ashok Dyalchand, director, IHMP highlighted that in villages where girls could access health information and services, marriage of adolescent girls went up from 16 years to 17 years and there was a delay in the first conception by another year.
The project worked at two levels – first by identifying vulnerable groups and then offering focused interventions through community-based surveillance system, extensive behaviour change communication (BCC) and a spruced up primary level care and referral service system. Care was taken to keep the model simple and affordable. Each NGO which partnered with IHMP took charge for a site, comprising a cluster of villages that included up to 20,000 residents. An average of Rs700 per capita, per girl was spent during each of the years under the study period.