Jeffrey Edmeades

This is the final story in a four-part series offering a rare glimpse into the lives of child brides in Ethiopia and how ICRW is making a difference for them.

AMHARA REGION, Ethiopia – Almaz and Wube-Alem, both 10 years old, cleaned house and fetched firewood before going to school this morning. After classes, they will likely head to the fields to feed cattle and gather more wood for cooking. They don’t play much, Wube-Alem says.

Both girls want to leave their rural village here in northern Ethiopia once they finish school – if not before. They have their eyes on the capital, Addis Ababa, with its multi-story shopping plazas, its busy streets where drivers make their own lanes and its sidewalks where children shine shoes for spare change and homeless mothers reach out a hand to passersby.

“If I go to Addis, [my parents will] stop bothering me about getting married,” Almaz says through an interpreter. “They tell me school or education will not be my lunch or dinner. They tell me there are men asking for me to marry and that will be my plan for the future.”

Last year Wube-Alem’s parents had also been considering marrying off their daughter.

She’s not alone. Despite laws in Ethiopia against early marriage, the Amhara region has one of the world’s highest rates of child marriage. However, when a handful of adults got word of what was being planned for the Wube-Alem and her friend, they broke with tradition and halted the nuptials.

Almaz and Wube-Alem were two of more than 40 girls who were saved from early marriage this year by adult “gatekeepers” who serve as liaisons between a joint International Center for Research on Women (ICRW) and CARE-Ethiopia program and the villages in which it takes place. Stopping marriages has been one of the unexpected outcomes of the program, which was designed to empower girls who are already married. That nuptials are actually being prevented as a byproduct of the program provides promising evidence that the program’s messages about the consequences of child marriage for girls are resonating in communities where the age-old tradition continues.

Called TESFA, which means “hope” in Amharic, the program targets 5,000 married girls – most are between ages 14 and 19 – with information about sexual and reproductive health, saving and investing money and tips on how to communicate effectively. It is one of the few efforts globally that focuses on the often overlooked population of married adolescent girls, who number about 60 million worldwide. 

Critically, TESFA aims to empower child brides to advocate for themselves within the confines of a life they did not choose. By doing so, these girls are likely to have a better chance of not only growing into healthy, productive adults, but also mothers who one day may stand against their own daughters being forced to marry. 

In the program, one group of girls receives lessons on health issues, another solely on financial habits and a third receives both. The curriculum and approach used in the project were designed by CARE, which also implements the program in partnership with local organizations, while ICRW designed the research plan for the program and is leading TESFA’s evaluation. 

The key goal of the evaluation will be to determine whether combining sexual and reproductive health and financial training programs result in better health and livelihood outcomes than providing each program separately. Among other things, ICRW will look at whether the program has affected the percentage of girls who are better informed about the reproductive health process, contraception, visits to health centers and sexually-transmitted infections. Researchers also will determine whether young wives increased their savings and investments, started an income-generating activity and gained more control over household assets.

There’s reason to believe that the combined approach will prove more beneficial for married adolescent girls, says Jeffrey Edmeades, a social demographer who directs TESFA for ICRW. “Healthier girls are more likely to be able to plan their economic future and take risks, however small, and wealthier girls are more likely to be able to access health services,” he says. “This project should provide evidence about whether this is actually true."

The key to success

One of the more noticeable changes in the behavior of the girls participating in TESFA is in their self-confidence. Program staff attributes this to the life skills training girls receive in all three arms of the project and the mere fact that they are included in a program that is valued by their communities. The financial literacy aspect of TESFA appears to be particularly attractive to participants, likely because the girls’ family sees it as a bonus for them, according to Edmeades. 

TESFA also trains girls how to communicate and negotiate with others around health and financial matters. This is critical as child brides worldwide have little say over household decisions, let alone their life’s path – husbands and in-laws tend to make those decisions. The communication training is proving to be a vital element of the curriculum for girls, which was not what researchers expected. “It’s really teaching them how to talk to other people who are more powerful than them and giving them a framework to do that,” Edmeades says. 

Indeed, many girls involved in TESFA appear to be gaining a voice in their households. Some are now advocating for themselves and even convincing their husbands to, for instance, let them return to school. “That’s pretty significant because having these kinds of skills will affect all aspects of their lives,” Edmeades says.

Meanwhile, support from TESFA’s adult “gatekeepers” – husbands, in-laws, village leaders and others – has helped legitimize the program and girls’ participation. Edmeades contends the program would not work without them. 

Gatekeepers were chosen by the community and take part in discussions on a variety of topics related to married girls’ well-being and their environment. Discussion topics are fashioned in a way to highlight certain issues and challenge adults – the influencers in girls’ lives – to question what has been the norm, understand its consequences and seek alternatives to it. 

Encouraging such conversations “humanizes these girls who are often viewed almost like property,” Edmeades says. For example, many adult gatekeepers know that women die during childbirth. But Edmeades says that what they didn’t realize is that it’s mostly younger women – and girls – who are dying. 

“What they’re learning in the program helps them connect the dots,” he says. 

With new information, adult leaders like health worker Semegie Haile are speaking out. “I try to teach the community that if girls marry before 18 they could face problems like fistula. Going to school and finishing their education is more beneficial,” says Haile, who adds that residents often challenge her, saying that they need to marry girls young because it helps her family benefit economically. 

But gatekeepers continue to push back. And their influence is potentially changing the course of girls’ lives here – girls like Almaz and Wube-Alem. 

Lasting change

ICRW is still analyzing data from TESFA and researchers will gather qualitative evidence from the girls in January to help interpret it. The Nike Foundation funded program ends April 2013. 

It’s unclear whether the lessons of TESFA will be sustainable over time, although CARE-Ethiopia is taking steps to ensure they are. Among other efforts, CARE is raising the visibility of the program in Amhara through radio interviews with high level officials about child marriage and by having TESFA staff and girls share their experiences over the radio. 

“We want to create awareness of the magnitude of the problem that still exists despite many people denying the fact,” says Dr. Feven Tassew, sexual reproductive health program coordinator for CARE-Ethiopia. “Any future development efforts by the government, aid organizations and others in Amhara should involve this overlooked group of girls who are literally half the population, given the rate of early marriage in the region. They are the current and future hope of society.” 

Edmeades stresses that although CARE-Ethiopia is on the ground with TESFA, it’s the communities that own the program.

“Theoretically, the married girls in our program will carry the knowledge they’ve gained with them for the rest of their lives – and they’ll influence others,” he says. “Hopefully, if they have a voice that’s been enhanced by participation in TESFA, they will be involved in community conversations and decisions that can help change the overall environment for all girls in the Amhara region.” 

Gillian Gaynair is ICRW’s senior writer and editor.

Related blog: The Gatekeeper

OUT OF THE SHADOWS
Read the previous stories in this series:
   Week one: Innovative Program Gives Hope to Child Brides
   Week two: The Birds and the Bees - and a better Future
   Week three: Making Every Penny Count

Watch the video: Voices from Ethiopia

This is the second story in a four-part series offering a rare glimpse into the lives of child brides in Ethiopia and how ICRW is making a difference for them.

AMHARA REGION, Ethiopia – Yeshi-Alem drapes a small, woven book bag over her left shoulder for the short walk to her first class. She enters the gate of her village's only school, six mud and straw buildings in the shape of a horseshoe where students sit three to a desk and where white chalk powder colors teachers' fingertips.

On the school's grounds, she passes a tree with a fading sign in Amharic that reads "Teaching girls is like teaching a whole community," before settling into the front row of her civics class of 55 students. Yeshi-Alem is happy to once again have a chance to learn.

Being able to go to school is just one of several wins in the past year that has transformed her from a shy, self-conscious girl into an outspoken evangelist for girls' education, access to birth control and for girls to have a say in when and whom they marry. Yeshi-Alem knows about not having such choices: She was forced to marry when she was 10 and dropped out when she had her son a few years later.

Now 18, Yeshi-Alem credits an International Center for Research on Women (ICRW) and CARE-Ethiopia program with helping her gain the confidence to convince her husband to let her return to school and hold off on having more children. Without the program, called TESFA, "I would have been giving birth every year," she says.

TESFA, which means "hope" in Amharic, targets 5,000 child brides in Ethiopia's Amhara region – most are between 14 and 19 – with information about sexual and reproductive health, how to save and invest money and lessons on everything from how to care for a newborn to how to communicate in a relationship. The program ultimately aims to empower child brides to advocate for themselves. By doing so, these girls likely will have a better chance of not only growing into healthy, productive adults, but also mothers who one day may stand against their own daughters being forced to marry. Indeed, they and their communities could ultimately have a role in eliminating the harmful practice of child marriage – at least in their corner of the world.

TESFA takes place in a region that has the highest rate of child marriage in Ethiopia, and one of the highest worldwide. It is one of the few programs globally that focuses on married adolescent girls. Although they make up the majority of sexually active girls in developing countries, according to Population Council they tend to be overlooked by sexual and reproductive health programs, which traditionally focus on unmarried girls and adult women.

"In Amhara and elsewhere globally, child brides are very isolated and not part of any 'system,' per se – they're not registered at birth, not registered in school and don't visit doctors regularly," says ICRW's Jeffrey Edmeades who directs TESFA "That makes them a particularly challenging population to identify and work with."

Wives and mothers, yet still children, their needs are unique to those of their unmarried peers.

"These girls have had such a swift transition from being a child to running a household, being a mother – and are constantly being exploited by their husbands and in-laws," says Dr. Feven Tassew, sexual reproductive health program coordinator for CARE-Ethiopia. "They have little or no exposure to education, friends, or even their family. Every basic right they have is violated."

For the TESFA project team, the challenge has been to create a program that gives girls a voice and direction within the confines of a life they did not choose.

Reach married girls early

With funding from the Nike Foundation, TESFA kicked off in 2010 in two rural districts of the Amhara region, where almost half of the girls marry by age 15 and nearly three out of four marry by 18.

In the program, one group of girls learns about sexual and reproductive health, including basic information that most don't know, such as how and why menstruation happens. Another learns about saving and investing money, and a third receives lessons in both areas. In each group there are smaller groups, each of which is facilitated by one of the girls.

ICRW is testing whether combining health and economic empowerment programming has a greater impact on girls' lives than providing such information separately.

Meanwhile, TESFA's adult "gatekeepers" – husbands, in-laws, religious leaders and others – serve as liaisons between the program and the villages in which it takes place. Gatekeepers' support has helped legitimize the program and girls' participation.

"The mother-in-law and husband play a great supporting role to make sure the girls can participate in the program," Tassew says. "And almost all the girls testify that this is why TESFA is working."

Worldwide, husbands and mothers-in-law hold significant power over married adolescents, deciding where they go or what they do outside of the domestic sphere. In Amhara, in-laws also traditionally decide when it's time for young wives to consummate their marriage, which is usually when the girls' physical changes at puberty become apparent. ICRW found that on average, girls in TESFA had their first sexual experience at 13 years old.

Most interviewed for this series described painful, unwanted first sexual encounters with their husbands. Few understood what was happening. Some girls said they realized they were pregnant only when an adult explained why something was moving in their belly.

Child brides worldwide have little power to negotiate safe sex practices with their husbands, and face an increased risk of contracting HIV or other sexually transmitted illnesses. And according to UNICEF, 70,000 girls aged 15 to 19 die each year due to complications from pregnancy and childbirth. Meanwhile, children born to young girls are more likely to experience malnutrition, stunting and ongoing health problems.

"Child marriage is directly tied to maternal and child mortality and illness," Edmeades says. "This is why it's so critical to reach married girls early and provide them with the kind of information that could very well save their lives."

Imagining a future

For Yeshi-Alem, being involved in TESFA appears to have sparked a turning point.

At 18, she's been married nearly half her life to her husband Moges, who is believed to be 28. Like most child brides globally, Yeshi-Alem didn't realized she had been promised to a man. Not until she says her family one day took her on a horse from her home to her future in-laws' house for the wedding ceremony. The next day, Yeshi-Alem went back to her home.

She spent the next few years shuffling between her village and her husband's, an hour's walk away. Then, at 15 or possibly earlier – few here are certain of their age - the family decided it was time for Yeshi-Alem to move in with Moges. She dropped out of school once their son Girma was born.

Recently, her mother-in-law had been pressuring her to have more children. "'What's the use of a wife if she doesn't give birth?'" Yeshi-Alem says she told her. She knew she wasn't ready for another child, so she applied what she learned in TESFA to convince Moges to let her use birth control.

If she had another baby, she wouldn't be able to take care of it well, Yeshi-Alem told him. She would focus on breast-feeding the newborn because that's good for brain development. But she may not be able to give as much attention to 4-year-old Girma. What's more, "We don't have land, so we can't afford to clothe two kids, feed two kids and send two kids to school."

"'If you promise to take care of the older one,'" Yeshi-Alem says she told Moges, " 'I'll have another one.' "

His response? "No, no, no!" she says, laughing.

Yeshi-Alem also used her newfound negotiation savvy to convince Moges to let her return to school. Now she attends classes in the morning, and in the afternoon helps Moges at a store the couple operates, which is stocked with everything from candles to bags of barley. She also serves customers at a small food and tea shop the couple recently added to the store.

TESFA, complemented by information provided by local health workers about reproductive health and the consequences of early marriage, are slowly contributing to subtle shifts in behaviors and attitudes in this corner of Amhara. For girls like Yeshi-Alem, such changes may very well help redirect the course of their lives.

She says she feels like a different person now. When asked how, a smile stretches across her face. She's enjoying a newly discovered confidence. She says no longer feels shy. She talks to everyone, spreading the word about the harms of early marriage, encouraging neighbors to keep their daughters in school.

"TESFA project," Yeshi-Alem says, "has opened my eyes."

Gillian Gaynair is ICRW's senior writer and editor.

OUT OF THE SHADOWS
Next story: Making Every Penny Count
Read the first story in the series:  Innovative Program Gives Hope to Child Brides 

Watch the video:  Voices from Ethiopia