PRACHAR: Promoting Change in Reproductive Behavior in Bihar, India
Funded by the David and Lucile Packard Foundation (with supplemental funding from UNFPA in 2009), PRACHAR, meaning "promote" in Hindi, was a twelve year innovative program which successfully changed reproductive behaviors of young couples and the social norms that pressure unmarried adolescents into early marriage, early child bearing, and inadequate child spacing in India.
Worldwide, few programs have addressed youth fertility and demonstrated results. The PRACHAR model adopted a unique approach to address youth fertility in India and was implemented across India's state of Bihar.
PRACHAR tested a government—non-governmental organization partnership model to change youth reproductive behavior through education on reproductive health and family planning by frontline government health workers.
Through the PRACHAR model, adolescents were presented with information they needed to make responsible reproductive decisions when they marry. At the same time, young couples were motivated to adopt a contraceptive method of their choice to delay their first child and to space the second child, and to continue using a contraceptive method.
Over its twelve years, PRACHAR reached approximately 960 villages, with populations totaling more than 10 million through project interventions.
Between 2009 and 2013, Pathfinder built the capacity of 994 ASHA and 176 Male Communicators to provide adolescent women and men with the thorough and accurate health information they need. By integrating the PRACHAR model into the state’s health care system, the project’s proven outcomes—increased contraceptive use and delayed marriage and first birth—can have greater reach across India.
Young women part of PRACHAR married about 2.6 years later than women not exposed to PRACHAR. They also had their first birth 1.5 years later.
Adjusting for education, caste, and age at marriage, young women in the PRACHAR intervention area were almost five times more likely to use contraception before the first birth compared with women in the comparison area.
Even though the PRACHAR project has ended, Pathfinder has ensured that our mechanism to train and supervise ASHA is embedded in Bihar’s public health system. The government has also issued guidance that these door-to-door health workers will continue to collect data during their visits with youth, as under PRACHAR, and will continue to receive incentives for promoting birth spacing.
PRAGYA: Multisectoral, Gendered Approach to Improve Family Planning and Sexual and Reproductive Health for Young People
PRAGYA, meaning "insight" in Sanskrit, is a mixed methods study commissioned by USAID and conducted by Pathfinder India to improve understanding of the effects of Phases I and II of the PRACHAR project.
This technical brief summarizes the evolution of PRACHAR, describes the intervention model and key evaluation results that informed each phase, and highlights next steps for dissemination and advocacy based on 11 years of project learning.
In 2012, Pathfinder went where the need was greatest—the places where women, men, and young people must fight every day to defend their sexual and reproductive health and rights. This annual report explores our successes during fiscal year 2012.
The Effect of Reproductive Health Communication Interventions on Age at Marriage and First Birth in Rural Bihar, India
This paper describes the results of a survey of participants in an adolescent education program implemented by the PRACHAR project in rural Bihar.
ANANYA aims to empower women to make informed decisions about maternal and neonatal health.
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Programa Geração Biz, Mozambique: how did this adolescent health initiative grow from a pilot to a national programme, and what did it achieve?
Rita Badiani joins a team of experts in conducting a systematic review of the literature to gather information on Pathfinder's Geração Biz.
World Health Partners and Pathfinder International are partnering, using a social franchising approach, to leverage rural human resources in order to extend maternal health coverage.