PRACHAR: Promoting Change in Reproductive Behavior in Bihar, India

Through open dialogue, PRACHAR reaches adolescents and their families with vital information about sexual and reproductive health.

“If a girl is educated she will look after her health. Even if she does not get an opportunity to work outside her home, she will nurture a healthy family and raise children with good values.”—Adolescent trained by the PRACHAR project.

In Bihar, one of India’s least developed, most populous states, a peer educator discusses contraception with a group of captivated young men.

In her home, a young woman learns about various contraceptive methods from an Accredited Social Health Activist or “ASHA.”

By integrating the PRACHAR model—including male sensitization meetings like this one—into the state’s health care system, the project’s proven outcomes can have greater reach across India.

The David and Lucile Packard Foundation and UNFPA funded the scale up of the most essential approaches of PRACHAR Phases I and II, 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 the third phase of funding, 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.

PRACHAR has reached more than 84,000 married women and 63,000 unmarried adolescent girls and boys with reproductive health and family planning information. In addition, PRACHAR has reached more than 16,500 unmarried adolescent girls and boys with training on adolescent reproductive and sexual health. A comprehensive evaluation of PRACHAR through its 10 years of implementation is being undertaken to assess its impact, the sustainability of behavior change achieved, and the effectiveness of scaling up the model through public-private partnerships.