Evidence-Based Communication Programming to Improve Health and Nutrition Behaviors in Young Rural Adolescent Girls in Uttar Pradesh, India

Background India's most populous state, Uttar Pradesh (UP) is home to 17.2 million adolescent girls mostly living in rural areas. Early marriage, undernutrition, anemia and low status of women contribute to an intergenerational cycle of ill health in mothers and children. An in-school communication package was developed to improve nutrition, reproductive health and hygiene behaviors.

Methods The data are part of a baseline assessment for a randomized cluster trial in 30 rural schools in Hardoi district, UP. Baseline data were collected in 2010 from 1195 girls (grades 6-8). Logistic regression models were fit to predict determinants of four behaviors -- food variety, protein consumption a day prior to the survey, handwashing with soap after defecation and vaginal cleansing with soap.

Results: Older girls (14 yrs) were more stunted (45 percent) (< median-2sd ) compared to younger girls (11 yrs) (25 percent stunted); 63 percent reported symptoms of menstrual morbidity; 48 percent reported zero protein consumption a day prior to the survey; 66 percent had low food variety; 70 percent reported handwashing with soap after defecation and 14 percent before eating. Only 8 percent reported daily vaginal cleansing with soap. Self efficacy, social influence for healthy behaviors, intergenerational communication and knowledge were low. Regression analysis indicates that self efficacy, social influence and intergenerational communication were the most significant predictors of the four behaviors studied.

Conclusions The communication intervention was revised to promote self efficacy, intergenerational communication and social influence. It will be scaled to 8000 schools reaching 1.2 million girls.