By Anita Ghimire, Fiona Samuels, Riju Tiwari and Samjhana Bhujel
Adolescence has powerful impacts on children’s capabilities – partly because of the physical transformations wrought by puberty and partly because children’s place in their family and broader community shifts as they approach adulthood (Jones et al., 2018). In South Asian cultures where there is a belief that female sexuality needs to be controlled, the onset of adolescence is more difficult, as the physical changes brought about by puberty invite stigma and censorship, and social (gendered) norms and expected behaviours become more stringent (Samuels et al., 2017). This has particularly strong impacts on women and girls in patriarchal societies where female sexuality is a taboo and where control over women’s and girls’ sexuality is the norm. In such societies, girls start losing any autonomy they may have enjoyed as younger children as soon as puberty begins; they often experience psychosocial violence and bear the brunt of harmful gender norms and discrimination in opportunities, thus falling behind their male peers in their personal development (Jones et al., 2018).
In Nepal, adolescents comprise almost a quarter of the population (Ministry of Health et al., 2017) and almost half of all adolescents are girls. Investment in adolescents is important not only because of their sheer numbers but also to sustain the significant investment the country has made in child wellbeing and towards achieving the Millennium Development Goals (MDGs). Nepal had fully achieved goal 3A (eliminating gender disparity in primary and secondary education) and 4 reducing child mortality, and partially achieved target 2A (ensuring that all children complete primary education). The government aims to make further progress on the partially achieved goals by tying actions in with the Sustainable Development Goals (SDGs). Hence, addressing the issues facing adolescent girls who lag behind their male peers will be a priority for Nepal in years to come.
While existing literatures have mapped programmes that focus on adolescents (see, for example, Stavropoulou and Gupta-Archer, 2017; Bakrania et al., 2018), we have limited evidence on how different interventions help to build girls’ capabilities, and under which circumstances. The objective of the broader GAGE research is to contribute to knowledge gaps on what works to develop adolescents' capabilities and improve their wellbeing. The objective of this baseline study phase is to understand adolescent vulnerabilities in different capability areas and to help us assess, in the second phase, whether interventions are addressing key capability deficits for adolescent girls and boys.
This report presents findings of a baseline study among adolescent girls and boys in Nepal. It is part of a nine year (2015–2024) longitudinal research programme, Gender and Adolescence: Global Evidence (GAGE), which follows the lives of adolescents in four diverse countries: Bangladesh, Ethiopia, Nepal and Rwanda. Using the ‘3 Cs’ conceptual framework (capabilities, change strategies and contexts), GAGE aims to fill the vast evidence gap on ‘what works’ to enable poor adolescent girls to emerge from poverty and fast-track social change for themselves, their families and communities, and their countries. GAGE’s research addresses two broad questions:
What do adolescents' lives look like as they evolve over the second decade of life and how are their experiences gendered?
What impact have change strategies (e.g. through programme interventions) had on adolescents’ development?
In Nepal, the first phase of the GAGE research is a baseline study for a peer learning programme, Rupantaran (meaning ‘transformation’) – an adolescent-focused life skills programme run by World Vision since 2016 as part of its Protection programme. Its objectives are:
to establish and train adolescent and youth groups to provide life skills to vulnerable young adolescent girls and boys;
to facilitate annual cycles of Rupantaran life skills curriculum with adolescents and youth groups to strengthen capacities across six domains (see below), including increased self-efficacy, self-esteem, agency, decision-making and communication skills.
Rupantaran programme from the World Vision uses peer education methods to teach a 15-module curriculum. It runs for between 7 and 10 months, which includes an inception phase. It was carried out in Morang district by World Vision, in the south-eastern Terai plains, and ended in 2018. . The study is divided into two phases, the first baseline phase and the second endline phase. The first phase of the study, on which this report is based, represents the baseline and was carried out in April 2018. It aimed to understand the current situation in terms of adolescents’ capabilities across six key domains: (1) education and learning; (2) health, sexual and reproductive health (SRH), and nutrition; (3) bodily integrity and freedom from violence; (4) psychosocial wellbeing; (5) voice and agency; and (6) economic empowerment. These capability areas were measured before programme implementation and will be measured again after implementation in order to discern any changes. We identified a control group of girls and boys from an area adjacent to each of the two research sites (see below) so that we can compare changes in the lives of participants that may be attributable to the programme. The control group participants were selected with the help of local World Vision staff who have long experience of working in the community and could thus help us identify sites with key similarities (for instance, in terms of caste and ethnicity) but with no programme intervention.
We conducted baseline research with 40 nodal adolescents and will conduct the follow-up survey with the same group at the end of the programme. We used qualitative and participatory methods, including semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs) with adolescent girls and boys, their parents, siblings and grandparents, teachers, community leaders, and local programme implementers. We explored the social networks that are meaningful to adolescents using social support analysis tools and through discussions. In group discussions with community members, we used historical process tracing of social norm change and community timelines to understand programmatic, infrastructural and institutional developments over time.
Recognising that adolescents are not a homogeneous group, we disaggregated data according to three cohorts: younger adolescents (10–12 years), mid-adolescents (13–15 years) and older adolescents (16–19 years). In the GAGE programme, we are interested in two cohorts, young adolescents (10–12 years) and older adolescents (15–17 years). However, in the field, there was a problem with sample size; there were only 4 programme participants aged 10–12 and few boys aged 16–17. It was impossible to find within such a small sample individuals meeting other criteria such as having a sibling, having a male or female sibling, etc., which we needed for the research. Lastly, the sample did not allow us to have an equal number of adolescents in the younger and older cohorts or even a sufficient sample. So, based on availability of participants, we opted for the three groups mentioned above.
Morang district was chosen as it is the district where World Vision (WV) Nepal has been working for a number of years and is where the Rupantaran programme will be implemented. While this district is viewed as one of the most industrialised and developed in Nepal, there are still pockets of extreme marginalisation, often linked to ethnicity. Thus, for instance, people belonging to the Madhesi ethnic group adhere to gendered social norms that are extremely discriminatory for girls; and while social norms among the Tharu ethnic group are more egalitarian, girls face other barriers to wellbeing, including lack of education. Little is known about adolescents in this area in general, and, more specifically, about the marginalised groups that the interventions focus on. Two study sites were selected – one urban (Biratnagar metropolitan city) and one rural (Gramthan rural municipality) – to capture differences in how norms and capability domains interact. To enable us to explore changes linked to Rupantaran, two villages were selected in each site – one that will take part in the programme, and one that will not (the control site).
Education and learning
Parents of today's adolescents are more likely to aspire to educate their children compared to parents' and grandparents' generation, but this aspiration is still not strong enough to substantially improve adolescents’ educational outcomes.
Although enrolment and retention rates have improved compared to the parents' generation, many children (especially those in the rural study site, older children, and those from the Madhesi community) drop out of school.
Older adolescent boys drop out due to the frustration of being humiliated by teachers, corporal punishment (which, though illegal, is widely practised) and dissatisfaction with the school system, such as its teaching methods. They also face family pressure to start earning and contributing to the household and thus drop out of school. Older adolescent girls drop out because they have to do unpaid care work or housework.
Older adolescent boys can benefit from peer learning even when they miss classes. However, due to restricted mobility, girls cannot benefit from peer learning to catch up on what they miss when absent from school.
Quality is a further disincentive: the level and quality of education that most boys and girls receive does not lead to jobs, also creating a sense of hopelessness.
Health, SRH and nutrition
The most common health problems for girls are around menstruation; girls reported that they had severe pain and heavy bleeding but their parents did not want them to go to the doctor as this was considered normal, and besides, speaking to a doctor about it would be embarrassing.
Girls and boys get most of their information about SRH from their peers (usually older adolescents).
Local primary health care centres are the most common services used by families; access is reported to be similar for girls and boys, and in urban and rural areas.
While premarital sex is taboo, it is happening more and more, especially among older adolescents. However, due to strong stigma, adolescents do not have access to relevant information, which puts them at high risk of sexually transmitted illnesses (STIs) and other problems. There are no formal institutions through which girls and boys can get information on SRH.
We did not find clear evidence to suggest any issues around gender discrimination in nutrition. Girls (and mothers) usually ate after men and boys, but they were not obliged to eat less food.
Bodily integrity and freedom from violence
Corporal punishment in school is common and severe, and ranges from slapping, to beating with a stick or iron bar. Boys typically face punishment at school as well as at home.
Boys are also punished or humiliated for things that are beyond their control (e.g. unable to do homework or pay fees, or for speaking Nepali in an English-medium school). This is largely the case for mid-adolescent and older adolescent boys, as humiliation and punishments increase as they grow older.
Harassment of girls in public places (roads or near secluded areas) is common, and girls are in constant fear of harassment when they travel to and from school. While at school, boys and girls both engage in some sort of verbal teasing with their peers.
Child marriage is common among the Madhesi community, where girls are married off as young as 15 years of age and mostly in secret and/or claiming that they are older (20 is the legal age of marriage). However, due to awareness-raising by local civil society groups (such as women's group, civil awareness centre) people are afraid to marry their daughters early.
Social norms constrain girls’ agency as they are expected to be subservient, not to question elders, nor voice their opinion if they do not agree with elders. They are also restricted from being in public spaces and interacting with the wider society. Older adolescent girls and girls from Madhesi and Dalit communities face severe restrictions in what is a strict hierarchical system, whereby younger people have to obey anything that elders say without question; if girls challenge this, they will be known as girls gone ‘bad’ and ‘out of control’ and thus bringing shame on the family. Few girls are able to defy the power of these strictly enforced norms, as to do so would bring unbearable stigma and psychological repercussions.
Older boys and mid-adolescent boys can defy norms more easily than girls and younger adolescent boys. Older adolescent girls are the least resilient, because the fact that gender norms are more stringent for this group.
The most important support networks for girls are mothers; for boys, it is their peers.
Schools do not provide any psychosocial support to adolescents, either through informal programmes or daily interactions with teachers.
Voice and agency
Mobility (freedom to leave the house alone) and public spaces are both gendered: adolescent boys (particularly older boys) have more mobility than girls. Mobility is highest among boys who have dropped out of school, and lowest among girls who have dropped out of school.
Older and mid-adolescent boys can congregate freely in public spaces but such spaces are largely off limits to girls.
There is mixed evidence around decision-making in personal lives, with older adolescent girls in the urban site given more of a say (albeit still limited) in decisions about their lives, while girls in the rural site and those from Madhesi families have very little say. Alongside parents, older brothers (particularly those who are working) have a significant say in decisions about their sisters’ education, marriage and employment. Young and mid-adolescents, boys and girls, have less say about decisions that affect their lives, largely due to parental concerns about protection.
There are no formal mechanisms through which adolescent boys and girls (whether younger or older) can participate in community decision-making. In other settings, children’s clubs have begun to give some children more of a say and a voice in school and community life; however, in both study sites, such clubs were limited to teaching dancing (for girls) and sport (for boys). Moreover, these clubs target young and mid-adolescents only.
Although schools are potentially a positive force in children’s lives, the school system in Nepal is top-down and hierarchical; boys and girls are not included in decision-making around teaching methods, teacher– student interactions are limited, and there is no adequate grievance mechanism to discuss problems arising in school – all of which combine to limit children’s voice and agency.
Migration to the Gulf countries is a common aspiration for older adolescent boys who drop out of school and those from rural areas, while boys who transition to higher education have role models who have acquired better jobs through this route. Girls do not migrate, nor do they have aspirations to do so.
When they drop out of school, boys find jobs locally (typically in factories, garages, construction sites, or as carpenters); girls do not take up such jobs, typically only earning cash through seasonal agricultural labour.
Boys who drop out of school do not have opportunities to develop their skills and learn while in the job. There is no provision for on-the-job- training or access to technical and vocational education. Since girls do not go for jobs once they drop out of school, there is no opportunity for girls to develop skills.
There is no access to economic endowments for boys. Older and mid-adolescent girls are sometimes given animals or jewellery as gifts from their grandparents. Boys also lack access to credit, and neither boys nor girls save.
There is a mismatch between the level of education and skills required to do certain jobs and the educational attainment of girls and boys. There are only a few programmes accessible to boys and girls; children’s clubs are the most common, and organise learning and fun exercise, but only cater for young adolescents.
World Vision’s programming largely focuses on building voice and agency around harmful traditional practices, providing psychosocial support for adolescents and equipping them with information on gender and other kinds of discrimination, as well as making them aware of the services available to them and policies that can benefit them. Its programming has fewer components addressing economic vulnerability. However, other programmes in the same area have economic components targeting selected adolescents with financial transfers. Some of the adolescent boys and girls in Rupantaran were also benefiting from these economic intervention programmes.
Given that it presents an important window of opportunity, a policy and programming focus on adolescence is necessary. Evidence shows, however, that there is less understanding of what works best to transform adolescent girls’ lives in low- and middle-income countries (LMICs), which are often fraught with challenges. The objective of GAGE is to fill this knowledge gap and the current study helps to contribute to the wider GAGE objective with case from Nepal.
Overall, this baseline study finds that gender norms remain restrictive for girls– much more so than for boys – across all six capability domains explored. However, there is evidence of change, especially when compared to earlier generations. This change has to do not only with changing norms but also due to availability of services and infrastructure, and awareness programmes such as through schools and community groups, commissioned by government and non-government stakeholders. There are, however, variations: thus younger adolescent girls aged 11–12 are likely to face fewer gender discriminatory norms than their mid-adolescent (13–15 years) and older adolescent (16–19 years) counterparts. Gender norms are also experienced more harshly among certain ethnic groups compared to others; in this case, Madhesi girls faced many more restrictions overall, irrespective of their age and location, when compared to their counterparts in the Tharu community.