"I'm saving money to make some changes in my life": A qualitative study of a combined economic empowerment and SRH program for married girls in Ethiopia

Abstract

Background

Addressing the intersecting needs of married adolescent girls in sub-Saharan Africa requires integrated programs that combine economic empowerment with sexual and reproductive health (SRH) services. Adolescents 360 implemented a multicomponent intervention in eight woredas in Ethiopia, combining business skills, financial literacy, and SRH education delivered in girls-only groups. This study explored girls’, husbands,’ and facilitators’ perspectives on the intervention and its effects on girls’ economic activities and contraceptive use.

Methods

This cross-sectional qualitative study included in-depth interviews with 20 married adolescent girls, eight husbands, and eight facilitators. Site locations were purposively selected to reflect high- and low-performing areas, and girls were randomly chosen from the participant lists. Husbands were randomly selected from among those whose wives consented to their contact, and facilitators were purposively sampled. Interviews were conducted face-to-face using a structured guide, translated during transcription, and analyzed thematically through two rounds of inductive and deductive coding to generate primary themes.

Results

All girls reported establishing financial goals, starting income-generating activities, forming peer networks, and exercising control over earnings. The participants linked contraceptive use to economic opportunities. Although some wished for greater financial benefits from the program, husbands supported their wives’ participation and developed shared financial goals.

Conclusion

Participation strengthened girls’ economic and social agencies. Success factors included support from husbands and engaged and skillful program facilitators. The relatively short duration of the intervention limits the ability to see major changes in economic activity and social norms around household decision making, although the findings are promising. Further longitudinal research is needed to identify which components yield the greatest impact and to strengthen the evidence for integrated SRH and economic interventions for married adolescent girls.