Abstract

India has one of the highest adolescent populations in the world, with approximately 253 million adolescents (10-19 years). Providing caregiver-based sexual and reproductive health (SRH) programming is a proven strategy to help equip adolescents with the knowledge and skills they need to adopt safe and healthy sexual behaviours including the use of contraceptives to delay pregnancy. Unmet need for contraception among adolescent girls remains high, with 10% of married adolescent girls (15-19 years) having no access to contraceptives& contraceptive use among adolescents is below 30%

The Families Matter! Program (FMP) is an evidence-based behavioural intervention targeting primary caregivers of adolescents aged 11 to 19 years. Its objectives are enhancing parenting practices, fostering effective parent-adolescent communication about sexuality, and promoting comprehensive knowledge of family planning, including delaying first pregnancies and understanding contraceptive options. It was implemented in eight states with high Total Fertility Rate (TFR) and high HIV prevalence. These states were selected due to their significant adolescent reproductive health challenges and the need for strengthened caregiver-based interventions.

This pre- and post-intervention comparative study evaluates the program’s impact on knowledge dissemination and behaviour change among both parents and adolescents. A hallmark of the program is its interactive sessions, where parents practice communication skills with their children aged 11-19 years, reinforcing the integration of knowledge into practice. Data collection, led by ChildFund India, and research organizations, included pre- and post-intervention surveys, focus group discussions (FGDs), Among participants, 65% were women caregivers, 80% were rural residents, and 85% belonged to marginalized communities, with 5,000 ASHA workers, ANMs, and teachers trained to sustain SRH education efforts. Evaluation data from 2024 demonstrate significant improvements in adolescents’ knowledge of contraception options. The percent of adolescents possessing comprehensive and accurate knowledge of contraceptive options increased from 32% in 2019 to 60% in 2024.

This study highlights the transformative potential of caregiver-based interventions like FMP in advancing SRH knowledge and promoting family planning. By empowering caregivers as primary educators, FMP helps parents and caregivers successfully transfer knowledge and encourages the establishment of lifelong healthy sexual behaviours, informed decision-making, and delayed first pregnancies among adolescents. There is also an opportunity to integrate FMP’s structured curriculum into school-based comprehensive sexuality education (CSE) and community-led initiatives through ASHA and Anganwadi networks. While the study demonstrated measurable improvements in contraceptive awareness, challenges such as limited male participation, and data gaps on long-term health outcomes need to be addressed