Drama queens (and kings!): Bright lights and applause for youth working to advance adolescent health

By Dr. Tessie San Martin
July 9, 2018

People scramble to find a seat. Adults and children of all ages gather in the fading light to ensure they have front row access to the show. The music begins and we are all quickly engrossed in a complex and emotional tale of a young woman, her parents and the consequences of one’s decisions. 

Sixty-seven percent of adolescent girls in Bangladesh are married, including 5% of those ages 10-14 and 48% of those ages 15-19. Teen marriages lead to a high proportion of teen pregnancies; 50% of all pregnancies in Bangladesh take place by age 18. This dynamic affects teen health — teen pregnancies have a higher chance of complications, and girls under the age of 18 are five times more likely to die at childbirth. Pregnant teens are much more likely to experience preterm births (along with low birth weight babies, who have their own health complications). In Bangladesh, you cannot address adolescent health without tackling child marriage.  

Teen marriage also explains why, despite the country’s considerable success increasing girls’ enrollment in primary and secondary school (net enrollment rates are higher for girls than boys), dropout rates for girls are much higher than for boys. The chances girls will attend, let alone finish, university are also very low. Early marriage and pregnancy are threatening to undo the great improvements Bangladesh has made in girls’ and women’s literacy and education.  

A central element in Plan International’s approach to tackling child marriage — and related issues of teen pregnancy — is youth leadership and engagement. Data and experience confirm that engaging both girls and boys in the design, planning and delivery of activities is essential for local ownership and sustainability beyond the life of the project. 

Making this happen requires creating safe spaces for youth to interact with adults in the community while enhancing youth capacity and self-confidence to participate in and lead discussions on these difficult topics (often through a series of “life skills” sessions). It also means capacity building for adults to enhance their ability to interact effectively with young people. The latter step is especially challenging, given the natural adult tendency is to dismiss youth as “too young to understand” or of being “easily manipulated.”

Nowhere is the power of youth engagement in advancing essential, yet difficult, behavioral change more visible than in Plan’s Theater for Development initiative. TFD is an element of the U.S. Agency for International Development’s Advancing Adolescent Health (A2H) project, being implemented in Rangpur, Bangladesh through Plan and local partners, Eco-Social Development Organization and Lutheran Aid to Medicine in Bangladesh. The TFD activities involve youth as playwrights, producers and actors, in partnership with the adults in the community.  

The play we attended was a mix of farcical comedy and high drama, telling its story with humor and empathy. The plot focused on a 14-year-old girl, Chompa, who is married off by her father, despite her mother’s deep misgivings. It highlighted the enormous pressures in the community — through friends, religious leaders, matchmakers (who often also have a financial incentive) and peers — pushing for the marriage.  

In the play, the new bride soon finds herself pregnant and living with a husband and family who neither appreciate nor nurture her. Unable to stand it any longer, she takes her own life (and that of the unborn child). The acting, by children, youth and adults from the community playing all the roles, was gripping. The audience laughed and cried, clapped and gasped. At the end of the play, the actors shed their roles and led the audience in a lively discussion starting with a key, and often divisive, question: Who is responsible for Chompa’s death? 

Initially audience members point to the husband (played as a suitably disagreeable fellow). Others point to the matchmaker, a few to the father (who comes to understand his central role in his daughter’s death) or the father-in-law. 

But eventually the dialogue yields a common understanding that it was everyone’s fault. No one action led to Chompa’s untimely death. It was the collection of social pressures that resulted in the outcome; the community must bear responsibility. It is a painful epiphany for the community and ends up being an effective way for the youth to engage their peers, adults and village leaders in a necessary dialogue about the topic of child marriage. Preventing child marriage and teen pregnancy is not one person’s responsibility, it is everyone’s. 

The Advancing Adolescent Health project staff are evaluating the effectiveness of this type of activity as an enabler of broader community behavioral change. Initial anecdotal evidence suggests this is an effective approach and that it is sustainable because the activity is owned by the community, not just the youth or the project partners. But there is a long path between receiving a message and acting on it. More research is required.

What is clear is the positive effect of the TFD activity on the youth themselves (both boys and girls), increasing their motivation, self-confidence and leadership skills. 

“I have learned about the consequence of early marriage from this drama,” a mother and community elder commented. “The dramas are a very effective way to spread messages against child marriage, because it brings all ages, all types of people together to deliver the message equally. We are now fully aware against child marriage, and if anyone else tries to arrange a marriage, we will prevent them by referring to these shows’ learnings.” 

There is a growing body of outcome research that suggests that structured voluntary activities, such as arts, theater, participation in organizations and sports, are especially effective at developing initiative and self-confidence in youth. TFD is an excellent illustration of a tool that supports positive youth development and leverages it toward a broader effort to address a complex web of societal and cultural pressures. 

Ultimately, there are no magic formulas to solving the child marriage problem, in Bangladesh or elsewhere. There is no one approach that will always work. USAID and the Advancing Adolescent Health staff understand that rather than insisting on one required approach, constant experimentation and innovation are needed, along with rigorous testing. And in this effort, the youth need to be given the space to be leaders, change agents and innovators — and not just treated as part of a “target group.”

This blog is brought to you by the Advancing Adolescent Health (A2H) project and is made possible by the generous support of the American people through USAID. The contents are the responsibility of Plan International and do not necessarily reflect the views of USAID or the U.S. government.