3.3 Qualitative results
We present themes based on intervention acceptability and usefulness of participating in the intervention, and barriers and facilitators to implementing this intervention, and conclude with program improvements suggested by participants and NGO staff and moderators.
Theme 1: Acceptability of the intervention
Nearly all the participants reported that attending meetings made them feel “good”. The participants elaborated that meetings offered a sense of ease to sit and talk about family planning, menstruation, and other topics.
“Being a part of the program has provided me with new information that I didn't have before. I have been connected with new people, who I did not know earlier. I've gained new knowledge since joining.” – DIL 10, Age 22, Scheduled Caste
“It feels good. Everyone sits and talks….meetings should happen because we get information. These are topics we didn’t know before” – DIL 8, Age 19, Scheduled Tribe
Interviews with NGO staff and moderators underscored the evident necessity for an intervention such as TARANG for newly married young women, reflecting the program's acceptance within the communities.
“There is definitely acceptance within people. The young married couples I talked with have found the need for such information. Young married couples don't have this kind of information. ….If they don't have this information and are able to grasp such information, then it is acceptable.” NGO staff 2
“People in my village share what they learn in meetings with each other, and it feels like they are learning something from us. Whatever we tell them, they are learning something new… Participants agree to continue with the program. I am receiving support from daughters-in-law, mothers-in-law, and even from husbands and fathers-in-law.” NGO moderator 1
Some women expressed appreciation for the TARANG intervention, as it equipped them with essential practical knowledge that had previously not been provided to them in any form, as well as increased mobility. They explained that given the gender norms in their villages, they were never allowed to step outside their homes to attend such sessions previously.
“I did not know before. Because we were not allowed to step outside the house. We used to go to school. Right after that, we used to go to the fields for work. They [parents] didn’t allow us to go anywhere.” DIL 10, Age 22, Scheduled Caste
Theme 2: Intervention’s usefulness
Many participants mentioned that the program was useful and was already bringing about tangible benefits in their life. The usefulness theme is described below in terms of their enhanced knowledge, decision-making and agency, new connections and social networks, relationship/communication with husband, and relationship with mother-in-law.
Usefulness: Knowledge
Overall, participants interviewed discussed benefitting from being part of the TARANG intervention, and none reported any negative consequences. Specifically, they noted that the curriculum was salient, increased their clarity on topics, and even introduced them to expanded knowledge previously not taught to them in schools or other settings.
“I enjoy attending the meetings; there's no one else to inform us. I wasn't aware at first, but I learned from didi [moderator]. I'm following the advice.” – DIL 9, Age 18, Scheduled Tribe
Specifically, most participants discussed gaining awareness of contraception methods, including condoms, pills, injections, and Copper-T, highlighting their improved knowledge of different options available for family planning and contraception. They also discussed about gaining awareness of their overall health and other topics such as menstruation.
“We discussed about different contraceptive options—condoms, pills,… There should be a three-year gap between the birth of two children. When you don’t space children, the body gets weak.” DIL 12, Age 21, Scheduled Caste
“It has taught us that we need to be careful when such situations (pregnancy) arise with us.” DIL 6, Age 23, Scheduled Caste
Several participants expressed the importance of spacing between children, suggesting a preference for a gap of around three years between each child. This demonstrates an understanding of the benefits of spacing in terms of the health and well-being of both the mother and the child.
“There should be a gap of two to three years between children. It means the first one should grow up, and preparations for the second one should be made, taking care of oneself…It's good that we discuss things related to our body parts; that's correct.” DIL 3, Age 21, Other Backward Class
“It felt good when they talked about us, they told us about the problem of the womb, and used to look at pictures in science during studies. Eggs, and sperm are formed, and information is received.” DIL 6, Age 23, Scheduled Caste
Few participants also discussed the ideal number of children, with responses indicating a preference for having one or two children. This suggests that participants have more a thoughtful approach to family planning after attending intervention sessions, and now can consider factors such as maternal health, and the ability to provide adequate care and support to each child before planning their pregnancy.
Not only had participants acquired knowledge, but they had also learned to contemplate the consequences of engaging in unprotected sex. For example, one participant even mentioned feeling fearful of engaging in sex without contraception.
“Yes, I feel worried; there's fear. Sometimes, engaging in relationships without contraceptives, child maybe conceived….” DIL 6, Age 23, Scheduled Caste
Interviews with the NGO staff also echoed TARANG intervention’s significant benefits, highlighting a common theme: prior to its implementation, newly married women lacked awareness of methods to prevent early pregnancies. The staff emphasized the necessity of interventions like ours, as these women had not previously been exposed to such awareness-raising initiatives.
Because what is the need to get pregnant at such a young age? The things they didn't know about, no one told them, whether it be about periods, having children, or contraceptive methods." NGO staff 1
Moderators who delivered the intervention also agreed that women had benefitted immensely from attending the TARANG intervention sessions. Specifically, they noted the benefit of activities done to teach the sessions to young newly married women. The “seed activity” conducted during one the TARANG sessions, which demonstrated how the gender of a child is determined, proved to be a meaningful and impactful experience for the participants. Through this activity, participants gained insight into the biological processes that influence the sex of a child, leading to a deeper understanding of the natural factors at play.
“When we conducted sessions, they didn't know before how pregnancy occurs, what a boy is like, and what a girl is like. Through activities, they are getting this kind of information. Through activities like “seeds”, they understand that there are two types of seeds, one for men and one for women. They now understand menstruation, are aware of their health, and know the benefit of spacing in children, including family planning awareness”. NGO moderator 1
Usefulness: Decision-making process and sense of agency
Few participants expressed a sense of newfound autonomy and agency in decision-making, particularly regarding matters related to reproductive health and family planning. They highlighted the shift from seeking approval or guidance from family members, such as mothers-in-law and husbands, to making independent decisions based on their own preferences and desires. The intervention encouraged participants to engage in open dialogue with their spouses, families, and communities, fostering a collaborative approach to decision-making. The participants felt that they could assert their own preferences and make decisions that aligned with their individual needs and goals. They reported a sense of empowerment to make more informed decisions about family planning and contraception.
“Earlier, I couldn't make decisions on my own. I used to ask my mother-in-law and husband. If it's about both of us, we make decisions by asking each other. If it is about my mother-in-law, I will ask her. If it is about anyone else in the family, I will consult with all the family members. And if it concerns me, I can make my own decision.” DIL 5, Age 25, Scheduled Caste
A few participants emphasized the importance of husband and wife jointly making decisions, indicating a recognition of the equal partnership and shared responsibility in decision-making within marital relationships.
Prior to the intervention, their approach to family planning may have been more passive or influenced by traditional norms. However, after gaining knowledge and critical thinking skills through TARANG sessions, they have become more proactive and deliberate in their approach to family planning. One participant mentioned considering factors such as the timing of childbirth and the desired age gap between children, suggesting a more thoughtful and informed decision-making process, as discussed below:
“There has been an impact on our family planning perspective, Earlier, we used to think about something, but now we think differently - When should we have a child, how much age gap should be there between children, etc.” DIL 3, Age 21, Other Backward Class
Usefulness: New connections and establishment of social networks
Many participants experienced discussed benefits from interacting with one another, forging connections, and establishing social networks within the community. Through these interactions, participants reflected on their ability to share experiences, exchange information, and provide support to one another, leading to a sense of camaraderie and belonging.
“We make friends by attending the meeting. We learn how to talk, get to know each other, and understand our bodies. We didn't know moderator madam before, but after joining this meeting, we got to know each other…All my friends are those who attend the meeting. As we get to know each other, we can laugh and joke together, and talk with each other.” DIL 3, Age 21, Other Backward Class
Usefulness: Relationship with husbands/ couples’ communication
A few participants reported that they shared information discussed during TARANG sessions with their husbands. This communication facilitated a deeper understanding and mutual support regarding topics related to reproductive health and family planning within their marital relationships.
“Yes, it is significant. I mean, if we have to make an important decision or if we are not liking something, we should speak openly. Likes and dislikes should be communicated. One should communicate their problems to their husband, to friends, especially to the husband… Like, we both take each other's opinions. We work by consulting each other. It was a bit less at first, but now it's fine” DIL 3, Age 21, Other Backward Class
Usefulness: Relationship with mothers-in-law
In addition to the noted benefits in their relationships with their husbands, some participants highlighted improvements in their relationships with their mothers-in-law. It is possible that the TARANG intervention's dedicated sessions involving mothers-in-law are also contributing to fostering understanding and harmony between daughters-in-law and mothers-in-law. This suggests a positive impact on family dynamics, promoting communication and support within the household.
“Like, when we are going to the meeting, my mother-in-law and husband listen to me, and I also listen to them. Everything is going well….In the session, we learned that one should consider their daughter-in-law as a daughter. For example, our mother-in-law considers her daughter, who got married, as a daughter-in-law, just like they (mothers-in-law) should consider us daughter-in-law as their daughter, and that's how we receive love.” DIL 3, Age 21, Other Backward Class
Theme 3: Barriers and facilitators (participant perspectives)
Participants noted a few barriers to attending sessions such as busy routine lives, time, and availability to come to sessions.
Workload, daily routines, and household responsibilities
Most participants’ lives revolve around household chores and agricultural farm labor work or cattle rearing with very little rest time or leisure time. Often, this busy schedule made it challenging for the participant to attend sessions regularly.
“I make roti [bread], fetch fodder for the buffalo, and eat roti [bread]. Bringing fodder for the goat, then taking a two-minute rest, going to the farm at three-four o’clock, and in the evening, making roti again” DIL 9, Age 18, Scheduled Tribe
A few participants faced additional care responsibilities, such as caring for sick father-in-law or assisting their mother-in-law with household tasks, which further restricted their ability to attend sessions.
“He is ill at home, plus the guests come. We attend them. My mother-in-law will come after Navratri [festival]. Added to this, recently, my father also underwent surgery due to a lump in his urinary tract. So, I have to take care of both the houses [paternal + in-laws]. I go to my father's place at night and return [to the in-laws] in the morning. There is grass-cutting work too, but I don’t do that. I primarily take care of the work at home.” DIL 5, Age 25, Scheduled Caste
Some resistance from husbands/fathers-in-law
While most participants felt supported to attend the sessions, a couple of participants said that they faced resistance from their husbands or fathers-in-law in attending sessions. In one instance, a participant’s husband discouraged her from attending, preferring she focus on household chores.
“My husband says that they teach you different things and they teach me different things.. He says that I should do household chores: rather than sit in the meetings.” DIL 2, Age 22, Scheduled Tribe
Moderators echoed that sometimes family members objected to women participating: “If we go to call these women every day, their families, particularly fathers-in-law, object, citing health concerns.” NGO moderator 2
A few participants navigated conflicting priorities and obtaining permission to attend the sessions. Despite facing occasional household chores or responsibilities, one participant expressed their desire to attend the sessions, indicating the importance she places on participating in the program, as noted below:
“They usually say to go, sometimes there is work, they ask me to come a bit early…They do give permission; even if they don't say, I still go. Sometimes I go without asking. Madam [moderator] comes, and if she asks, they say, "Go, come on time." DIL 6, Age 23, Scheduled Caste
Distance to the meeting venue for participants
A few participants mentioned that some women in their group lived away from the meeting venue which often makes it hard for them to attend.
“It takes 15 minutes for women in my group to arrive at the meeting because they live far away.” DIL 12, Age 21, Scheduled Caste
Strong desire to attend meetings to navigate barriers
Despite these challenges, a few participants expressed a strong desire to attend sessions, saying that they managed their time by working around their schedules to attend these meetings, highlighting the value these sessions were generating for them.
“No, still, we manage time for the meeting. There is no big deal with work, as Work is never-ending.. Whenever there was time, we used to ask about the meeting time beforehand. We allocate two hours for the meeting. If there is any work, we complete it before attending.” DIL 3, Age 21, Other Backward Class
Theme 4: Barriers and facilitators (NGO staff and moderator perspectives)
Challenges in recruiting newly married women for the study
NGO staff and moderators explained the concept of “gauna or aana” in Rajasthan, wherein newly married brides transition to their in-laws’ home and consummate their marriage, typically after a period, varying from several months to perhaps a year or more, rather than immediately after marriage. This made it challenging for the team to find “eligible” households for the study. Despite this challenge, we were on average able to recruit about 10–11 women in our sample for the pilot study.
“In our area, there's a custom where newlywed brides move to their husband's family home, called 'gauna' or 'aana'. This usually happens after some time, ranging from a few months to even a year after marriage. Different communities have their own timings for this based on regional traditions. It's quite common for brides to stay with their parents for a while before shifting to their husband's place. This made it tough for us to find suitable households for our study. We needed married women aged 18 to 25 who had been living with their husband for at least six months and living with their mother-in-law. But because of the varying timing of 'aana', it was tricky to find households that met all our criteria. Plus, we also had to consider that the marriages had to be within the past year, which added another layer of complexity." NGO Staff 2
Limited time availability for newly married women to engage with the intervention
Moderators also echoed that participants had limited time to attend sessions due to their demanding daily routines and chores. They mentioned that many prioritize household tasks over attending meetings, fearing that neglecting these responsibilities will lead to household work suffering due to lack of time. Moderators also shared that because a significant portion of participants are engaged in labor-intensive work, it is difficult for them to attend meetings. Finally, they stressed that the ongoing grass-cutting season at the time of the qualitative study (it is seasonal and intensive labor work in Rajasthan often undertaken by women) added to the participants’ workload and time constraints.
“Today, these same women say, we have learned a lot. But it's quite challenging to call women for meetings as they are busy with fieldwork. Sometimes when I invite them to a meeting, they respond, we must go home to our guests. The biggest challenge is that 90 per cent give more priority to household chores, fearing that if they attend the meeting, the household work will suffer, due to a lack of time.” NGO moderator 1
“For example, if the daughter-in-law comes home, and if the mother-in-law has small children, then if the mother-in-law goes somewhere, the daughter-in-law has to take care of them. Currently, the grass-cutting season is going on, so they are busy with that too.” NGO moderator 2
Initial shyness and need for rapport building
Moderators mentioned how shyness among newly married women posed a barrier at first. They talked about participants being hesitant to speak up during group sessions or ask questions due to feelings of embarrassment or shyness. This inhibits their ability to fully participate and benefit from the sessions.
“At first, they hesitate to speak, and if they don't understand, they don't ask again because they feel embarrassed” NGO moderator 1
In a few cases, moderators took the effort to engage participants by asking the women’s mothers-in-law to encourage them and support the newly married women in overcoming their shyness. This also potentially reassured women to engage in the intervention because they felt they had permission of the mothers-in-law.
“Initially, newlywed brides wouldn't talk to us, and wouldn't even disclose their names. When asked something, they would become shy and wouldn't share anything. Even in the sessions, there was hesitation. Even after repeated questioning, they wouldn't respond. Due to shyness, they would hide in someone else's house. Then, we spoke to their mother-in-law to encourage them (women/their daughter-in-law) to talk.” NGO moderator 2
Festivals, weddings, events
Moderators highlighted how religious functions and festivals pose significant obstacles to conducting sessions effectively. There are certain months such as Sawan (monsoon), festivals (such as Holi, Diwali, etc.) when women are particularly engaged in religious and cultural activities. During these events, women participate in village gatherings, fairs, and religious rituals, which takes precedence over attending sessions. Often local fairs and community events involve extended periods of absence from their husband’s home, further making it challenging to schedule and conduct sessions effectively.
“The biggest challenge is that we are including DIL members whose marriage happened just six months ago. In this case, she will be busy with her piyar [parent’s home] for a month during the first Sawan. If she is associated with the Gameti community, there is a Gavari program for her, and Navratri (another Indian festival celebrated for 9-days in the month of Oct/November) is also there. To highlight a significant obstacle, attending DIL sessions for the entire month of Holi is challenging.” NGO Staff 1
Newly married women’s extended period of stay at their natal homes
The transitional period for newly married brides, as they acclimate to their marital homes, often results in extended stays at their natal/parental homes, presenting a significant barrier to their consistent attendance at sessions.
“Daughter-in-law (DIL) visits their parents quite frequently, due to being newly married, she stays in the in-laws' house for some time and sometimes in her parental home.” NGO Staff 2
In some cases moderators facilitated women’s attendance by going and personally escorting them.
“Many women don't come on time; we have to go and call them, sometimes even escort them back” NGO moderator 1
“Our colleagues bring them sitting on a scooter, many times when the husbands do not have the resources, both the husband and wife are brought for the session.” NGO moderator 3
Theme 5: Suggestions for intervention improvement
A few intervention improvement themes emerged from interviews with both participants and NGO staff.
Themes in the meetings/sessions
Most participants agreed that the TARANG intervention was catering to their desire to learn and already covering topics of their interest.
The moderators also felt the TARANG intervention was appropriate, and the content was just “right”, although they highlighted that the intervention should be sensitively delivered.
“The content is right. It is essential how sensitively it is being taken to them. There are some topics where it is ensured that the trainer’s bias doesn’t come, and I do not give a wrong message. The content is based on the subject we are talking about.” NGO Staff 1
Length/time of the meetings
A few participants felt that the meeting length could be increased: “It should be increased. The more time we sit for the meeting, the more we will talk.” DIL 9, Age 18, Scheduled Tribe
Another woman described liking having ample time: “We discuss so much. It feels good when moderator madam says something, we can sit together, and talk” DIL 10, Age 22, Scheduled Caste
NGO staff also felt longer duration of sessions would be beneficial as it would allow them to listen to more of what women have to say.
“If the session duration is increased.. During the session, participants also share personal experiences, so it's important to listen to them too” NGO moderator 2
Conduct of sessions by moderators
Nearly all participants expressed appreciation for the moderators' effectiveness in delivering the sessions. They commended the moderators for their ability to explain topics in a language that participants could understand and for contextualizing the information to make it relevant to their lives. They were satisfied, stating that the moderators maintained a calm demeanor. The participants reported that they enjoyed the engaging nature of the sessions.
“Madam's way of explaining is correct; she explains to us in our language. She keeps the sessions very lively - fun and not serious. I like her teaching very much.” DIL 5, Age 25, Scheduled Caste
“Yes, it's good, absolutely perfect. She explains things calmly; for example, if we didn't understand something in the meeting yesterday, she explained it again. When she asks us questions, it's good to answer.” DIL 3, 21 years, Other Backward Class
Intervention delivery to include videos
When probed about the benefit of videos, most participants felt that videos would enhance their understanding of the topics. They likened videos to stories, indicating they found them engaging and effective for learning: “.. We can watch; we can watch at night. Watching videos will help in understanding, it's like a story only.” DIL 6, Age 23, Scheduled Caste
Specifically, one participant appreciated the use of various multimedia methods such as pictures, stories, case studies, and audio during meetings, suggesting a preference for diverse instructional approaches: “In the meeting, things are explained through pictures, stories, case studies, and audio and all these methods are fine”. DIL 7, Age 19, Other Backward Class
In terms of the intervention delivery, NGO staff and moderators also echoed the benefits of the videos, as they perceived it resonated better with women.
“There should be more videos because the one who listens may not be understanding it well.” NGO moderator 2
“After showing them the videos, we can discuss them with them. This way, their interest will be maintained in watching the videos, whose language is easy, and understandable”. NGO Staff 1