Evaluating the effectiveness of a School and Community Based Social and Behavioral Change Communication (SBCC) Sukarya Program on Adolescent Girls’ Health Knowledge, and Attitudes in Tijara, Rajasthan, India.

Abstract

Background: Adolescence defined by WHO, is a period between 10-19 years, a period characterized by rapid changes emotionally, physically, psychologically. India is home to approximately 253 million adolescents, of whom are girls comprise nearly half. Adolescent girls in rural areas face significant gaps across multiple domains, compounded by sociocultural norms, gender inequality, and limited access to age-appropriate health information. Social and Behavioral Change Communication (SBCC) programs represent a key strategy within India's national adolescent health framework for addressing these gaps, yet rigorous evaluation of their effectiveness at the school and community level remains limited. Objectives: This study aimed to assess health related knowledge and selected attitudes among adolescent girls participating in Sukarya's school-and community-based SBCC program in Tijara, Rajasthan, across six priority domains, and to descriptively compare findings with baseline needs assessment data from the general adolescent population in the same setting. Methods: A post program cross-sectional study was used. A total of 244 adolescent girls aged 10-19 years, completed a 24 item close ended evaluation form covering six health domains: nutrition and anemia, personal health and hygiene (WASH), menstrual health, sexual and reproductive health, family planning and rights, and mental health and gender. Each item was binary coded as correct and incorrect, and knowledge scores were calculated on a scale of 0-4. Descriptive statistics were used, including frequencies, proportions, and 95% CIs. Findings were descriptively compared with a baseline need assessment in the general population in Tijara. Results: Overall, participants demonstrated a moderate level of health knowledge, with a mean total score of 14.44 out of 24 (SD = 5.83). The strongest domains were Personal Health and Hygiene and Menstrual Health (Mean = 2.81 each), while Sexual and Reproductive Health (SRH) recorded the lowest mean domain score (Mean = 1.95), followed by Mental Health and Gender (Mean = 2.09) and Family Planning and Rights (Mean = 2.18). Critical knowledge gaps were identified in HIV transmission (23.0% correct), mental health definition (31.6% correct), and family planning methods (45.1% correct). Selected attitudinal findings indicated positive help-seeking behavior (69.7%) and moderate gender equality awareness (57.8%) among participants. Conclusions: Sukarya’s SBCC program has contributed to foundational health knowledge necessary for attitude and behaviour change particularly with domains characterized by concrete and repeated delivered content, consistent with program established institutional strengths in nutrition and menstrual health programming. Persistent gaps in SRH, mental health, and family planning reflect deep-seated sociocultural barriers that extend beyond the reach of a single program cycle. Strengthened, targeted SBCC strategies engaging community gatekeepers alongside adolescent girls combined with robust pre-post evaluation designs are needed to advance knowledge, attitude, and behavior change.