Adolescent girls' life aspirations and reproductive health in Nepal.

The study described in this paper takes a participatory and positive approach to improving adolescent reproductive health in a rural and urban community in Nepal. It shows that adolescent girls in these communities have dreams and aspirations for a better future and that adults acknowledge and support these ideals. However, social norms and institutions are restrictive, especially for girls, who are often unable to realise their hopes for continuing education, finding better-paid work or delaying marriage and childbearing, and this directly impacts reproductive outcomes. Insight into the broader context of adolescent girls' lives provides a valuable framework for designing positive programmatic actions which take as their entry point the disjuncture between girls' aspirations and realities. Interventions begun in these communities include youth clubs for safe social interaction and literacy classes; training of peer educators to teach life-skills, including for married adolescents; forums for parents, teachers and health service providers to discuss their own concerns and those of adolescents; and work with the community to design programmes that will contribute to greater financial independence and employment opportunities for adolescents.