Evidence-based evolution of child marriage prevention-a decade of sexual and reproductive health programming in Pakistan.

Child marriage in Pakistan is sustained by deeply entrenched patriarchal norms and socioeconomic structures that limit girls' agency and access to sexual and reproductive health and rights (SRHR). This paper analyses a decade of programme learning from the Awareness to Action project (A2A, 2013-2016) and the Yes I Do Alliance (YID, 2016-2020), drawing on a baseline study, mid-term evaluation, external endline evaluation, and the YID inception report. Findings showed substantial individual- and community-level gains: 80% of adolescent girls correctly defined reproductive health at midline, 92% demonstrated improved SRHR knowledge at endline, and 42% reported participation in marriage decisions, suggesting contributions to child-marriage advocacy and youth-policy dialogue. However, persistent early marriage and limited decision-making show that knowledge gains did not translate into marital autonomy for the adolescent girls. Sustainable change requires cross-sectoral action addressing the economic and structural drivers of gender inequality.