The PRO-GRESS model: A conceptual framework for gender-responsive reproductive health promotion among survivors of child marriage

Child marriage is a global problem affecting the health and well-being of women, especially in developing countries such as Indonesia. This study aims to develop a gender-responsive reproductive health promotion model to prevent violence against women survivors of child marriage, defined as girls who were married before age 18 and remain vulnerable to gender-based violence as a consequence of early marriage. Using an exploratory qualitative approach with a phenomenological design, the data were collected through in-depth interviews with seven female survivors of child marriage. Data were collected between late 2023 and mid-2024 who were married before age 18. Participants were selected using purposive sampling. The focus group discussion (FGD) was conducted with policymakers, and NGOs representatives in East Java, Indonesia, to capture policy and structural perspectives that support the development of the PRO-GRESS model. Many women are trapped in a cycle of violence and reproductive health problems due to gender inequality and social pressures. The findings revealed key themes, including triggers for child marriage, the psychological experiences of victims, and social and structural barriers after marriage. The PRO-GRESS (Promotion of Gender Responsiveness for Reproductive Empowerment and Safe Sexual Health) model was developed as a framework for promoting gender-responsive reproductive health and preventing violence. This study suggests the need for cross-sector collaboration to address this issue comprehensively, involving policymakers, non-governmental organizations, and the wider community. These findings have important implications for the development of policies and programs that support women's empowerment and the protection of children's rights. Specifically, the PRO-GRESS Model offers a novel contribution by moving beyond the prevailing focus on the prevention of child marriage, and instead emphasizing the need to address survivors' post-child-marriage lives through empowerment, psychosocial recovery, and the provision of gender-responsive reproductive health services.