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Randomized Controlled Trial
. 2016 May 11;11(5):e0153190.
doi: 10.1371/journal.pone.0153190. eCollection 2016.

Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India

Anita Raj  1 , Mohan Ghule  2 , Julie Ritter  1 , Madhusudana Battala  3 , Velhal Gajanan  4 , Saritha Nair  2 , Anindita Dasgupta  1 , Jay G Silverman  1 , Donta Balaiah  2 , Niranjan Saggurti  3
Affiliations
Randomized Controlled Trial

Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India

Anita Raj et al. PLoS One. .

Abstract

Background: Despite ongoing recommendations to increase male engagement and gender-equity (GE) counseling in family planning (FP) services, few such programs have been implemented and rigorously evaluated. This study evaluates the impact of CHARM, a three-session GE+FP counseling intervention delivered by male health care providers to married men, alone (sessions 1&2) and with their wives (session 3) in India.

Methods and findings: A two-armed cluster randomized controlled trial was conducted with young married couples (N = 1081 couples) recruited from 50 geographic clusters (25 clusters randomized to CHARM and a control condition, respectively) in rural Maharashtra, India. Couples were surveyed on demographics, contraceptive behaviors, and intimate partner violence (IPV) attitudes and behaviors at baseline and 9 &18-month follow-ups, with pregnancy testing at baseline and 18-month follow-up. Outcome effects on contraceptive use and incident pregnancy, and secondarily, on contraceptive communication and men's IPV attitudes and behaviors, were assessed using logistic generalized linear mixed models. Most men recruited from CHARM communities (91.3%) received at least one CHARM intervention session; 52.5% received the couple's session with their wife. Findings document that women from the CHARM condition, relative to controls, were more likely to report contraceptive communication at 9-month follow-up (AOR = 1.77, p = 0.04) and modern contraceptive use at 9 and 18-month follow-ups (AORs = 1.57-1.58, p = 0.05), and they were less likely to report sexual IPV at 18-month follow-up (AOR = 0.48, p = 0.01). Men in the CHARM condition were less likely than those in the control clusters to report attitudes accepting of sexual IPV at 9-month (AOR = 0.64, p = 0.03) and 18-month (AOR = 0.51, p = 0.004) follow-up, and attitudes accepting of physical IPV at 18-month follow-up (AOR = 0.64, p = 0.02). No significant effect on pregnancy was seen.

Conclusions: Findings demonstrate that men can be engaged in FP programming in rural India, and that such an approach inclusive of GE counseling can improve contraceptive practices and reduce sexual IPV in married couples.

Trial registration: ClinicalTrials.gov NCT01593943.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. CHARM Consort Figure.
See this image and copyright information in PMC

References

    1. Alkema L, Kantorova V, Menozzi C, Biddlecom A. National, regional, and global rates and trends in contraceptive prevalence and unmet need for family planning between 1990 and 2015: a systematic and comprehensive analysis. Lancet. 2013;381(9878):1642–52. Epub 2013/03/16. 10.1016/s0140-6736(12)62204-1 . - DOI - PubMed
    1. National Family Health Survey (NFHS-3), 2005–06: India: Volume I. Mumbai, IIPS: International Institute for Population Sciences (IIPS) and Macro International, 2007.
    1. Jejeebhoy SJ, Santhya KG, Zavier AJ. Demand for contraception to delay first pregnancy among young married women in India. Studies in family planning. 2014;45(2):183–201. Epub 2014/06/17. 10.1111/j.1728-4465.2014.00384.x . - DOI - PubMed
    1. Raj A, McDougal L, Rusch ML. Effects of young maternal age and short interpregnancy interval on infant mortality in South Asia. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2014;124(1):86–7. Epub 2013/10/26. ; PubMed Central PMCID: PMCPmc4058333. - PMC - PubMed
    1. Raju S L A. Men as supportive partners in reproductive health: Moving from rhetoric to reality. New Delhi, India: Population Council, 2000.

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