Effects of the reaching married adolescents program on modern contraceptive use and intimate partner violence: results of a cluster randomized controlled trial among married adolescent girls and their husbands in Dosso, Niger

Reproductive Health

Research

Shweta Tomar¹  Sabrina C. Boyce¹  Lotus McDougal¹  Holly Baker¹  Stephanie DeLong¹  Anita Raj¹  Sneha Challa¹  Jay G. Silverman¹  Nicole E. Johns¹  Abdoul Moumouni Nouhou²  Mohamad I. Brooks³  Sani Aliou³ 

[1] Center On Gender Equity and Health, School of Medicine, University of California San Diego, 92093, La Jolla, CA, USA;GRADE Africa-Niger, Niamey, Niger;Pathfinder International, Watertown, USA;

关键词: Niger;    Family planning;    Contraception;    RCT;    IPV;    Behavior change;    Adolescent marriage;    Adolescent fertility;   

DOI  :  10.1186/s12978-023-01609-9

 received in 2022-06-14, accepted in 2023-04-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundNiger has the highest rate of adolescent fertility in the world, with early marriage, early childbearing and high gender inequity. This study assesses the impact of Reaching Married Adolescents (RMA), a gender-synchronized social behavioral intervention designed to improve modern contraceptive use and reduce intimate partner violence (IPV) among married adolescent couples in rural Niger.MethodsWe conducted a four-armed cluster-randomized trial in 48 villages across three districts in Dosso region, Niger. Married adolescent girls (ages 13–19) and their husbands were recruited within selected villages. Intervention arms included home visits by gender-matched community health workers (CHWs) (Arm 1), gender-segregated, group discussion sessions (Arm 2), and both approaches (Arm 3). We used multilevel mixed-effects Poisson regression models to assess intervention effects for our primary outcome, current modern contraceptive use, and our secondary outcome, past year IPV.ResultsBaseline and 24-month follow-up data were collected April–June 2016 and April–June 2018. At baseline, 1072 adolescent wives were interviewed (88% participation), with 90% retention at follow-up; 1080 husbands were interviewed (88% participation), with 72% retention at follow-up. Adolescent wives had higher likelihood of modern contraceptive use at follow-up relative to controls in Arm 1 (aIRR 3.65, 95% CI 1.41–8.78) and Arm 3 (aIRR 2.99, 95% CI 1.68–5.32); no Arm 2 effects were observed. Relative to those in the control arm, Arm 2 and Arm 3 participants were significantly less likely to report past year IPV (aIRR 0.40, 95% CI 0.18–0.88 for Arm 2; aIRR 0.46, 95% CI 0.21–1.01 for Arm 3). No Arm 1 effects were observed.ConclusionsThe RMA approach blending home visits by CHWs and gender-segregated group discussion sessions is the optimal format for increasing modern contraceptive use and decreasing IPV among married adolescents in Niger.Trial registration This trial is retrospectively registered with ClinicalTrials.gov, Identifier NCT03226730

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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