Unintended pregnancies threaten the health of mothers and children alike, and are often attributable to disuse of contraceptive failure. In marital relationships where wives face opposition from husbands regarding contraceptive use, women also often face sexual violence and abuse form their partners. These tensions point to a need to engage both women and men in discussions about family planning, contraceptive use and marital violence. Rural India represents some of the lowest rates of contraception and highest rates of marital violence, globally. The Counseling Husbands to Achieve Reproductive health and Marital equity (CHARM) intervention was a gender equity family planning intervention aimed at engaging men in rural India, delivered by male health providers. CHARM improved contraceptive use and reduced likelihood of martial sexual violence in young married couples, but did not influence a reduction in unintended pregnancy. CHARM2 will seek to provide the CHARM sessions to men and women in parallel, and aims to evaluate its impact on contraceptive use, unintended pregnancy, and marital sexual violence among married couples in rural India, and to assess its potential for sustainability in rural India. CHARM2 aims to reduce unintended pregnancies and marital sexual violence, and promote spacing contraception, including long acting reversible contraception (LARC). To evaluate the impact of CHARM2, a two armed cluster randomized controlled trail will be conducted with 1200 married couples from geographic clusters in rural Maharashtra, India. Participants will receive CHARM2 or the standard of care control condition, which will involve community health workers offering pills/condoms and linking women to public health clinics. Outcomes will be assessed with pregnancy testing and surveys at baseline and 9 and 18-month follow-ups. Implementation science methods will assess the quality, scalability, and replicability of CHARM2 for uptake by rural health care systems (i.e., sustainability). If you would like more information regarding the CHARM2 intervention, please email firstname.lastname@example.org, with the subject line "CHARM2 Information Request."
Funding Source: National Institute of Health (NIH), National Institute of Child Health & Human Development (NICHD)
Raj A, Ghule M, Ritter J, Battala M, Gajanan V, Nair S, Dasgupta A, Silverman JG, Balaiah D, Saggurti N. Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India. PIos one. 2016;11(5):e0153190. Epub 2016/05/12. PubMed PMID: 27167981; PMCID: PMC4864357