BackgroundRigorous evidence of the effectiveness of male engagement interventions, particularly on how these interventions impact relationship power dynamics and women’s decision-making, remains limited. This study assessed the impact of the Bandebereho gender-transformative couples’ intervention on impact on multiple behavioral and health-related outcomes influenced by gender norms and power relations.MethodsWe conducted a multi-site randomised controlled trial in four Rwandan districts with expectant/current fathers and their partners, who were randomised to the intervention (n = 575 couples) or control group (n = 624 couples). Primary outcomes include women’s experience of physical and sexual IPV, women’s attendance and men’s accompaniment at ANC, modern contraceptive use, and partner support during pregnancy. At 21-months post-baseline, 1123 men and 1162 partners were included in intention to treat analysis. Generalized estimating equations with robust standard errors were used to fit the models.FindingsThe Bandebereho intervention led to substantial improvements in multiple reported outcomes. Compared to the control group, women in the intervention group reported: less past-year physical (OR 0.37, p<0.001) and sexual IPV (OR 0.34, p<0.001); and greater attendance (IRR 1.09, p<0.001) and male accompaniment at antenatal care (IRR 1.50, p<0.001); and women and men in the intervention group reported: less child physical punishment (women: OR 0.56, p = 0.001; men: OR 0.66, p = 0.005); greater modern contraceptive use (women: OR 1.53, p = 0.004; men: OR 1.65, p = 0.001); higher levels of men’s participation in childcare and household tasks (women: beta 0.39, p<0.001; men: beta 0.33, p<0.001); and less dominance of men in decision-making.ConclusionsOur study strengthens the existing evidence on male engagement approaches; together with earlier studies our findings suggest that culturally adapted gender-transformative interventions with men and couples can be effective at changing deeply entrenched gender inequalities and a range of health-related behavioral outcomes.Trial registrationClinicalTrials.gov NCT02694627

Background Intimate partner violence (IPV) is associated with increased HIV risk and other adverse health and psychosocial outcomes. We assessed the impact of Unite for a Better Life (UBL), a gender-transformative, participatory intervention delivered to men, women, and couples in Ethiopia in the context of the coffee ceremony, a traditional community-based discussion forum.

Objective To investigate the relationship between adolescent pregnancy and neonatal mortality in a nutritionally deprived population in rural Nepal, and to determine mechanisms through which low maternal age may impact neonatal mortality. Design Nested cohort study using data from a population-based, cluster-randomized, placebo-controlled trial of newborn skin and umbilical cord cleansing with chlorhexidine. Setting Sarlahi District of Nepal. Participants Live-born singleton infants of parity 0 or 1 women under 25 years of age (n=10,745) were included in this analysis. Main Exposure Maternal age at birth of offspring. Outcome Measure Crude and adjusted odds ratios (OR) of neonatal mortality by maternal age category. Results Infants born to women aged 12−15 years were at a higher risk of neonatal mortality than those born to women aged 20−24 years (OR=2.24, 95% CI 1.40−3.59). After adjustment for confounders, there was a 53% excess risk of neonatal mortality among infants born to women in the youngest versus oldest age category (OR=1.53, 95% CI 0.90, 2.60). This association was attenuated upon further adjustment for low birthweight (LBW), preterm birth or small for gestational age (SGA). Conclusions The higher risk of neonatal mortality among adolescent women in this setting is partially explained by differences in socioeconomic factors in younger versus older women and is mediated primarily through preterm delivery, SGA and LBW or some interaction of these variables.

Inhibition of kinesin-5, a molecular motor protein best known for its essential role in mitosis, has notable effects on the morphology and microtubule organization of dendrites of terminally postmitotic neurons. Kinesin-5 acts as a brake that can limit the capacity of other motor proteins to influence microtubule organization and distribution.