Protocol for cluster randomized evaluation of reaching married adolescents - a gender-synchronized intervention to increase modern contraceptive use among married adolescent girls and young women and their husbands in Niger

Challa, Sneha; DeLong, Stephanie M.; Carter, Nicole; Johns, Nicole E.; Shakya, Holly B.; Boyce, Sabrina C.; Vera-Monroy, Ricardo; Aliou, Sani; Ibrahima, Fatouma A.; Brooks, Mohamad I.; Corneliess, Caitlin; Moodie, C.A.; Nouhou, Abdoul Moumouni; Souley, Illa; Raj, Anita; Silverman, Jay G.

doi:10.1186/s12978-019-0841-3

Cited by 29 publications

(39 citation statements)

References 13 publications

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“…Girls were considered eligible if they were: 1) aged 13–19 years old, 2) married, 3) fluent in Hausa or Zarma, 4) residing in the village where recruitment was taking place with no plans to move away in next 18 months or plans to travel for more than 6 months during that period, and 5) not currently sterilized. More information about study design and data collection can be found in the protocol paper for this study [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

Associations of spousal communication with contraceptive method use among adolescent wives and their husbands in Niger

et al. 2020

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Objectives This study aims to examine associations between spousal communication about contraception and ever use of modern contraception, overt modern contraceptive use (with husband’s knowledge), and covert modern contraceptive use (without husband’s knowledge) among adolescent wives and their husbands in Niger. Study design Cross-sectional data, from the Reaching Married Adolescents Study , were collected from randomly selected adolescent wives (ages 13–19 years) and their husbands from 48 randomly selected villages in rural Niger (N = 1,020 couples). Logistic regression models assessed associations of couples’ reports of spousal communication about contraception with wives’ reports of contraception (overall, overt, and covert). Results About one-fourth of adolescent wives and one-fifth of husbands reported spousal communication about contraception. Results showed couples’ reports of spousal communication about contraception were positively associated with ever use of modern contraception. Couples’ reports of spousal communication about contraception were negatively associated with covert modern contraceptive use compared to overt use. Wives’ reports of spousal communication were marginally associated with covert use compared to no use but husbands’ reports were not. Conclusion Among a sample of couples in Niger, spousal communication about contraception was positively associated with modern contraceptive use (compared to no use) and negatively with covert use (compared to overt use) but wives’ and husbands’ reports showed differential associations with covert use compared to no use. Since there is little understanding of couple communication surrounding covert contraceptive use decisions, research should focus on characterizing content and context of couple communication particularly in cases of disagreement over fertility decisions.

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Section: Methodsmentioning

confidence: 99%

Associations of spousal communication with contraceptive method use among adolescent wives and their husbands in Niger

et al. 2020

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“…Cross-sectional data used for this analysis were collected from April-June 2016 as part of the baseline survey for the Reaching Married Adolescents (RMA) Study [51]. This ongoing study employs a fourarm cluster randomised control design to evaluate the effects of multiple community-based approaches to expand access to modern FP methods among married adolescents in the Dosso region of Niger.…”

Section: Data Sourcementioning

confidence: 99%

Associations of reproductive coercion and intimate partner violence with overt and covert family planning use among married adolescent girls in Niger

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Background: In Niger the prevalence of girl child marriage and low female control over family planning (FP) has resulted in the world's highest adolescent fertility. Male control of FP is associated with intimate partner violence (IPV) and reproductive coercion (RC). We assessed associations of IPV and RC with FP use among married adolescent girls (ages 13À19 years) in Dosso, Niger (N = 1072). Methods: Multivariable, cross-sectional regression models assessed associations between physical IPV, sexual IPV, and RC and any FP use, FP use with husband knowledge (overt use), and FP use without husband knowledge (covert use). Findings: One in four married adolescent girls using FP reported doing so without husband's knowledge. Unadjusted and adjusted models indicated that physical IPV and RC were associated with covert FP use (vs. no use and vs. overt use), but not with overt use vs. no use. Only physical IPV remained significantly associated with covert use in models including all three forms of violence (AOR: 1.94 vs. any use; AOR: 3.63 vs. overt use). Interpretation: Married adolescents experiencing physical IPV or RC were more likely that others to use FP without their husbands' knowledge. No form of GBV affected odds of FP use with husbands' knowledge. Current results suggest caution regarding promoting engagement of men in decisions to use FP in this context, as this may undermine the reproductive autonomy of girls and women who will choose to use FP without the knowledge of their male partners.

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“…We followed World Health Organization Guidelines related to minimizing risk of IPV when both a wife and husband were interviewed. This information is discussed further, elsewhere [35].…”

Section: Ethicsmentioning

confidence: 88%

“…Details of the sampling design and intervention can be found elsewhere. [35] Adolescent girls and young women and their husbands were eligible to participate in the study if an AGYW was a married 13-19 year old fluent in Zarma or Hausa. She could not be sterilized and could not have plans to move over the subsequent 18 months or travel more than 6 months across the study period.…”

Section: Study Data and Analytic Sample Formationmentioning

confidence: 99%

Married very young adolescent girls in Niger at greatest risk of lifetime male partner reproductive coercion and sexual violence

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The purpose of this analysis was to compare and contrast reproductive health (RH), gender equity attitudes, and intimate partner violence (IPV) among married very young adolescent (VYA) girls with married older adolescent girls and young women (AGYW) in rural Niger given limited literature on the topic. Methods We conducted an exploratory analysis of baseline data from the Reaching Married Adolescents Trial in Dosso region, Niger. We report counts and percents, by age group (13-14 years (VYA), 15-16 years, 17-19 years), of AGYW's self-efficacy to use family planning (FP), accurate knowledge of FP, current use of modern FP, and unintended last pregnancy (UIP); lifetime reproductive coercion (RC), physical IPV, and sexual IPV; and gender equity attitudes. We also assess whether percents differ between VYA and older groups using Pearson's Chi-Square and Fisher's exact p-values. Results are stratified by parity. Finally, we use logistic regression to consider associations. Results There were 49 VYA, 248 girls aged 15-16, and 775 AGYW aged 17-19 in our sample (n = 1072). Accurate knowledge of FP, self-efficacy to use FP, current use of modern FP, and UIP increased with age; all percents between VYA and AGYW 17-19 were marginally or statistically significantly different. We also saw VYA report higher lifetime RC and sexual IPV versus older groups, with sexual IPV statistically different between VYA and girls 17-19. Parous VYA reported a significantly higher percent of lifetime RC versus older AGYW. Among 17-19 year-olds, odds of current use of FP were higher among AGYW who reported physical IPV, and odds of UIP were higher among those reporting more gender equitable attitudes, both adjusted for parity.

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Protocol for cluster randomized evaluation of reaching married adolescents - a gender-synchronized intervention to increase modern contraceptive use among married adolescent girls and young women and their husbands in Niger

Cited by 29 publications

References 13 publications

Associations of spousal communication with contraceptive method use among adolescent wives and their husbands in Niger

Associations of spousal communication with contraceptive method use among adolescent wives and their husbands in Niger

Associations of reproductive coercion and intimate partner violence with overt and covert family planning use among married adolescent girls in Niger

Married very young adolescent girls in Niger at greatest risk of lifetime male partner reproductive coercion and sexual violence

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