Testing Gender-based Violence Response in Family Planning and Antenatal Care Services in Nigeria

Not Applicable

Completed

• Conditions: Gender-based Violence; Intimate Partner Violence; Reproductive Coercion

• Registration Number: NCT05331508
• Lead Sponsor: Jhpiego

Brief Summary

To pilot and evaluate the integration of first-line response to gender- based violence (GBV), particularly intimate partner violence (IPV), sexual violence and reproductive coercion, within family planning (FP) and antenatal care (ANC) services at public health facilities in Ebonyi and Sokoto states in Nigeria.

GBV first-line response in the health setting includes screening , empowerment counseling, safety planning, and support to connect to additional services needed.

Detailed Description

This study seeks to:

1. Assess effectiveness of an integrated service delivery model (integration of GBV first-line response and empowerment counseling in standard of care FP or ANC services) in reducing on-going experience of intimate partner violence (IPV) and increasing utilization of modern contraceptive methods among clients.

1a. Assess effectiveness of the intervention in reducing IPV, increasing utilization of modern contraceptive methods, and improving safety and self-efficacy among clients seeking interval FP services.

1b. Assess effectiveness of the intervention in reducing IPV and improving safety and self-efficacy to seek GBV care among clients seeking ANC services.

2. Explore factors influencing feasibility, acceptability and ability to implement GBV first-line response as part of FP and ANC services.

Study Timeline

• Study First Submitted: 2022-02-28
• Study Start: 2022-04-06
• Study First Submitted QC: 2022-04-10
• Study First Posted: 2022-04-15
• Primary Completion: 2023-04-30
• Study Completion: 2023-06-30
• Status Verified: 2023-08
• Last Update Submitted: 2023-08-03
• Last Update Posted: 2023-08-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 1756

Inclusion Criteria

• Woman of reproductive age (18 to 49 years) seeking FP or ANC services at study sites
• Women who believe they are able to conceive (i.e. who have not undergone a tubal ligation, hysterectomy, or oophorectomy, or are menopausal) (for FP clients)
• Have a male partner they currently have sex with
• Have a mobile phone that can be safely used for re-contacting for follow-up surveys
• Do not have any accompanying male partners or family members aged 5 or above present

Exclusion Criteria

• Any individuals that do not meet all of the above inclusion criteria or do not agree to participate in the study will be excluded from data collection.
• In addition, individuals with impaired cognitive abilities (I.e. unable to make decisions/respond to questions on their own without assistance by someone else)will also be excluded from the data collection.
• Finally, women who share a mobile phone with their partner/husband or another family member will also be excluded.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Percentage of clients that report receiving a family planning method from healthcare provider	day of intervention
Change in percentage of clients disclosing exposure to intimate partner or sexual violence in past 3 months	baseline to 3-months and 6-months post-intervention	Disclosure will be defined by a positive response to either of the following questions: * Has your current partner ever slapped you, punched you, hit or kicked you, or done anything else to hurt you physically?; * Has your current male partner ever forced you to have sex or do something sexual when you didn't want to?

Secondary Outcome Measures

Name	Time	Method
Change in self-reported use of safety measures to protect respondent or her child/children from violence	baseline to 3-months and 6-months post-intervention	Whether an IPV survivor has ever done any of the following to protect herself or her child/children for fear that her partner would become violent: * Identified a safe place to go in case she needs to leave her home ?; * Identified a friend or relative to whom she could seek help?; * Set aside some things she may need, such as clothes, documents in case she needs to leave in a hurry?; * Set aside funds in case she needs to leave your home/partner?; * Made a plan for what she would do with her child/children in case she needs to leave home?
Change in percentage of clients reporting experiences of reproductive coercion in 3 months prior to data collection	baseline to 3-months and 6-months post-intervention	Reproductive coercion is behavior that interferes with the autonomous decision-making of a woman, with regards to reproductive health, including whether client felt pressured or forced by current partner to become pregnant or made it difficult to use family planning. Reproductive coercion will be defined by a positive response to either of the following questions: * Have you ever felt pressured or forced by your current partner to become pregnant when you did not want to be?; * Has your current partner ever made it difficult for you to get family planning or to use family planning?
Change in percentage of clients demonstrating family planning self efficacy, as measured by Contraceptive Self-Efficacy among women in sub-Saharan Africa (CSESSA) sub-scale	baseline to 3-months and 6-months post-intervention	Family planning self-efficacy is a women's belief about her own ability to complete the actions necessary for successful family planning.
Change in demonstrated self-efficacy to access IPV services	baseline to 3-months and 6-months post-intervention	Self-efficacy to access IPV services is an IPV survivor's confidence to develop and execute a plan when her partner becomes violent/ if her partner were to become violent. Self-efficacy will be defined by an affirmative response to the following questions: * I am confident that I could develop a plan for seeking help 'when my partner becomes violent/ if my partner were to become violent'; * I am confident that I would be able to execute my plan 'in times when my partner becomes violent / if my partner were to become violent'.

Trial Locations

Locations (39)

AZUIYIOKWU Health Center; 🇳🇬 Abakaliki, Ebonyi, Nigeria

GMELINA Health Center; 🇳🇬 Abakaliki, Ebonyi, Nigeria

NEW TIMBER SHADE Health Center; 🇳🇬 Abakaliki, Ebonyi, Nigeria

AMAECHARA Primary Health Center; 🇳🇬 Afikpo North, Ebonyi, Nigeria

Izeke Health Center; 🇳🇬 Afikpo North, Ebonyi, Nigeria

NKAGBOGO NDEMIYI MDG Primary Health Center; 🇳🇬 Afikpo North, Ebonyi, Nigeria

Owutu Primary Health Center; 🇳🇬 Afikpo South, Ebonyi, Nigeria

Uwana Primary Health Center; 🇳🇬 Afikpo South, Ebonyi, Nigeria

MCH Onueke; 🇳🇬 Ezza South, Ebonyi, Nigeria

AZUNRAMURA Health Center; 🇳🇬 Ezza, Ebonyi, Nigeria

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