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评估印度一项计划生育项目CHARM2对性别态度、亲密伴侣暴力、生殖胁迫和婚姻质量的影响。

Assessing the impact of CHARM2, a family planning program on gender attitudes, intimate partner violence, reproductive coercion, and marital quality in India.

作者信息

Chatterji Sangeeta, Johns Nicole E, Ghule Mohan, Begum Shahina, Averbach Sarah, Battala Madhusudana, Raj Anita

机构信息

School of Social and Political Science, University of Edinburgh, Edinburgh, United Kingdom.

Center on Gender Equity and Health, School of Medicine, University of California San Diego, San Diego, California, United States of America.

出版信息

PLOS Glob Public Health. 2024 May 21;4(5):e0003220. doi: 10.1371/journal.pgph.0003220. eCollection 2024.

Abstract

Using a two-armed cluster randomised controlled trial, CHARM2 (Counselling Husbands to Achieve Reproductive health and Marital equity), a 5-session gender equity and family planning intervention for couples in rural India, showed an impact on family planning outcomes in primary trial analyses. This study examines its effects on gender-equitable attitudes, intimate partner violence, reproductive coercion, and marital quality. We used multilevel mixed-effects models to assess the intervention impact on each outcome. Both male (aIRR at 9 months: 0.64, C.I.: 0.45,0.90; aIRR at 18 months: 0.25, C.I.: 0.18,0.39) and female (aIRR at 9 months: 0.57, C.I.: 0.46,0.71; aIRR at 18 months: 0.38, C.I.: 0.23,0.61) intervention participants were less likely than corresponding control participants to endorse attitudes accepting physical IPV at 9- and 18-month follow-ups. Men in the intervention, compared to those in the control condition, reported more gender-equitable attitudes at 9- and 18 months (ß at 9 months: 0.13, C.I.: 0.06,0.20; ß at 18 months: 0.26, C.I.: 0.19,0.34) and higher marital quality at the 18-month follow-up (ß: 0.03, C.I.: 0.01,0.05). However, we found no effects on women's experiences of IPV, reproductive coercion, or marital quality. CHARM2 shows promise in improving men's and women's attitudes towards gender equality and male perceptions of marital quality. Still, IPV and reproductive coercion reductions may require more intensive programming than that provided within this 5-session model focused on family planning.

摘要

在一项双臂整群随机对照试验中,针对印度农村夫妇开展的为期5节的性别平等与计划生育干预项目CHARM2(指导丈夫实现生殖健康与婚姻平等),在初步试验分析中显示出对计划生育结果有影响。本研究考察了该项目对性别平等态度、亲密伴侣暴力、生殖胁迫和婚姻质量的影响。我们使用多层次混合效应模型来评估干预对各项结果的影响。在9个月时,干预组的男性(调整后发病率比值:0.64,置信区间:0.45,0.90)和女性(调整后发病率比值:0.57,置信区间:0.46,0.71)以及18个月时,干预组的男性(调整后发病率比值:0.25,置信区间:0.18,0.39)和女性,相比于相应的对照组参与者,在9个月和18个月的随访中,认可接受肢体亲密伴侣暴力态度的可能性更低。与对照组相比,干预组的男性在9个月和18个月时报告了更性别平等的态度(9个月时β值:0.13,置信区间:0.06,0.20;18个月时β值:0.26,置信区间:0.19,0.34),并且在18个月随访时婚姻质量更高(β值:0.03,置信区间:0.01,0.05)。然而,我们发现对女性的亲密伴侣暴力经历、生殖胁迫或婚姻质量没有影响。CHARM2在改善男性和女性对性别平等的态度以及男性对婚姻质量的认知方面显示出前景。不过,要减少亲密伴侣暴力和生殖胁迫,可能需要比这个专注于计划生育的5节模式提供更密集的项目。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f7b/11108161/3a9ab072b069/pgph.0003220.g001.jpg

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