Gopalakrishnan Lakshmi, Choudhary Usha, Vallin Janelli, Das Debangana, Sharma Payal, Kachhwaha Ankur, Panjalingam Tamera, Ruwala Richa, Diamond-Smith Nadia
Institute for Global Health Sciences, University of California, San Francisco, CA, USA.
Vikalp Sansthan, Udaipur, India.
Glob Health Action. 2025 Dec;18(1):2554435. doi: 10.1080/16549716.2025.2554435. Epub 2025 Sep 8.
Despite evidence that mothers-in-law (MILs) influence daughters-in-law's (DILs) fertility and family planning decisions in South Asia, emphasizing early fertility and male grandchildren, few reproductive health interventions engage MILs directly.
We assessed the feasibility, acceptability, and qualitative impact of a reproductive health and life skill-based intervention on MILs in tribal Rajasthan, India, using a mixed-methods, single-group cluster pilot study.
We tested a light-touch four-session intervention delivered over 4 months to MILs of newly married women that covered MILs' health, conception, and communication with DILs and sons and addressed modern healthcare misconceptions, while challenging son preference and fertility norms. This MIL intervention was complemented by a broader 16-session curriculum for newly married women. In July 2023 and January 2024, 42 MILs participated in baseline and endline surveys. We conducted in-depth interviews with 13 MILs and 6 NGO staff members for qualitative insights and to understand barriers and facilitators to the intervention. We also analyzed the data using thematic analysis.
Our results demonstrated the acceptability and feasibility of the intervention (80% attendance, 97.6% satisfaction, 97.6% retention rate). The qualitative findings revealed the impact of the intervention across multiple domains: improved reproductive health knowledge, better gender attitudes and attitudes towards modern healthcare practices, and positive changes in intergenerational relationships. Key implementation barriers included time constraints due to agricultural/household work, while family support and flexible scheduling facilitated participation.
Our findings challenge conventional approaches targeting young women, suggesting the value of including influential family members, such as mothers-in-law, in reproductive health interventions, particularly in societies with extended family structures.
CLINICALTRIALS.GOV: The study is registered at ClinicalTrials.gov (NCT06320964). Registered retrospectively on 13 March 2024, https://clinicaltrials.gov/study/NCT06320964 IRB Approval number: 22 -37,173.
尽管有证据表明，在南亚，婆婆会影响儿媳的生育和计划生育决策，倾向于早育和生孙子，但很少有生殖健康干预措施直接涉及婆婆。
我们采用混合方法、单组整群试点研究，评估了一项基于生殖健康和生活技能的干预措施对印度拉贾斯坦邦部落地区婆婆的可行性、可接受性和定性影响。
我们对新婚女性的婆婆进行了一项为期4个月、共四节的轻松干预措施测试，内容涵盖婆婆的健康、受孕以及与儿媳和儿子的沟通，并解决了现代医疗保健方面的误解，同时挑战了重男轻女观念和生育规范。这项针对婆婆的干预措施辅以一项针对新婚女性的更广泛的16节课程。2023年7月和2024年1月，42名婆婆参与了基线和终线调查。我们对13名婆婆和6名非政府组织工作人员进行了深入访谈，以获取定性见解，并了解干预措施的障碍和促进因素。我们还使用主题分析法对数据进行了分析。
我们的结果证明了该干预措施的可接受性和可行性（出勤率80%，满意度97.6%，保留率97.6%）。定性研究结果揭示了干预措施在多个领域的影响：生殖健康知识得到改善，性别态度和对现代医疗保健做法的态度有所改善，代际关系发生积极变化。关键的实施障碍包括农业/家务劳动导致的时间限制，而家庭支持和灵活的日程安排促进了参与。
我们的研究结果挑战了针对年轻女性的传统方法，表明在生殖健康干预措施中纳入有影响力的家庭成员，如婆婆，具有重要价值，特别是在大家庭结构的社会中。
该研究已在ClinicalTrials.gov注册（NCT06320964）。于2024年3月13日追溯注册，https://clinicaltrials.gov/study/NCT06320964 机构审查委员会批准号：22 -37,173。
