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

NCT ID: NCT05331508

Last Updated: 2023-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1756 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-06

Study Completion Date

2023-06-30

Brief Summary

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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

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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.

Conditions

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Gender-based Violence Reproductive Coercion Intimate Partner Violence

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Treatment group

Prior to commencement of the study, providers responsible for FP and ANC service provision will participate in a 3-day competency-based skills-building training activity on Caring for women subjected to violence: A WHO curriculum for training health-care providers and the ARCHES intervention. Following the training, providers will (1) introduce routine client screening for GBV, including intimate partner violence, sexual violence, and reproductive coercion using a standardized screening form, in FP and ANC services,(2) for individuals disclosing GBV, provide first-line response-empathetic counseling, including listening, inquiring about experiences sensitively, and validating experiences, helping clients develop safety plans, and providing support; (3) regardless of disclosure of GBV, provide counseling and information, education and communication (IEC) materials on IPV, including reproductive coercion, and FP options, to both FP and ANC clients.

Group Type EXPERIMENTAL

gender-based violence screening, first-line support (LIVES) and reproductive coercion empowerment counseling (ARCHES)

Intervention Type BEHAVIORAL

Providers will (1) introduce routine client screening for GBV, including intimate partner violence, sexual violence, and reproductive coercion using a standardized screening form, in FP and ANC services,(2) for individuals disclosing GBV, provide first-line response-empathetic counseling, including listening, inquiring about experiences sensitively, and validating experiences, helping clients develop safety plans, and providing support; (3) regardless of disclosure of GBV, provide counseling and information, education and communication (IEC) materials on IPV, including reproductive coercion, and FP options, to both FP and ANC clients.

Control group

FP clients and ANC clients will receive standard care. For FP services, this includes standard contraceptive care provided by personnel who have completed training on contraceptive service delivery by the Nigerian Federal Ministry of Health and partners. For ANC services, the standard is a minimum of 8 visits with health personnel trained on ANC care during pregnancy. This includes identification of women and girls at increased risk of developing complications during labor and childbirth; prevention, detection, and management of pregnancy-related and concurrent conditions; health education and promotion; promotion of the use of skilled attendance at birth and healthy behaviors such as breastfeeding, early postnatal care, and planning for optimal pregnancy spacing, routine examinations, detection of complications, prevention of malaria in pregnancy and other infections; provision of holistic care to ensure normal progression of the baby and good health of the mother.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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gender-based violence screening, first-line support (LIVES) and reproductive coercion empowerment counseling (ARCHES)

Providers will (1) introduce routine client screening for GBV, including intimate partner violence, sexual violence, and reproductive coercion using a standardized screening form, in FP and ANC services,(2) for individuals disclosing GBV, provide first-line response-empathetic counseling, including listening, inquiring about experiences sensitively, and validating experiences, helping clients develop safety plans, and providing support; (3) regardless of disclosure of GBV, provide counseling and information, education and communication (IEC) materials on IPV, including reproductive coercion, and FP options, to both FP and ANC clients.

Intervention Type BEHAVIORAL

Other Intervention Names

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GBV screening, LIVES and ARCHES

Eligibility Criteria

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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

* 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.
Minimum Eligible Age

18 Years

Maximum Eligible Age

49 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Jhpiego

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Myra Betron

Role: PRINCIPAL_INVESTIGATOR

Jhpiego

Locations

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AZUIYIOKWU Health Center

Abakaliki, Ebonyi State, Nigeria

Site Status

GMELINA Health Center

Abakaliki, Ebonyi State, Nigeria

Site Status

NEW TIMBER SHADE Health Center

Abakaliki, Ebonyi State, Nigeria

Site Status

AMAECHARA Primary Health Center

Afikpo North, Ebonyi State, Nigeria

Site Status

Izeke Health Center

Afikpo North, Ebonyi State, Nigeria

Site Status

NKAGBOGO NDEMIYI MDG Primary Health Center

Afikpo North, Ebonyi State, Nigeria

Site Status

Owutu Primary Health Center

Afikpo South, Ebonyi State, Nigeria

Site Status

Uwana Primary Health Center

Afikpo South, Ebonyi State, Nigeria

Site Status

MDG Randa

Ebonyi, Ebonyi State, Nigeria

Site Status

MCH Onueke

Ezza South, Ebonyi State, Nigeria

Site Status

AZUNRAMURA Health Center

Ezza, Ebonyi State, Nigeria

Site Status

Cottage Hospital

Ikwo, Ebonyi State, Nigeria

Site Status

Echara Health Center

Ikwo, Ebonyi State, Nigeria

Site Status

Item Health Center

Ikwo, Ebonyi State, Nigeria

Site Status

Noyo Health Center

Ikwo, Ebonyi State, Nigeria

Site Status

NDIOKOROUKWU Health Center

Ivo, Ebonyi State, Nigeria

Site Status

Anike Health Center

Onicha, Ebonyi State, Nigeria

Site Status

Okaria Health Center

Onicha, Ebonyi State, Nigeria

Site Status

Oshiri Health Center

Onicha, Ebonyi State, Nigeria

Site Status

GH Bodinga

Bodina, Sokoto State, Nigeria

Site Status

Durbawa Primary Health Center

Dange Sguni, Sokoto State, Nigeria

Site Status

Kwannawa Primary Health Center

Dange Sguni, Sokoto State, Nigeria

Site Status

Ruga Dubu

Dange Sguni, Sokoto State, Nigeria

Site Status

GH Gada

Gada, Sokoto State, Nigeria

Site Status

Mamman Suka Primary Health Center

Gwadabawa, Sokoto State, Nigeria

Site Status

Araba Health Center

Ilela, Sokoto State, Nigeria

Site Status

Darna Sabon Gari Health Center

Ilela, Sokoto State, Nigeria

Site Status

Garu

Ilela, Sokoto State, Nigeria

Site Status

Gidan Chiwake Health Center

Ilela, Sokoto State, Nigeria

Site Status

Gidan Hamma Health Center

Ilela, Sokoto State, Nigeria

Site Status

Kalmalo

Ilela, Sokoto State, Nigeria

Site Status

Rungumawar Gatti Health Center

Ilela, Sokoto State, Nigeria

Site Status

Tozai Health Center

Ilela, Sokoto State, Nigeria

Site Status

AKAEZEUKWU Health Center

Ivo, Sokoto State, Nigeria

Site Status

Durbawa Primary Health Center

Kware, Sokoto State, Nigeria

Site Status

Gan Gam Primary Health Center

Shagari, Sokoto State, Nigeria

Site Status

Horo Primary Health Center

Shagari, Sokoto State, Nigeria

Site Status

Kajiji Primary Health Center

Shagari, Sokoto State, Nigeria

Site Status

Sanyinnawal Primary Health Center

Shagari, Sokoto State, Nigeria

Site Status

Kaura Kimba Health Post

Wamako, Sokoto State, Nigeria

Site Status

Countries

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Nigeria

References

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Uysal J, Carter N, Johns N, Boyce S, Liambila W, Undie CC, Muketo E, Adhiambo J, Gray K, Wendoh S, Silverman JG. Protocol for a matched-pair cluster control trial of ARCHES (Addressing Reproductive Coercion in Health Settings) among women and girls seeking contraceptive services from community-based clinics in Nairobi, Kenya. Reprod Health. 2020 May 27;17(1):77. doi: 10.1186/s12978-020-00916-9.

Reference Type BACKGROUND
PMID: 32460786 (View on PubMed)

Pallitto C, Garcia-Moreno C, Stoeckl H, Hatcher A, MacPhail C, Mokoatle K, Woollett N. Testing a counselling intervention in antenatal care for women experiencing partner violence: a study protocol for a randomized controlled trial in Johannesburg, South Africa. BMC Health Serv Res. 2016 Nov 5;16(1):630. doi: 10.1186/s12913-016-1872-x.

Reference Type BACKGROUND
PMID: 27814706 (View on PubMed)

Bacchu L, Mezey G, Bewley S. Women's perceptions and experiences of routine enquiry for domestic violence in a maternity service. BJOG. 2002 Jan;109(1):9-16. doi: 10.1111/j.1471-0528.2002.00514.x.

Reference Type BACKGROUND
PMID: 11843378 (View on PubMed)

Boyle A, Jones PB. The acceptability of routine inquiry about domestic violence towards women: a survey in three healthcare settings. Br J Gen Pract. 2006 Apr;56(525):258-61.

Reference Type BACKGROUND
PMID: 16611513 (View on PubMed)

McDonnell E, Holohan M, Reilly MO, Warde L, Collins C, Geary M. Acceptability of routine enquiry regarding domestic violence in the antenatal clinic. Ir Med J. 2006 Apr;99(4):123-4.

Reference Type BACKGROUND
PMID: 16972587 (View on PubMed)

Waalen J, Goodwin MM, Spitz AM, Petersen R, Saltzman LE. Screening for intimate partner violence by health care providers. Barriers and interventions. Am J Prev Med. 2000 Nov;19(4):230-7. doi: 10.1016/s0749-3797(00)00229-4.

Reference Type BACKGROUND
PMID: 11064226 (View on PubMed)

Hamberger L.K.; Guse C.; Boerger J.; Minsky D.; Pape D.; Folsom C. Evaluation of a Health Care Provider Training Program to Identify and Help Partner Violence Victims. Journal of Family Violence, Volume 19, Number 1, February 2004, pp. 1-11

Reference Type BACKGROUND

McNulty A, Andrews P, Bonner M. Can screening for domestic violence be introduced successfully in a sexual health clinic? Sex Health. 2006 Sep;3(3):179-82. doi: 10.1071/sh05056.

Reference Type BACKGROUND
PMID: 17044223 (View on PubMed)

McNutt LA, Carlson BE, Rose IM, Robinson DA. Partner violence intervention in the busy primary care environment. Am J Prev Med. 2002 Feb;22(2):84-91. doi: 10.1016/s0749-3797(01)00407-x.

Reference Type BACKGROUND
PMID: 11818176 (View on PubMed)

Taft A, Colombini M. Healthcare system responses to intimate partner violence in low and middle-income countries: evidence is growing and the challenges become clearer. BMC Med. 2017 Jul 12;15(1):127. doi: 10.1186/s12916-017-0886-5.

Reference Type BACKGROUND
PMID: 28697810 (View on PubMed)

McFarlane JM, Groff JY, O'Brien JA, Watson K. Secondary prevention of intimate partner violence: a randomized controlled trial. Nurs Res. 2006 Jan-Feb;55(1):52-61. doi: 10.1097/00006199-200601000-00007.

Reference Type RESULT
PMID: 16439929 (View on PubMed)

Tiwari A, Leung WC, Leung TW, Humphreys J, Parker B, Ho PC. A randomised controlled trial of empowerment training for Chinese abused pregnant women in Hong Kong. BJOG. 2005 Sep;112(9):1249-56. doi: 10.1111/j.1471-0528.2005.00709.x.

Reference Type RESULT
PMID: 16101604 (View on PubMed)

Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, Schoenwald P, Silverman JG. A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception. 2011 Mar;83(3):274-80. doi: 10.1016/j.contraception.2010.07.013.

Reference Type RESULT
PMID: 21310291 (View on PubMed)

Kiely M, El-Mohandes AAE, El-Khorazaty MN, Gantz MG. An integrated intervention to reduce intimate partner violence in pregnancy: a randomized controlled trial. Obstet Gynecol. 2010 Feb;115(2 Pt 1):273-283. doi: 10.1097/AOG.0b013e3181cbd482.

Reference Type RESULT
PMID: 20093899 (View on PubMed)

Betron M, Bryce E, Obafemi S, Yusuf S, Abdullahi H, Ifemenam E, Dikeocha N, Maiakwai A, Kabir B, Oduenyi C. Effectiveness of a clinic-based counselling intervention on risk of experiencing intimate partner violence and reproductive coercion: a matched-pair cluster-controlled trial in Ebonyi and Sokoto, Nigeria. BMJ Glob Health. 2025 Oct 28;10(10):e016898. doi: 10.1136/bmjgh-2024-016898.

Reference Type DERIVED
PMID: 41151831 (View on PubMed)

Related Links

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https://apps.who.int/iris/handle/10665/330084

World Health Organization. (2019). Caring for women subjected to violence: a WHO curriculum for training health-care providers. World Health Organization.

Other Identifiers

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MCGL-IRB17494

Identifier Type: -

Identifier Source: org_study_id

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