Diamond-Smith, Nadia, Vaishnav, Yogesh, Choudhary, Usha, Sharma, Payal, Kachhwaha, Ankur, Panjalingam, Tamera, Vallin, Janelli, Das, Debangana, and Gopalakrishnan, Lakshmi
Background: Despite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men's perspective of the pilot of a gender transformative intervention for newly married couples in India. Methods: A pilot study was conducted of TARANG, a 4 month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June 2023-January 2024. Results: Men had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. Conclusions: Men in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement. Trial registration clinicaltrials.gov : 03/13/24.NCT06320964 Plain language summary: Despite many years of calls to engage men in reproductive health programming, there are still a paucity of interventions that engage men. In the Indian context, with high prevalence of arranged marriages, strict gender norms, and patrilocal marriage patterns where women move into their husbands family's home, engaging men is especially important as they are critical decision-makers. With this in mind, we designed an intervention for newly married women, with an add on component for their husbands, to help young couples meet their reproductive goals. In this paper we report on the feasibility and acceptability of a 6 month pilot of this intervention with 40 newly married men in Rajasthan, India using mixed methods. We find that the intervention was highly feasibility and acceptable, and men felt that the intervention had value and should be considered. However, attendance was low due to work commitments and migration. The intervention appeared to change norms and increase knowledge about family planning and communication about childbearing. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. This suggests that engaging newly married men is possible, but interventions must be designed carefully to be sure to be able increase participation. [ABSTRACT FROM AUTHOR]