Mey-Ling Sommer, Lisa Bogler, S V Subramanian, Sebastian Vollmer
{"title":"参与式学习和行动干预对未满足避孕需求的影响：印度比哈尔邦农村的一项集群随机对照试验。","authors":"Mey-Ling Sommer, Lisa Bogler, S V Subramanian, Sebastian Vollmer","doi":"10.1186/s12978-025-02055-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Unmet need for contraception is a persistent issue in rural India. This work evaluates the impact of Gram Varta - a participatory learning and action intervention employed in women's self-help groups in rural Bihar, India - on women's contraceptive behavior and unmet need for contraception. Trained facilitators used an active and participatory communication approach in 20 group meetings to discuss health-related topics focusing on the improvement of communities' knowledge and practice related to health, nutrition, water, sanitation and hygiene. One of the meetings focused on family planning measures, the benefits of various measures, and a discussion on the availability of various means of contraception through the government health system. The intervention was also meant to increase women's empowerment.</p><p><strong>Methods: </strong>Gram Varta was evaluated in one district of Bihar, Madhepura, with a cluster-randomized controlled trial. We used a difference-in-differences model to estimate the intention-to-treat effect of Gram Varta on women's contraceptive behaviour and unmet need for contraception using a panel dataset with 972 observations collected in 2015 and 2016.</p><p><strong>Results: </strong>We find a statistically marginally significant increase in contraceptive use by 5.8 percentage points (95%-CI [0.00;0.12]) and a statistically significant reduction in unmet need for limiting childbirth by 7.2 percentage points (95%-CI [-0.14;0.00]) among women in treatment villages but no effect on spacing childbirth.</p><p><strong>Conclusions: </strong>There is indicative evidence that participatory learning and action intervention increased contraception use among women of reproductive age in rural India, but the effect on unmet need was inconsistent.</p><p><strong>Trial registration: </strong>The randomized controlled trial was registered with and a pre-analysis plan was submitted to 3ie before intervention roll-out. In addition, it was retrospectively registered in the AEA RCT Registry with the identification number AEARCTR-0004700 on September 16, 2019.</p>","PeriodicalId":20899,"journal":{"name":"Reproductive Health","volume":"22 1","pages":"121"},"PeriodicalIF":3.4000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220481/pdf/","citationCount":"0","resultStr":"{\"title\":\"The impact of a participatory learning and action intervention on unmet need for contraception: a cluster-randomized controlled trial in rural Bihar, India.\",\"authors\":\"Mey-Ling Sommer, Lisa Bogler, S V Subramanian, Sebastian Vollmer\",\"doi\":\"10.1186/s12978-025-02055-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Unmet need for contraception is a persistent issue in rural India. This work evaluates the impact of Gram Varta - a participatory learning and action intervention employed in women's self-help groups in rural Bihar, India - on women's contraceptive behavior and unmet need for contraception. Trained facilitators used an active and participatory communication approach in 20 group meetings to discuss health-related topics focusing on the improvement of communities' knowledge and practice related to health, nutrition, water, sanitation and hygiene. One of the meetings focused on family planning measures, the benefits of various measures, and a discussion on the availability of various means of contraception through the government health system. The intervention was also meant to increase women's empowerment.</p><p><strong>Methods: </strong>Gram Varta was evaluated in one district of Bihar, Madhepura, with a cluster-randomized controlled trial. We used a difference-in-differences model to estimate the intention-to-treat effect of Gram Varta on women's contraceptive behaviour and unmet need for contraception using a panel dataset with 972 observations collected in 2015 and 2016.</p><p><strong>Results: </strong>We find a statistically marginally significant increase in contraceptive use by 5.8 percentage points (95%-CI [0.00;0.12]) and a statistically significant reduction in unmet need for limiting childbirth by 7.2 percentage points (95%-CI [-0.14;0.00]) among women in treatment villages but no effect on spacing childbirth.</p><p><strong>Conclusions: </strong>There is indicative evidence that participatory learning and action intervention increased contraception use among women of reproductive age in rural India, but the effect on unmet need was inconsistent.</p><p><strong>Trial registration: </strong>The randomized controlled trial was registered with and a pre-analysis plan was submitted to 3ie before intervention roll-out. In addition, it was retrospectively registered in the AEA RCT Registry with the identification number AEARCTR-0004700 on September 16, 2019.</p>\",\"PeriodicalId\":20899,\"journal\":{\"name\":\"Reproductive Health\",\"volume\":\"22 1\",\"pages\":\"121\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220481/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reproductive Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12978-025-02055-5\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12978-025-02055-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
The impact of a participatory learning and action intervention on unmet need for contraception: a cluster-randomized controlled trial in rural Bihar, India.
Background: Unmet need for contraception is a persistent issue in rural India. This work evaluates the impact of Gram Varta - a participatory learning and action intervention employed in women's self-help groups in rural Bihar, India - on women's contraceptive behavior and unmet need for contraception. Trained facilitators used an active and participatory communication approach in 20 group meetings to discuss health-related topics focusing on the improvement of communities' knowledge and practice related to health, nutrition, water, sanitation and hygiene. One of the meetings focused on family planning measures, the benefits of various measures, and a discussion on the availability of various means of contraception through the government health system. The intervention was also meant to increase women's empowerment.
Methods: Gram Varta was evaluated in one district of Bihar, Madhepura, with a cluster-randomized controlled trial. We used a difference-in-differences model to estimate the intention-to-treat effect of Gram Varta on women's contraceptive behaviour and unmet need for contraception using a panel dataset with 972 observations collected in 2015 and 2016.
Results: We find a statistically marginally significant increase in contraceptive use by 5.8 percentage points (95%-CI [0.00;0.12]) and a statistically significant reduction in unmet need for limiting childbirth by 7.2 percentage points (95%-CI [-0.14;0.00]) among women in treatment villages but no effect on spacing childbirth.
Conclusions: There is indicative evidence that participatory learning and action intervention increased contraception use among women of reproductive age in rural India, but the effect on unmet need was inconsistent.
Trial registration: The randomized controlled trial was registered with and a pre-analysis plan was submitted to 3ie before intervention roll-out. In addition, it was retrospectively registered in the AEA RCT Registry with the identification number AEARCTR-0004700 on September 16, 2019.
期刊介绍：
Reproductive Health focuses on all aspects of human reproduction. The journal includes sections dedicated to adolescent health, female fertility and midwifery and all content is open access.
Reproductive health is defined as a state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. Good reproductive health implies that people are able to have a satisfying and safe sex life, the capability to reproduce and the freedom to decide if, when, and how often to do so. Men and women should be informed about and have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and the right to appropriate health-care services that enable women to safely go through pregnancy and childbirth.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
