Assessing the impact of CHARM2, a family planning program on gender attitudes, intimate partner violence, reproductive coercion, and marital quality in India
Outcomes: Gender‑Based Violence, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways The CHARM2 intervention demonstrates that structured, gender-synchronized counseling with both men and women can improve attitudes toward gender equality and reduce social acceptance of intimate partner violence in patriarchal settings. However, despite shifts in normative attitudes, behavior change such as reductions in intimate partner violence or reproductive coercion may require more intensive or longer-term interventions. The findings highlight the importance of addressing underlying social norms around male dominance, communication, and respect within marriage, while also ensuring adequate dosage and content to achieve sustainable change in behaviors.
Objectives This study assessed the impact of CHARM2, a gender equity and family planning intervention, on gender attitudes, intimate partner violence, reproductive coercion, and marital quality among young married couples in rural Maharashtra, India.
Methods A two-arm cluster randomized controlled trial was conducted with 1,201 couples. Participants were surveyed at baseline, 9 months, and 18 months post-intervention. Multilevel mixed-effects models were used to analyze the intervention’s impact on each outcome. Measures included a validated reproductive coercion scale, WHO’s intimate partner violence instrument, the Gender-Equitable Men (GEM) Scale, and marital quality indices for both spouses.
Intervention Details CHARM2 consisted of five sessions over four to six months. Two sessions were delivered individually to each spouse by gender-matched providers (including government and private health professionals), and a final joint session was conducted for couples. The intervention addressed family planning options, reproductive goals, intimate partner violence, reproductive coercion, gender norms, and healthy communication, using visual aids and a person-centered counseling approach. The program aimed to foster shared decision-making and respect, and included discussions on son preference, male dominance, and violence.
Results Men in the intervention group reported significantly more gender-equitable attitudes and higher marital quality at 18 months. Both men and women showed a marked reduction in acceptance of violence. However, the intervention did not significantly impact women’s self-reported experiences of physical, sexual, or emotional intimate partner violence, nor did it affect rates of reproductive coercion or improve women’s marital quality.
Conclusions CHARM2 effectively improved gender-equitable attitudes and reduced normative support for intimate partner violence but did not translate into reduced experiences of intimate partner violence or coercion. These findings suggest that attitudinal change is an important first step, but greater intensity, duration, or content depth may be needed to influence behaviors, particularly in contexts with entrenched gender norms and low baseline reporting of intimate partner violence.
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