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Study Overview

Title:
Bandebereho Father Groups: a randomized control trial to assess the impact of maternal, newborn and child health group education for new and expecting fathers
Study is 3ie funded:
No
Study ID:
RIDIE-STUDY-ID-56c5ce370df1d
Initial Registration Date:
02/18/2016
Last Update Date:
09/12/2018
Study Status:
Completed
Change History for Status
Changed On Previous Value
07/20/2018 Ongoing
Location(s):
Rwanda
Abstract:
This study seeks to assess the impact of the MenCare+/Bandebereho fathers’/couples’ group education intervention on men’s attitudes towards, and participation in, sexual and reproductive health, maternal, newborn and child health, and equitable and non-violent relationships with their children and partners. The MenCare+/ Bandebereho program is a multi-component comprehensive intervention being implemented by the Rwanda Men’s Resource Center (RWAMREC) and Promundo-US, in collaboration with the Rwanda Ministry of Health and local authorities in Karongi, Musanze, Nyaruguru and Rwamagana districts. The proposed study will evaluate one component of the program, a 15-session group education intervention targeting young fathers and mothers. The impact of the fathers’ group education will be assessed through a randomized control trial design with an intervention arm of men and women participating in the father groups and a control arm of men and women who do not participate in the intervention. The study will collect quantitative and qualitative data over a period of approximately three years.
Categories:
Health, Nutrition, and Population
Multisector
Other
Additional Keywords:
gender, caregiving, maternal and child health, violence, sexual and reproductive health, couple relationships, parenting
Secondary ID Number(s):

Principal Investigator(s)

Name of First PI:
Kate Doyle
Affiliation:
Promundo-US
Name of Second PI:
Ruti Levtov
Affiliation:
Promundo-US

Study Sponsor

Name:
Dutch Ministry of Foreign Affairs, MacArthur Foundation, anonymous donor
Study Sponsor Location:

Research Partner

Name of Partner Institution:
Rwanda Men's Resource Center
Type of Organization:
NGO (local) or other civil society organization
Location:
Rwanda
Intervention

Intervention Overview

Intervention:
MenCare+/Bandebereho is a 3 year project to engage men in maternal, newborn and child health (MNCH) and in sexual and reproductive health in Rwanda. A core component of the project is fathers’/couples’ group education The target participants are first-time parents or parents of young children (ages 21-35) living in 16 rural and semi-urban sectors selected by the implementing partner in collaboration with local authorities. Eligible participants are identified by the implementing partner in collaboration with community health workers and local leaders and invited to participate by a group facilitator. The MenCare+/Bandebereho fathers’/couples’ group education engages men in 15 weekly sessions of group discussion, critical reflection and interactive activities led by a trained facilitator, using a curriculum developed by RWAMREC and Promundo and approved by the Rwandan Ministry of Health, adapted from the Program P Manual. Men’s partners participate in 6-8 sessions. The sessions focus on men’s role in MNCH, family planning, sharing household responsibilities, intimate partner violence, conflict resolution, family budgeting, and gender equality.
Private Intervention Details:
Theory of Change:
Multiple Treatment Arms Evaluated?
Yes

Implementing Agency

Name of Organization:
Rwanda Men's Resource Center with technical assistance from Promundo-US
Type of Organization:
NGO (local)/Community Based Organization/Other civil society organization

Program Funder

Name of Organization:
Dutch Ministry of Foreign Affairs
Type of Organization:
Foreign or Multilateral Aid Agency

Intervention Timing

Intervention or Program Started at time of Registration?
Yes
Start Date:
02/01/2015
End Date:
07/31/2015
Evaluation Method

Evaluation Method Overview

Primary (or First) Evaluation Method:
Randomized control trial
Other (not Listed) Method:
Additional Evaluation Method (If Any):
Other (specify)
Other (not Listed) Method:

Method Details

Details of Evaluation Approach:
The MenCare+/Bandebereho fathers'/couples' study is a two-arm, multi-site randomized control trial (RCT). The RCT will measure the impact of the fathers'/couples' group education intervention. The trial will include three rounds of data collection with intervention and control participants: one at baseline, one at endline (four months post-intervention), and one follow-up at 16-months post-intervention. The main analysis will involve a comparison of data from treatment and control participants at endline and follow-up. For each site, local authorities and community health workers identified 25 men who met the eligibility criteria: aged 21-35 years; expectant father or father of young children under-5; and living in a sector with a group facilitator. Community health workers and local authorities assisted in identifying eligible men through a convenience sample. The implementing partner verified men’s eligibility, and eligible men who agreed to participate in the study were then randomized into intervention (n=576 men) and control groups (n=624). The participating women are the partners of the men participating in the study.
Private Details of Evaluation Approach:
We will collect data from male participants at three time points, but from female participants only at endline and follow-up.
Outcomes (Endpoints):
Primary outcomes: 1) Gender division of caregiving and domestic tasks 2) Men's participation in family planning and maternal, newborn and child health 3) Gender-related attitudes 4) Women's experiences of intimate partner violence Secondary outcomes: 1) Use of violence/harsh punishment against children 2) Relationship quality 3) Couple communication Unless otherwise specified, outcomes are self-reported by men and women.
Unit of Analysis:
Individual
Hypotheses:
1) Male and female intervention participants will report higher levels of men's participation in caregiving and domestic duties compared to control participants; 2) Male and female intervention participants will be more likely to use family planning and report higher levels of men's participation in antenatal care compared to control participants; 3) Male and female intervention participants will have more gender equitable attitudes compared to control participants; 4) Female intervention participants will report lower rates of intimate partner violence compared to control participants.
Unit of Intervention or Assignment:
Individual men and their partners
Number of Clusters in Sample:
Number of Individuals in Sample:
1200 men and their partners (total n=2400)
Size of Treatment, Control, or Comparison Subsamples:
1152 individuals in treatment, 1248 individuals in control

Supplementary Files

Analysis Plan:
Other Documents:
Data

Outcomes Data

Description:
Interviewer administered individual survey of men and women in treatment and control groups
Data Already Collected?
Yes
Data Previously Used?
No
Data Access:
Not restricted - access with no requirements or minimal requirements (e.g. web registration)
Data Obtained by the Study Researchers?
Yes
Data Approval Process:
Approval Status:

Treatment Assignment Data

Participation or Assignment Information:
Yes
Description:
Data Obtained by the Study Researchers?
Data Previously Used?
Data Access:
Data Obtained by the Study Researchers?
Data Approval Process:
Approval Status:

Data Analysis

Data Analysis Status:
No

Study Materials

Upload Study Materials:

Registration Category

Registration Category:
Prospective, Category 3: Data for measuring impacts have been obtained/collected by the research team but analysis for this evaluation has not started
Completion

Completion Overview

Intervention Completion Date:
07/31/2015
Data Collection Completion Date:
12/31/2016
Unit of Analysis:
Individual
Clusters in Final Sample:
N/A
Total Observations in Final Sample:
1123 men and 1162 women
Size of Treatment, Control, or Comparison Subsamples:
Treatment: 533 men; 557 women; Control: 590 men; 605 women

Findings

Preliminary Report:
Yes
Preliminary Report URL:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192756
Summary of Findings:
This study assessed the impact of the Bandebereho gender-transformative couples’ intervention on impact on multiple behavioral and health-related outcomes influenced by gender norms and power relations. Primary outcomes include women’s experience of physical and sexual IPV, women’s attendance and men’s accompaniment at ANC, modern contraceptive use, and partner support during pregnancy. The Bandebereho intervention led to substantial improvements in multiple reported outcomes. Compared to the control group, women in the intervention group reported: less past-year physical (OR 0.37, p<0.001) and sexual IPV (OR 0.34, p<0.001); and greater attendance (IRR 1.09, p<0.001) and male accompaniment at antenatal care (IRR 1.50, p<0.001); and women and men in the intervention group reported: less child physical punishment (women: OR 0.56, p = 0.001; men: OR 0.66, p = 0.005); greater modern contraceptive use (women: OR 1.53, p = 0.004; men: OR 1.65, p = 0.001); higher levels of men’s participation in childcare and household tasks (women: beta 0.39, p<0.001; men: beta 0.33, p<0.001); and less dominance of men in decision-making.
Paper:
Yes
Paper Summary:
Title: Gender-transformative Bandebereho couples’ intervention to promote male engagement in reproductive and maternal health and violence prevention in Rwanda: Findings from a randomized controlled trial Rigorous evidence of the effectiveness of male engagement interventions, particularly on how these interventions impact relationship power dynamics and women’s decision-making, remains limited. This study assessed the impact of the Bandebereho gender-transformative couples’ intervention, which demonstrated substantial improvements in multiple reported outcomes. Our study strengthens the existing evidence on male engagement approaches; together with earlier studies our findings suggest that culturally adapted gender-transformative interventions with men and couples can be effective at changing deeply entrenched gender inequalities and a range of health-related behavioral outcomes.
Paper Citation:
Doyle K, Levtov RG, Barker G, Bastian GG, Bingenheimer JB, Kazimbaya S, et al. (2018) Gender-transformative Bandebereho couples’ intervention to promote male engagement in reproductive and maternal health and violence prevention in Rwanda: Findings from a randomized controlled trial. PLoS ONE 13(4): e0192756. https://doi.org/10.1371/journal.pone.0192756

Data Availability

Data Availability (Primary Data):
Yes--Available now
Date of Data Availability:
Data URL or Contact:
research@promundoglobal.org
Access procedure:
Data are available upon request. Per our protocol, the authors have committed to sharing the data underlying for this study upon request from qualified researchers; priority to Rwandan researchers.

Other Materials

Survey:
Yes
Survey Instrument Links or Contact:
You can access the survey instruments (male / female) from the PLOS One article: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192756
Program Files:
No
Program Files Links or Contact:
External Link:
External Link Description:
Description of Changes:

Study Stopped

Date:
Reason: