# Enhancing male participation in interventions to prevent unintended pregnancy

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2021 · $507,079

## Abstract

Globally, 41% of all pregnancies are unintended, increasing risk for maternal and infant morbidities and
mortality. Most unintended pregnancies occur in the context of contraceptive non-use or failure. Women
with husbands not supportive of contraception are more likely to report contraceptive non-use, and
women with sexually abusive husbands are more likely to report contraceptive failure. Such findings 
highlight the need for family planning (FP) interventions that engage both women and men, focus on 
eliminating marital sexual violence (MSV) and promote use of effective (low failure risk) spacing contraception 
including long-acting reversible contraception (LARC; e.g. intrauterine device or IUD). Rural India, with
some of the lowest rates of contraception and highest rates of marital violence globally, offers an 
important context in which to test such interventions, with global implications. Prior research from this team
documents promise of the original CHARM intervention, a gender equity (GE) FP intervention engaging
men and delivered by male health providers over three months. This intervention improved contraceptive
use and reduced likelihood of MSV, but demonstrated no reduction in unintended pregnancy; additionally,
it demonstrated good participation from men (91%) but less from couples (51%), largely due to women’s
discomfort with a male provider. Poor reach to women and provision of only short-acting contraceptives
(pill, condom) more vulnerable to contraceptive failure, likely compromised unintended pregnancy 
outcomes. Based on these findings, we propose CHARM2, which will include CHARM sessions for men AND
parallel women-focused GE+FP sessions delivered by a female provider and inclusive of broader 
contraceptive options, including LARC. This study seeks a) to implement CHARM2, b) to evaluate its impact on
contraceptive use, unintended pregnancy, and MSV with rural couples in India, and c) to assess its 
potential for sustainability in rural India, using implementation science methods. To evaluate the impact of
CHARM2 on our outcomes of interest, a two armed cluster randomized controlled trial will be conducted
with N=1000 married couples from 50 geographic clusters (n=20 couples per cluster) in rural 
Maharashtra, India. Participants will receive CHARM2 or the standard of care control condition, which will involve
community health workers offering pills/condoms and linking women to public health clinics. Outcomes will
be assessed via pregnancy testing and surveys at baseline and 9&18-month follow-ups. Implementation
science methods will be used to assess the quality, scalability, and replicability of CHARM2 for uptake by
rural health care systems (i.e., sustainability). Specifically, in-depth interviews will be conducted with
CHARM2 intervention couples (n=50) and providers (n=20); focus groups will be conducted with key
stakeholders from the family planning and rural health infrastructures at state, national and international
lev...

## Key facts

- **NIH application ID:** 10167745
- **Project number:** 5R01HD084453-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Anita Raj
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $507,079
- **Award type:** 5
- **Project period:** 2017-09-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10167745

## Citation

> US National Institutes of Health, RePORTER application 10167745, Enhancing male participation in interventions to prevent unintended pregnancy (5R01HD084453-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10167745. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*