# The impact of group-based life skills and health empowerment for young, married, women to avoid unintended pregnancies in India.

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $614,129

## Abstract

PROJECT SUMMARY
Unintended pregnancies put women at risk of poor maternal and child health outcomes. In India, half of all
pregnancies are unintended and younger women have the highest risk of having an unmet need for
contraception. New evidence suggests that young, newly married women in this setting desire to postpone
pregnancy, yet have low use of contraception and high rates of unintended pregnancy, and desire reproductive
health knowledge. Young women in India also have low empowerment, and desire training in life skills that
could be used to help them gain status and opportunity in their households and communities. Few rigorously
designed and tested interventions have focused on women’s empowerment (including life skills and health-
related) and unintended pregnancy, especially among young, married women in India. This proposal tests the
impact of a combined life skills and health empowerment intervention for young married women on avoiding
unintended pregnancy, and other health and empowerment outcomes. The intervention, DAMINI, is currently
on-going in villages in Uttar Pradesh, India, and the goal of this proposal is to conduct a two-arm randomized
cluster study of (1) DAMINI (life skills and health empowerment); and (2) the standard of care health education
and access to contraceptives provided by community health workers. This approach will focus on recently
married women aged 18-25 years who are at risk of pregnancy but do not want a pregnancy at the time of
enrollment and will follow them for two years post-intervention through in-person surveys. DAMINI is delivered
in groups and we will work in 40 intervention and 40 control village clusters; with 1 group per cluster and 6-7
women in each cluster/group (total N=520). We will also collect longitudinal triadic in-depth interviews with
newly married women, their husbands, and mothers-in-law to understand changing norms and pathways of
impact. The first aim is to determine the effectiveness of DAMINI on the risk of having an unintended
pregnancy, compared to health education alone. Survival analysis of time to pregnancy (primary outcome) will
be used to analyze the impact on unintended pregnancy. Given potentially different factors affecting parous vs.
nulliparous women, we will model the effect of DAMINI on them separately, and include parity specific
measures such as sex of previous births and duration since marriage.The second aim is to assess the
effectiveness of DAMINI on intermediary outcomes related to life skills and health empowerment, compared to
health education alone, using the same methodological approach. Finally, to inform future implementation
research, we will use an effectiveness-implementation hybrid design to conduct a mixed methods process
evaluation with participants and their households and DAMINI and community leaders. This will also include an
economic evaluation, specifically a cost effectiveness analysis. If proven effective, it is anticipated that this
interv...

## Key facts

- **NIH application ID:** 10707910
- **Project number:** 5R01HD108252-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** NADIA GRIFFI DIAMOND-SMITH
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $614,129
- **Award type:** 5
- **Project period:** 2022-09-30 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10707910

## Citation

> US National Institutes of Health, RePORTER application 10707910, The impact of group-based life skills and health empowerment for young, married, women to avoid unintended pregnancies in India. (5R01HD108252-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10707910. Licensed CC0.

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