Effects of a clinic-based reproductive empowerment intervention on reproductive coercion, intimate partner violence, and pregnancy outcomes: A cluster-controlled trial in Nairobi Kenya
- 1University of California, San Diego
Abstract
BackgroundTo address reproductive coercion and intimate partner violence, the ARCHES (Addressing Reproductive Coercion in Health Settings) intervention was adapted for clinics in Nairobi, Kenya and evaluated to assess impacts on reproductive coercion (primary outcome), physical and sexual intimate partner violence (primary outcomes) and incident pregnancy (secondary outcome).
MethodsA parallel, non-blinded, non-randomized, cluster-controlled trial in six health clinics (1:1 allocation) was conducted. Clinics were allocated to receive ARCHES provider training or no additional training based on feasibility. Non-pregnant, non-sterilized female clients seeking family planning services were recruited. Inverse probability by treatment weighting (IPTW) used in difference-in-differences modified intent-to-treat (mITT) and as-treated approaches to assess the change in primary outcomes.
ResultsA total of 659 women were recruited (328 ARCHES, 331 control). ARCHES was associated with significantly greater reductions in physical intimate partner violence compared to controls [mITT beta -0.98 (-1.58, -0.39), as-treated beta -0.56 (-1.19. 0.07)]. Both groups experienced reductions in reproductive coercion and sexual intimate partner violence decreased in both groups but controls showed greater reductions in reproductive coercion, and differences in sexual violence were not significant in as-treated models. ARCHES participants had lower odds of incident pregnancy at six-month follow-up [mITT AOR 0.42 (0.27, 0.67), as-treated AOR 0.29 (0.08. 1.02)].
ConclusionsARCHES may improve womens safety and reproductive agency in Nairobi. Further study is required to clarify effects on reproductive coercion and sexual intimate partner violence.
Trial registrationClinicalTrials.gov [NCT03534401]
Related
- Impact of Lactiplantibacillus plantarum UBLP-40 intervention on iron status indicators in iron-deficient women of reproductive age: a double-blind, randomized controlled trial
- Effectiveness of a parent-based intervention to improve adolescents’ sexual and reproductive health knowledge: a pilot study
- Dietary Enhancement for Iron Deficiency and Anaemia Treatment (DEFeAT): study protocol for a randomised controlled trial to assess the effect of a mineral-enriched powder on iron deficiency in women of reproductive age
- Associated factors and machine learning-based prediction model construction for positive reproductive tract group B streptococcus screening in late-pregnancy women
- Prenatal psychological care to prevent emotional and reproductive complications in pregnancy after perinatal loss: a mixed methods study
BibTeX
@misc{silverman2026effects,
title = {{Effects of a clinic-based reproductive empowerment intervention on reproductive coercion, intimate partner violence, and pregnancy outcomes: A cluster-controlled trial in Nairobi Kenya}},
author = {J. Silverman and J. Uysal and C.-C. Undie and W. Liambila and L. McDougal and E. Pearson and S. Boyce and N. Johns and S. Wendoh},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.21.26366167},
url = {https://www.medrxiv.org/content/10.64898/2026.10.21.26366167v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Effects of a clinic-based reproductive empowerment intervention on reproductive coercion, intimate partner violence, and pregnancy outcomes: A cluster-controlled trial in Nairobi Kenya
AU - J. Silverman
AU - J. Uysal
AU - C.-C. Undie
AU - W. Liambila
AU - L. McDougal
AU - E. Pearson
AU - S. Boyce
AU - N. Johns
AU - S. Wendoh
PY - 2026
DA - 2026/10/21
PB - medRxiv
DO - 10.64898/2026.10.21.26366167
UR - https://www.medrxiv.org/content/10.64898/2026.10.21.26366167v1
AB - BackgroundTo address reproductive coercion and intimate partner violence, the ARCHES (Addressing Reproductive Coercion in Health Settings) intervention was adapted for clinics in Nairobi, Kenya and evaluated to assess impacts on reproductive coercion (primary outcome), physical and sexual intimate partner violence (primary outcomes) and incident pregnancy (secondary outcome). MethodsA parallel, non-blinded, non-randomized, cluster-controlled trial in six health clinics (1:1 allocation) was conducted. Clinics were allocated to receive ARCHES provider training or no additional training based on feasibility. Non-pregnant, non-sterilized female clients seeking family planning services were recruited. Inverse probability by treatment weighting (IPTW) used in difference-in-differences modified intent-to-treat (mITT) and as-treated approaches to assess the change in primary outcomes. ResultsA total of 659 women were recruited (328 ARCHES, 331 control). ARCHES was associated with significantly greater reductions in physical intimate partner violence compared to controls [mITT beta -0.98 (-1.58, -0.39), as-treated beta -0.56 (-1.19. 0.07)]. Both groups experienced reductions in reproductive coercion and sexual intimate partner violence decreased in both groups but controls showed greater reductions in reproductive coercion, and differences in sexual violence were not significant in as-treated models. ARCHES participants had lower odds of incident pregnancy at six-month follow-up [mITT AOR 0.42 (0.27, 0.67), as-treated AOR 0.29 (0.08. 1.02)]. ConclusionsARCHES may improve womens safety and reproductive agency in Nairobi. Further study is required to clarify effects on reproductive coercion and sexual intimate partner violence. Trial registrationClinicalTrials.gov [NCT03534401]
ER -