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Raising Voices

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

This study assessed the impact of the Bandebereho gender-transformative couples’ intervention in Rwanda on impact on multiple behavioural and health-related outcomes influenced by gender norms and power relations. 

The research team conducted a multi-site randomised controlled trial (RCT) in four Rwandan districts with expectant/current fathers and their partners, who were randomised to the intervention (n = 575 couples) or control group (n = 624 couples). 

The primary outcomes measured included women’s experience of physical and sexual IPV, women’s attendance and men’s accompaniment at ante-natal clinics, modern contraceptive use, and partner support during pregnancy. At 21-months post-baseline, 1123 men and 1162 partners were included in intention to treat analysis. 

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 and sexual IPV and greater attendance and male accompaniment at antenatal care; and women and men in the intervention group reported: less child physical punishment; greater modern contraceptive use; higher levels of men’s participation in childcare and household tasks; and less dominance of men in decision-making. 

The study results strengthen the existing evidence on male engagement approaches. The 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 behavioural outcomes. 

The Bandebereho Intervention

This couples intervention engaged men and their partners in participatory, small group sessions of critical reflection and dialogue. This was part of MenCare+, a four country initiative to engage men in sexual, reproductive and maternal health coordinated by Rutgers and Promundo and implemented by RWAMREC in Rwanda.

The curriculum comprised 15 sessions, some with men only, some with couples:

  • Gender equality
  • Becoming a father
  • Pregnancy
  • Supporting your pregnant partner
  • Childbirth
  • Family olanning
  • Caring for a baby
  • My parents’ impact
  • Identifying violence
  • Genderbased violence
  • Resolving conflict
  • Alcohol and drug abuse
  • Raising Children
  • Sharing responsibilities at home
  • Reflection
Date published
  • 2018
Author(s)
  • Kate Doyle
  • Ruti Levtov
  • Gary Barker
Published by Plos One
Population
Key quote "The 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 behavioural outcomes. "