Impact of Sumadhur intervention on fertility and family planning decision-making norms: a mixed methods study

Ashley Mitchell; Mahesh C Puri; Minakshi Dahal; Alia Cornell; Ushma D Upadhyay; Nadia G Diamond-Smith

doi:10.1186/s12978-023-01619-7

Impact of Sumadhur intervention on fertility and family planning decision-making norms: a mixed methods study

Ashley Mitchell, Mahesh C Puri, Minakshi Dahal, Alia Cornell, Ushma D Upadhyay, Nadia G Diamond-Smith

Department of Social & Policy Sciences

Research output: Contribution to journal › Article › peer-review

2 Citations (SciVal)

Abstract

BACKGROUND: Mindful of social norms shaping health among women pressured to prove early fertility in Nepal, a bi-national research team developed and piloted a 4-month intervention engaging household triads (newly married women, their husbands, and mothers-in-law) toward advancing gender equity, personal agency, and reproductive health. This study evaluates the impact on family planning and fertility decision-making.

METHODS: In 2021, Sumadhur was piloted in six villages with 30 household triads (90 participants). Pre/post surveys of all participants were analyzed using paired sample nonparametric tests and in-depth interviews with a subset of 45 participants were transcribed and analyzed thematically.

RESULTS: Sumadhur significantly impacted (p < .05) norms related to pregnancy spacing and timing, and sex preference of children, as well as knowledge about family planning benefits, pregnancy prevention methods, and abortion legality. Family planning intent also increased among newly married women. Qualitative findings revealed improved family dynamics and gender equity, and shed light on remaining challenges.

CONCLUSIONS: Entrenched social norms surrounding fertility and family planning contrasted with participants' personal beliefs, highlighting needed community-level shifts to improve reproductive health in Nepal. Engagement of influential community- and family-members is key to improving norms and reproductive health. Additionally, promising interventions such as Sumadhur should be scaled up and reassessed.

Original language	English
Number of pages	16
Journal	Reproductive health
Volume	20
Issue number	1
DOIs	https://doi.org/10.1186/s12978-023-01619-7
Publication status	Published - 25 May 2023

Bibliographical note

Funding: This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number 1K01HD086281-01A1). The funder was not involved in the design or execution of the research study

© 2023. The Author(s).

Funding

This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number 1K01HD086281-01A1). The funder was not involved in the design or execution of the research study.

Keywords

Pregnancy
Child
Female
Humans
Family Planning Services
Contraception Behavior
Fertility
Sex Education
Family Characteristics

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10.1186/s12978-023-01619-7Licence: CC BY

Cite this

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title = "Impact of Sumadhur intervention on fertility and family planning decision-making norms: a mixed methods study",

abstract = "BACKGROUND: Mindful of social norms shaping health among women pressured to prove early fertility in Nepal, a bi-national research team developed and piloted a 4-month intervention engaging household triads (newly married women, their husbands, and mothers-in-law) toward advancing gender equity, personal agency, and reproductive health. This study evaluates the impact on family planning and fertility decision-making.METHODS: In 2021, Sumadhur was piloted in six villages with 30 household triads (90 participants). Pre/post surveys of all participants were analyzed using paired sample nonparametric tests and in-depth interviews with a subset of 45 participants were transcribed and analyzed thematically.RESULTS: Sumadhur significantly impacted (p < .05) norms related to pregnancy spacing and timing, and sex preference of children, as well as knowledge about family planning benefits, pregnancy prevention methods, and abortion legality. Family planning intent also increased among newly married women. Qualitative findings revealed improved family dynamics and gender equity, and shed light on remaining challenges.CONCLUSIONS: Entrenched social norms surrounding fertility and family planning contrasted with participants' personal beliefs, highlighting needed community-level shifts to improve reproductive health in Nepal. Engagement of influential community- and family-members is key to improving norms and reproductive health. Additionally, promising interventions such as Sumadhur should be scaled up and reassessed.",

keywords = "Pregnancy, Child, Female, Humans, Family Planning Services, Contraception Behavior, Fertility, Sex Education, Family Characteristics",

author = "Ashley Mitchell and Puri, {Mahesh C} and Minakshi Dahal and Alia Cornell and Upadhyay, {Ushma D} and Diamond-Smith, {Nadia G}",

note = "Funding: This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number 1K01HD086281-01A1). The funder was not involved in the design or execution of the research study {\textcopyright} 2023. The Author(s).",

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AU - Dahal, Minakshi

AU - Cornell, Alia

AU - Upadhyay, Ushma D

AU - Diamond-Smith, Nadia G

N1 - Funding: This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number 1K01HD086281-01A1). The funder was not involved in the design or execution of the research study © 2023. The Author(s).

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N2 - BACKGROUND: Mindful of social norms shaping health among women pressured to prove early fertility in Nepal, a bi-national research team developed and piloted a 4-month intervention engaging household triads (newly married women, their husbands, and mothers-in-law) toward advancing gender equity, personal agency, and reproductive health. This study evaluates the impact on family planning and fertility decision-making.METHODS: In 2021, Sumadhur was piloted in six villages with 30 household triads (90 participants). Pre/post surveys of all participants were analyzed using paired sample nonparametric tests and in-depth interviews with a subset of 45 participants were transcribed and analyzed thematically.RESULTS: Sumadhur significantly impacted (p < .05) norms related to pregnancy spacing and timing, and sex preference of children, as well as knowledge about family planning benefits, pregnancy prevention methods, and abortion legality. Family planning intent also increased among newly married women. Qualitative findings revealed improved family dynamics and gender equity, and shed light on remaining challenges.CONCLUSIONS: Entrenched social norms surrounding fertility and family planning contrasted with participants' personal beliefs, highlighting needed community-level shifts to improve reproductive health in Nepal. Engagement of influential community- and family-members is key to improving norms and reproductive health. Additionally, promising interventions such as Sumadhur should be scaled up and reassessed.

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KW - Female

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KW - Contraception Behavior

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Impact of Sumadhur intervention on fertility and family planning decision-making norms: a mixed methods study

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