Outcomes
The primary proximal outcome reported in this study is uptake of a modern contraceptive method, assessed as a binary measure at exit where clients report having “received a family planning method today” from their provider including the IUD, implant, injection, contraceptive pills, or male/female condoms. Other distal primary outcomes are reported separately [forthcoming].Secondary proximal outcomes, assessed as the change from baseline to three- and baseline to six-month follow-up, include self-efficacy to use contraceptives in the face of RC, covert use of contraceptives, attitudes justifying RC and IPV, and awareness and use of local IPV survivor services (Supplement 1).Self-efficacy to use contraceptives in the face of RC is assessed using three items on participants’ confidence in their ability to use a contraceptive method in the face of opposition (e.g. “How confident are you in your ability to use family planning if your partner tries to interfere?”). Participants respond on a three-point Likert scale. The variable is modelled as a complete-case sum score (range 0-6, Cronbach’s alpha = 0.75). Originally four items were asked; only three items were retained based on internal reliability assessments.Covert use of contraceptives in the past three-months is assessed as a binary outcome based on participants’ response that they “used family planning without telling a male partner,” in the past three months.Attitudes justifying RC are assessed via an eight-item scale where participants agree or disagree that it is appropriate for male partners to perpetrate forms of RC (e.g. “Is it acceptable for a male partner to force or pressure women to use family planning”) in a variety of situations (e.g. “if he wants more children than his partner”). Attitudes justifying IPV is assessed via a seven-item scale adapted from the Demographic and Health Survey wife-beating justification scale.Awareness of local IPV survivor services is assessed as a binary outcome based on if participants “think a woman experiencing physical or sexual violence from her male partner could get help” from a list of four local IPV services. Participants who respond yes to at least one of the services are considered aware of local IPV survivor services. Utilisation of such services is also assessed as a binary outcome based on whether participants report having “called or visited” any of the services listed or any other services for IPV in the past three months.