Background
WEST, SECONDARY
The West African Francophone country of Niger has the highest prevalence of girl child marriage (marriage < 18 years) in the world [Across sub-Saharan Africa, adolescent girls face myriad structural, community, and interpersonal barriers to contraceptive use [At the interpersonal level, power dynamics favor husbands’ control over both household- and fertility-related decisions, with only 7% of married women in Niger made their own decisions regarding sex, contraception, and healthcare [There is critical need for family planning programs in Niger, to provide quality sexual and reproductive health (SRH) services for married adolescents, but also to address the gendered power dynamics that compromise reproductive agency for married girls in this context. Based on this premise, Pathfinder International developed the Reaching Married Adolescents (RMA) program to promote modern contraceptive use, and greater female control thereover, by increasing knowledge, attitudes, and norms supportive of modern contraceptive access and female reproductive autonomy [A cluster randomized controlled trial (cRCT) was conducted to evaluate the effects of the RMA program on current modern contraceptive use (primary outcome) and past year experiences of physical and sexual IPV (secondary outcome) [