Outcomes

Table 1 describes the outcomes. The primary and secondary outcomes were pre-specified for the endline, 22 months post-baseline. To enhance learning, we also collected data at midline (12 months post-baseline). Outcomes and time periods were pre-specified in the trial protocol.¹³

Primary and secondary outcomes for the trial

IPV, intimate partner violence; NA, not available.

Reflecting the uncertainty in how best to assess IPV in trial settings and the multiple objectives of the trial, the trial had three primary outcomes, two of which related to women’s experience of physical IPV.

Past year physical IPV was assessed with a modified version of the WHO Violence Against Women Scale.²⁶ Five questions asked about physical IPV experienced in the past year from their husband and a range of different forms of physical violence (eg, slapped, beaten, threatened with a gun). Response options were never, once, few or many. A response of once or more frequently to any item led to a participant being classed as having experienced physical IPV in the past year.

Past year severe IPV used the same items as past year physical IPV, but coded responses differently. Women were classified as having experienced severe IPV if they responded positively to two or more items, or else responded few or many to any single item from the five questions. The classification of severity of IPV is derived from previous studies suggesting significantly greater health impacts for those experiencing two or more IPV experiences.²⁷

Past week depressive symptoms were assessed through 20 items comprising the Center for Epidemiological Studies Depression scale (CES-D). An example was: “During the past week I had crying spells”, with possible responses being rarely or none of the time, some or little of the time, moderate amount of time or most or all of the time. The scale was summed and higher scores indicated more depressive symptoms.

Secondary outcomes are described in table 1.