Gender-Transformative Interventions and Normative Beliefs About Reproductive Decision-Making (Beyond)

July 27, 2026 updated by: Technical University of Munich

Beyond the Couple: Gender-Transformative Interventions and Normative Beliefs About Reproductive Decision-Making of Newly Married People in India

The ECOVI trial is a two-arm cluster randomized controlled trial (cRCT) conducted in rural and urban communities across Maharashtra, Andhra Pradesh, and Rajasthan, India, and funded by the European Research Council (ERC). The trial evaluates the impact of a couples-based financial literacy and gender-transformative intervention ("Let Us Grow Together: Economic Wellbeing for Families") on economic intimate partner violence (IPV), economic decision-making, and economic empowerment among 2,276 married couples across 150 clusters.

This sub-study examines an understudied downstream question: whether such couples-based programs change normative beliefs that extend beyond the treated couple's own relationship to younger generations, particularly their daughters and their sons. Specifically, we ask whether the intervention shifts how treated women and men think about who should have the main say in reproductive decisions for newly married couples, for their daughters and their sons. In an additional analysis, we examine whether respondents apply different standards when reproductive decisions concern their daughter and her husband versus their son and his wife. A difference in the endorsement of women's reproductive autonomy across the two scenarios may indicate an asymmetry in the application of egalitarian norms, whereby respondents are more accepting of autonomy for biological daughters than for daughters-in-law. We further examine whether the intervention reduces this gap by promoting more consistent endorsement of women's reproductive decision-making autonomy across both scenarios.

Items measuring normative beliefs regarding younger generations are added to the ECOVI endline survey before the start of endline data collection. This pre-registration protocol is submitted before any endline data is collected, providing a fully prospective analysis plan. All mediator variables, internalized gender norms, and female household decision-making participation are collected at both baseline and endline as part of the main ECOVI trial.

The sub-study pursues four interconnected objectives: (1) to estimate the causal effect of the intervention on normative beliefs regarding reproductive decision-making; (2) to test whether any such effect operates through a shift in internalized gender norms (the norm internalization channel); (3) to test whether any such effect operates through a shift in perceived community gender norms (the perceived norms channel); and (4) to test whether any such effect operates through an increase in women's participation in household decision-making (the agency channel).

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

2276

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • India
      • Pune, India
        • Maharashtra; Rajasthan; Andhra Pradesh

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • married and co-habiting husband-wife pairs;
  • women aged 18-49 and men aged 18 and older;
  • primary residence in a study cluster in Maharashtra, Andhra Pradesh, or Rajasthan;
  • completion of at least primary schooling (4th grade);
  • both partners provide written informed consent and agree to participate in six sessions, baseline and endline surveys, and SMS follow-ups;
  • both partners understand the local language used in sessions;
  • no plans for relocation or prolonged absence before endline.

Exclusion Criteria:

  • either partner under 18 years;
  • refusal of consent or unwillingness to participate by either partner;
  • serious physical or mental condition preventing safe active participation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Let Us Grow Together: Economic Wellbeing for Families
The ECOVI intervention "Let Us Grow Together: Economic Wellbeing for Families" integrates financial literacy education with gender-transformative content on equitable household roles, communication skills, and joint decision-making, delivered in six structured community-based sessions for couples. Married couples in clusters assigned to the intervention receive a structured program of six community-based sessions. Each session lasts between 2.5 and 3 hours and includes participatory activities, discussions, and exercises. All six sessions would be conducted by the same two facilitators - one male and one female. The content integrates financial literacy (e.g., household budgeting, saving practices, joint financial planning) with gender-transformative training (e.g., equitable household roles, communication skills, conflict resolution, and fostering empathy between spouses). Sessions are delivered by trained facilitators in a group setting with fifteen couples, approximately every 2-4
Other: Let Us Grow Together: Economic Wellbeing for Families
The ECOVI intervention "Let Us Grow Together: Economic Wellbeing for Families" integrates financial literacy education with gender-transformative content on equitable household roles, communication skills, and joint decision-making, delivered in six structured community-based sessions for couples.
No Intervention: Control
Married couples in clusters assigned to the control arm do not receive the special couples training during the study period. Participants in control group continue with standard activities and resources available in the community but without the structured sessions provided to the intervention arm. This control condition represents the status quo against which the added effect of the intervention can be measured. After the conclusion of the study, control clusters may be offered the intervention materials or sessions via the NGO partners in case investigators find overall positive treatment effects, ensuring ethical considerations are me

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Intergenerational Normative Beliefs Items
Time Frame: T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))
Normative beliefs regarding reproductive decision-making are assessed using three hypothetical scenario-based items with identical wording and response options. Respondents indicate who should have the main say in deciding whether and when a newly married couple has children in three contexts: (1) a newly married couple in the community, (2) the respondent's daughter and her husband, and (3) the respondent's son and his wife. Response options include wife, joint decision by spouses, husband, other family members, other, and prefer not to say.
T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Internalized Gender Norms:
Time Frame: T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))
Women's own gender norm attitudes are measured using five items assessing personal beliefs about gender roles: (1) boys should have more educational opportunities than girls; (2) a man should have the final word about decisions in his home; (3) a wife should eat after her husband and children; (4) daughters should have equal inheritance rights as sons; and (5) it would be a good idea to elect a woman as village leader. Responses use a five-point agree/disagree scale. Items 1-3 are coded 1 if the respondent agrees or strongly agrees (traditional response); items 4-5 are reverse-coded so that disagreeing is coded 1 (traditional response). The score is the mean of available items, ranging from 0 to 1, with higher values indicating more traditional gender attitudes. The mediating variable is the endline score, with baseline score included as a covariate.
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))
Perceived Community Gender Norms:
Time Frame: T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))
Perceived norms are measured using the same five items, but respondents are asked to estimate how many out of ten community members would agree with each statement. Items 1-3 are summed directly; items 4-5 are subtracted (reversed), yielding an additive index where higher scores indicate more traditional perceived community norms. The mediating variable is the endline score, with baseline score included as a covariate.
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))
Household Decision-Making Participation:
Time Frame: T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))
Women's decision-making power is assessed across seven domains: healthcare or medication for herself; number of children and timing; contraception and family planning; children's marriage, healthcare, education, and rearing; major household purchases; spending on food and groceries; and spending on her own clothing. Each item is scored 1 (sole decision) to 4 (someone else decides), with responses 92 (not applicable) and 98 (prefer not to say) treated as missing. The composite score is the mean across available items, with higher values indicating less decision-making power. For interpretability, the scale is reverse-coded in all analyses so that higher scores indicate greater participation. The mediating variable is the endline score, with baseline score included as a covariate.
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))
Covariates
Time Frame: T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))
  • Respondent age
  • Respondent education
  • Respondent socioeconomic status
  • Household economic strain
  • Residential type (rural vs. urban)
  • Living arrangement (co-residing with in-laws vs. not)
  • State fixed effects (Maharashtra, Andhra Pradesh, Rajasthan)
T1 = baseline (prior to session 1); T2 = endline (~6 months after intervention, approx. 1.5 years after baseline))

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Technical University of Munich

Collaborators

Sambodhi Research and Communication Pvt., Ltd.

Investigators

  • Principal Investigator: Janina I Steinert, Dr., Technical University of Munich

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 15, 2025

Primary Completion (Estimated)

November 30, 2026

Study Completion (Estimated)

November 30, 2026

Study Registration Dates

First Submitted

July 9, 2026

First Submitted That Met QC Criteria

July 27, 2026

First Posted (Actual)

July 29, 2026

Study Record Updates

Last Update Posted (Actual)

July 29, 2026

Last Update Submitted That Met QC Criteria

July 27, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 101115963

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared. However, fully anonymized datasets may be shared with project partners and qualified researchers working on related topics (e.g., gender norms and economic violence) for secondary analyses, including cross-country or pooled analyses, subject to data sharing agreements and ethical approvals.

Access Criteria:

Available on request upon approval by overall study PI Prof. Dr. Steinert

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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