At roughly 1.3 billion people, India is the second most populous country in the world, but will likely surpass China as the most populous nation within six years, reaching 1.7 billion by 2050, according to United Nations estimates.

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Hence, family planning services in India carry extra imperative. Researchers at the University of California San Diego School of Medicine have published a rare analysis on one such program, reporting that the program's comparatively rare combination of increased male engagement and gender-equity counseling with both husband and wife improved contraceptive practices and reduced marital sexual violence among married couples in rural India.

The intervention involved rural private providers partnering with the public health system to reach men as well as couples. An international team of scientists conducted a two-armed randomized controlled trial of 1,081 couples living in rural India.

Roughly half of the participants participated in CHARM, a family planning program in which both husband and wife receive counseling intervention, both as individuals and as a couple. The other half consisted of similar couples who received no family planning counseling.

The study lasted 18 months, with follow-ups at the midway and end points.The researchers found that women in the CHARM cohort were more likely to have contraceptive communication at the 9-month follow up and use modern contraceptives throughout than their control group peers.

Men in the CHARM cohort were less likely than controls to report attitudes accepting of intimate partner violence and they were less likely to be sexually violent or coercive with wives. First author, Anita Raj said, "These findings demonstrate that including men in gender equity-focused family planning counseling not only can support better contraceptive communication and use in married couples, it can support prevention of marital sexual violence."

She added, "As the Indian government broadens it basket of contraceptive options and reach, it may benefit from gender equity and male inclusive models of family planning, such as the CHARM program, to better support its family planning goals.

"Co-author Niranjan Saggurti noted, "CHARM is not only a demonstration that men can be effectively engaged in family planning, it also shows that private providers can support the public health family planning system to achieve India's goals to reduce unintended pregnancy at a national scale."The findings are published online in PLOS ONE.