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Testing the ARCHES intervention to improve reproductive health among abortion clients experiencing intimate partner violence and reproductive coercion in Bangladesh

Erin Pearson, Harvard T.H. Chan School of Public Health

Project abstract

Reproductive coercion and partner violence are associated with unwanted pregnancy and abortion globally. In Bangladesh, women reporting partner violence are more likely to access abortion outside the health system and less likely to access post-abortion contraception, especially if accompanied to the clinic by their partner, which suggests additional intervention is needed to support clients’ reproductive autonomy and ultimately their ability to safely control their fertility.

ARCHES (Addressing Reproductive Coercion in HEalth Settings) is a clinic-based harm reduction intervention that empowers women to implement strategies that mitigate the impact of reproductive coercion on their reproductive health. ARCHES has been shown to reduce reproductive coercion among family planning clients in the U.S., but it has not previously been used in Asia or specifically with abortion clients.

Ipas, an international NGO working on prevention of unsafe abortion, is funding adaptation of ARCHES for use with abortion clients in low and middle income countries, and a feasibility study in Bangladesh to assess safety and intermediate outcomes of the adapted intervention (Phase I). This proposal seeks funding for Phase II of this project to conduct a cluster randomized controlled trial to test the impact of the adapted intervention.

Overall, this study is expected to result in 1) evidence of the effectiveness of the adapted ARCHES intervention in increasing contraceptive use and reducing reproductive coercion, and ultimately in reducing the risk for future unintended pregnancy and unsafe abortion, and 2) evidence on the elements required for successful implementation in high volume public sector abortion clinics.


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