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Open Access Study protocol

Minimizing risks and monitoring safety of an antenatal care intervention to mitigate domestic violence among young Indian women: The Dil Mil trial

Suneeta Krishnan12*, Kalyani Subbiah1, Prabha Chandra3 and Krishnamachari Srinivasan2

Author Affiliations

1 Women’s Global Health Imperative, RTI International, 114 Sansome Street, Suite 500, San Francisco, CA, 94104, USA

2 St. John’s Research Institute, St. John’s National Academy of Health Sciences, Koramangala, Bangalore, 560034, India

3 National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore, 560029, India

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BMC Public Health 2012, 12:943  doi:10.1186/1471-2458-12-943

Published: 1 November 2012

Abstract

Background

Domestic violence - physical, psychological, or sexual abuse perpetrated against women by one or more family members – is highly prevalent in India. However, relatively little research has been conducted on interventions with the potential to mitigate domestic violence and its adverse health consequences, and few resources exist to guide safety planning and monitoring in the context of intervention research. Dil Mil is a promising women’s empowerment-based intervention developed in India that engages with young women (daughters-in-law) and their mothers-in-law to mitigate domestic violence and related adverse health outcomes. This paper describes the design of a randomized controlled trial of Dil Mil in Bengaluru, India, with a focus on strategies used to minimize study-related risks and monitor safety.

Methods/design

A phase 2 randomized controlled trial using a parallel comparison of the Dil Mil intervention versus standard care will be implemented in three public primary health centers in Bengaluru. Young pregnant women in the first or second trimester of pregnancy will be recruited from antenatal services at study health centers and through community outreach. If eligible and willing, their mother-in-law will also be recruited. Once enrolled, dyads will participate in a baseline interview and then randomized either to the control arm and receive standard care or to the intervention arm and receive standard care plus the Dil Mil intervention. Additional evaluations will be conducted at 3 months and 6 months postpartum. Data will be analyzed to examine the feasibility and safety of the intervention and the effect of the intervention on intermediary outcomes (the empowerment of daughters-in-law and mothers-in-law), incidence of domestic violence among daughters-in-law, and health outcomes including perceived quality of life, psychosocial status and maternal and infant health outcomes.

Discussion

This study offers approaches that may help guide safety planning and monitoring in other domestic violence intervention trials in similar settings. Moreover, given the staggeringly high prevalence of domestic violence against young women in India (and indeed globally) and the dearth of data on effective interventions, this study is poised to make an important contribution to the evidence-base for domestic violence prevention.

Trial registration

ClinicalTrials.gov Identifier: NCT01337778

Keywords:
Domestic violence; Women’s empowerment; Randomized controlled trial; India