Increasing global capacity to address reproductive coercion: Adapting the ARCHES evidence-based clinical model from the United States to low- and middle-income country settings

Publication Date


Document Type


Publication Title

Annual Public Health Association (APHA) 2018 Annual Meeting & Expo

Conference Location

San Diego, CA


Background: Reproductive coercion (RC) refers to a set of specific behaviors, most often perpetrated by male partners, to control women's fertility and interfere with contraceptive use. RC is associated with intimate partner violence (IPV) and contributes to negative reproductive health outcomes such as unintended pregnancy and unsafe abortion. However, few evidence-based interventions exist that address RC and IPV in low and middle-income country (LMIC) contexts. Addressing Reproductive Coercion in HEalth Settings (ARCHES) is a brief clinical intervention designed to provide education, targeted-support, and empowerment to women facing RC or IPV. In two U.S. NIH-funded randomized controlled trials, a single exposure to ARCHES significantly reduced pregnancy coercion and increased women's self-efficacy to use contraceptives despite partner opposition. Adaptation: The UCSD Center on Gender Equity and Health, in collaboration with Population Council, International Planned Parenthood Federation, and local health organizations, has adapted the ARCHES intervention for use by family planning providers in Kenya. The multi-step adaptation process funded by USAID included conducting interviews and focus group discussions with family planning clients and providers at community-based clinics in Nairobi, and creating a provider toolkit for implementing ARCHES in LMIC settings. Purpose: This session will share insights from the formative research used to adapt ARCHES to LMIC country contexts, and will introduce the new ARCHES toolkit currently being pilot-tested in Kenya. These adaptations will inform ongoing efforts to adapt ARCHES for use in other high-need environments, building local capacity to address RC and IPV in global health settings.


Reproductive Health, Domestic Violence


Social Work