Integrating gender-based violence first-line response into family planning and antenatal care services: an assessment of feasibility, appropriateness and acceptability to healthcare providers in Sokoto and Ebonyi States, Nigeria

Chioma Oduenyi; Sylverius Obafemi; Myra Betron; Emily Bryce; Nneka Chijioke-Dikeocha

doi:10.1186/s12913-025-13739-w

Integrating gender-based violence first-line response into family planning and antenatal care services: an assessment of feasibility, appropriateness and acceptability to healthcare providers in Sokoto and Ebonyi States, Nigeria

Chioma Oduenyi, Sylverius Obafemi, Myra Betron, Emily Bryce, Nneka Chijioke-Dikeocha, Emeka Ifemenam, Adamu Maiakwai, Samaila Yusuf, Bello Kabir, Emeka Sampson, Hadiza Yaro, Gertrude Odezugo, Oniyire Adetiloye, Chioma Oduenyi, Sylverius Obafemi...

BioMed Central (2025) • Volume 25, Issue 1, Pages 1500-1500

Empirical-ClinicalObservational-CohortPDF AvailableGrade Eligible⚠️ Moderate Risk Flags

Overall Assessment

Limited Methodological Quality

Assessment created by PaperScores Medical AI v0 on Dec 14, 2025

D

45/100

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Quality Dimensions

Bias & Integrity

COI handling, outcome switching, selective reporting

C60

Methods Rigour

Protocol clarity, sampling, controls

D48

External Validity

Generalisability, setting, population

C-55

Transparency & Reproducibility

Data/code/materials availability, preregistration

F20

Significance & Novelty

Contribution vs prior art; context if known

C60

Statistical Validity

Models, assumptions, multiplicity, CI priority

D-35

Integrity & Transparency

Integrity checks

P-hacking risk?

?

None suspected

Signs of selective hypothesis testing or analysis choices that could inflate false positive rates.

Outcome switching?

?

Review recommended

Evidence that primary outcomes were changed during or after the study, potentially distorting results.

Conflict of interest?

?

None suspected

Authors have financial or other relationships that could bias research findings.

Data integrity issues?

?

None suspected

Concerns about the accuracy, completeness, or authenticity of the reported data.

Open science signals

Research data

?

Upon request

Raw data used in the analyses is publicly available or accessible upon request.

Analysis code

?

Not shared

Code or scripts used to analyze the data are shared for reproducibility.

Study materials

?

Restricted

Protocols, questionnaires, and other materials are publicly available.

Premise

Primary Research Question

Is integrating GBV first-line response (LIVES+ARCHES) into ANC/FP services feasible, appropriate and acceptable to providers in two Nigerian states?

Hypothesis is Falsifiable

✓Yes

Measured predefined implementation outcomes with repeated surveys/QA.

PICO Framework

Population✓Yes

Nurses-midwives and CHEWs at 20 facilities; 75 trained; 57 analysed.

Intervention✓Yes

LIVES+ARCHES training, job aids, supervision; routine screening and counselling.

Comparison—Not specified

No comparator arm; before–after within sites only.

Outcome✓Yes

Feasibility, appropriateness, acceptability via pulse surveys; facility QA.

Literature Positioning

Literature Review Balanced

Well covered

Background cites WHO guidance and multiple LMIC/HIC studies.

Evidence: pp. 3–5; refs 12, 19–24

Research Gap Clearly Stated

Well covered

Notes paucity of feasibility/acceptability evidence in LMIC clinics.

Evidence: p. 4

Stated Contribution Clear

Well covered

Assesses feasibility, appropriateness, acceptability of LIVES+ARCHES integration.

Evidence: Abstract p.1; Methods p.5

Study Provenance

Peer reviewed venueGrant funding disclosedNo conflicts declared4 affiliations listed

Authors & Affiliations

Jhpiego/Johns Hopkins (Nigeria, USA), Ebonyi & Sokoto State MoH, USAID-Nigeria.

Funding Statement

USAID grant #7200AA20CA00002; funder had no role.

Conflicts of Interest

Authors declare no competing interests.

Peer Review

✓BMC Health Services Research; Received 1 Apr 2025; Accepted 5 Nov 2025; Published 20 Nov 2025.

Evidence: p. 16–17

Methodological Assessment

Observational StudySTROBEObservational

9 applicable checklist items.

Yes 4 · No 4 · Unclear 1

Study Design & Definitions

✓

Participant Selection Described

Selection described: 20 facilities; 75 trained; 57 implemented/analysed.

Evidence: Results p.8

✓

Variable Definitions Clear

Implementation outcomes defined; Likert 1–4; validated/adapted tools.

Evidence: Table 2 p.7; Methods p.6

✗

Confounding Addressed

No control arm; no covariate adjustment beyond paired t-tests.

Evidence: Analysis p.8

✓

Temporality Established

Repeated measures at months 1, 3, and 9; baseline QA vs 9-month.

Evidence: Table 3 p.9; Table 4 p.10

✓

Exposure Definition Anchored

Exposure (LIVES+ARCHES) components, duration, and supervision detailed.

Evidence: Intervention p.5–6

Bias Mitigation

✗

Selection Bias Addressed

Convenience sampling; transfers/absence; attrition not handled.

Evidence: Results p.8

?

Misclassification Assessed

Tools adapted from validated sources; no misclassification assessment.

Evidence: Methods p.6–7

✗

Time-varying Confounding Handled

No modelling of time-varying confounders.

Robustness

✗

Model Diagnostics Reported

No model diagnostics or assumption checks reported.

Evidence: Analysis p.8

Modules without applicable checklist items (8)

These designs were fully marked as not applicable but remain available for reference.

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Study Overview

Study Design

Observational Cohort

Primary classification used to evaluate this research.

Population

Healthcare providers in ANC/FP clinics across 20 public facilities in Ebonyi and Sokoto States, Nigeria.

Brief summary of who or what was studied.

Sample Size

57

Number of participants included in the study analyses.

Pre-registration

Not registered

Indicates whether the protocol or trial was registered before data collection.

Randomisation

None reported

How participants were allocated to groups: None (no randomisation), Simple (random order), Blocked (groups balanced in blocks), Stratified (balanced within subgroups), Adaptive (allocation adjusted based on previous enrollments).

Blinding

None

Who was unaware of group assignments: None (everyone knew), Single blind (participants didn't know their group), Double blind (participants and researchers didn't know), Triple blind (also outcome assessors didn't know).

Analysis Set

Other

Which participants were included in analysis: ITT (all randomized, regardless of adherence), mITT (modified ITT, excluding some for valid reasons), Per protocol (only those who completed as planned), As treated (grouped by actual treatment received), Other (alternative approach).

Follow-up

9 months (provider pulse at months 1, 3, 9; QA at baseline, 3, 9)

Duration of observation or follow-up for outcomes.

Loss to Follow-up

24%

Percentage of participants who did not complete follow-up.

Primary Outcome

Primary outcome was pre-specified in the protocol or registry.

Reviewer Notes

Mixed-methods before–after cohort of providers; repeated measures and facility QA; no comparison arm.

Publication Details

DOI

10.1186/s12913-025-13739-w

Published

November 20, 2025

Citations

0 citations

External Resources

DOI Link OpenAlex

Disclaimer: This assessment is generated by AI and should not be the sole basis for clinical or research decisions. Always review the original paper and consult with domain experts.

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