Introduction Samvedana Plus is a multilevel intervention working with sex workers, their intimate partners (IPs) and communities to reduce intimate partner violence (IPV) and to increase condom use within intimate relationships of sex workers in Northern Karnataka, India.
Methods A cluster randomised controlled trial in 47 villages. Female sex workers with IPs in the last 6 months were eligible for baseline (2014), midline (2016) and endline (2017) surveys. 24 villages were randomised to Samvedana Plus and 23 to a wait-list control. Primary outcomes among sex workers included experience of physical and/or sexual IPV or severe physical/sexual IPV in the last 6 months and consistent condom use with their IP in past 30 days. Analyses adjusted for clustering and baseline cluster-level means of outcomes.
Result Baseline (n=620) imbalance was observed with respect to age (33.9 vs 35.2) and IPV (31.4% vs 45.0%). No differences in physical/sexual IPV (8.1% vs 9.0%), severe physical/sexual IPV (6.9% vs 8.7%) or consistent condom use with IPs (62.5% vs 57.3%) were observed by trial arm at end line (n=547). Samvedana Plus was associated with decreased acceptance of IPV (adjusted OR (AOR)=0.62, 95% CI 0.40 to 0.94, p=0.025), increased awareness of self-protection strategies (AOR=1.73, 95% CI=1.04–2.89, p=0.035) and solidarity of sex workers around issues of IPV (AOR=1.69, 95% CI=1.02–2.82, p=0.042). We observed an increase in IPV between baseline (25.9%) and midline (63.5%) among women in Samvedana Plus villages but lower in comparison villages (41.8%–44.3%) and a sharp decrease at end line in both arms (~8%).
Conclusion We found no evidence that Samvedana Plus reduced IPV or increased condom use, but it may impact acceptance of IPV, increase knowledge of self-protection strategies and increase sex worker solidarity. Inconsistencies in reported IPV undermined the ability of the trial to assess effectiveness.
Men whose sexual behaviors place them at risk of HIV often exhibit a “cluster” of behaviors, including alcohol misuse and violence against women. Called the “Substance Abuse, Violence and AIDS (SAVA) syndemic,” this intersecting set of issues is poorly understood among heterosexual men in sub-Saharan Africa. We aim to determine cross-sectional associations between men's use of alcohol, violence, and HIV risk behaviors using a gendered syndemics lens. We conducted a baseline survey with men in an informal, peri-urban settlement near Johannesburg (Jan–Aug 2016). Audio-assisted, self-completed questionnaires measured an index of risky sex (inconsistent condom use, multiple partnerships, transactional sex), recent violence against women (Multicountry Study instrument), alcohol misuse (Alcohol Use Disorders Tool), and gender attitudes (Gender Equitable Men's Scale). We used logistic regression to test for syndemic interaction on multiplicative and additive scales and structural equation modeling to test assumptions around serially causal epidemics. Of 2454 men, 91.8% reported one or more types of risky sex. A majority of participants reported one or more SAVA conditions (1783, 71.6%). After controlling for socio-demographics, higher scores on the risky sex index were independently predicted by men's recent violence use, problem drinking, and inequitable gender views. Those men reporting all three SAVA conditions had more than 12-fold greater odds of risky sex compared to counterparts reporting no syndemic conditions. Each two-way interaction of alcohol use, gender inequitable views, and IPV perpetration was associated with a relative increase in risky sex on either a multiplicative or additive scale. A structural equation model illustrated that gender norms predict violence, which in turn predict alcohol misuse, increasing both IPV perpetration and risky sex. These data are consistent with a syndemic model of HIV risk among heterosexual men. Targeting intersections between syndemic conditions may help prevent HIV among heterosexual men in peri-urban African settings.
This paper explores the relationship between changes in individual beliefs and behaviours, couple relationship dynamics and gender norms – and how interventions can influence these. It draws on longitudinal qualitative research with heterosexual couples who participated in the Indashyikirwa programme in Rwanda. The couples followed a curriculum designed to improve relationship skills and reduce the gender-inequitable beliefs, behaviours and norms that underpin intimate partner violence. Qualitative findings show that the programme resulted in moderate, but significant, positive ‘shifts’ in individual beliefs and behaviours, couple relationship dynamics and levels of inequality - increasing men’s engagement in domestic duties, women’s participation in household decision making, and women’s access to economic resources. They also suggest which parts of the couples’ curriculum were most effective in catalysing these changes. However, the data also show that these ‘shifts’ occurred without fully transforming deeply-entrenched beliefs and norms around gender roles and male authority over economic resources. The paper suggests that the persistence of these beliefs and norms constrained the extent of changes among couples – and could potentially constrain their longevity and act as an obstacle to longer-term, larger-scale changes in gender inequalities and violence.
Violence against women and girls (VAWG) is driven in part by gender attitudes, norms on gender inequality and the acceptability of violence, which are socially reproduced and shared. Women’s rights organizations across the global south have dedicated themselves to challenging these. Early evaluations of work they have championed has shown that sufficiently equipped community volunteers, guided in a long-term structured programme, can enable widespread diffusion of new ideas on gender and VAWG and ultimately achieve changes in harmful attitudes and norms across communities.
DFID’s What Works to Prevent Violence against Women and Girls Global Programme (What Works) has generated new evidence on the effect of these interventions in a range of settings – from rural areas and small towns of the Eastern Democratic Republic of the Congo (DRC), Ghana, Rwanda, Nepal, to urban informal settlements in South Africa. Rigorous evaluations have shown the potential for preventing VAWG through multi-year, intensive change interventions with welltrained and supported community action teams, that purposefully engage both women and men to effect change.
Violence against women and girls (VAWG) is an important human rights concern and a pervasive issue affecting women and girls during times of conflict and humanitarian crisis. In 2016, the What Works to Prevent VAWG programme published an evidence brief [GF1] summarising the existing evidence base on VAWG in these settings. While the brief demonstrated that there is very limited evidence on what works to prevent and respond to VAWG in conflict and humanitarian settings, it did highlight key areas of learning and specify what information gaps remain.
Since the publication of the 2016 What Works evidence brief, researchers and practitioners have continued to conduct research and expand the international community’s knowledge base around VAWG and the effectiveness of programmes that seek to prevent and respond to this violence. These efforts include new results from eight research studies conducted by members of the What Works consortium in various conflict-affected and humanitarian settings. This new brief synthesises the key results of these What Works studies as well as other key findings from contemporaneous research efforts published since 2015. It aims to provide an up-to-date resource for practitioners, policymakers and researchers on the state of evidence on VAWG in conflict and humanitarian settings.
By Aisling Swaine, Michelle Spearing, Maureen Murphy, Manuel Contreras-Urbina
Published 12 May 2019
This article makes three major contributions to guide researchers and policymakers in addressing VAWG in post-conflict contexts. First, it identifies critical gaps in understanding the intersection between VAWG and post-conflict statebuilding and peacebuilding processes. Second, it presents an ecological model to explore the drivers of VAWG during and after armed conflict. Third, it proposes a conceptual framework for analysing and addressing the intersections of VAWG with both post-conflict statebuilding and peacebuilding. The article concludes that application of this framework can help policymakers shape statebuilding and peacebuilding processes to more effectively institutionalise approaches to VAWG so that post-conflict transitions advance sustainable, positive peace.
By Maureen Murphy, Jeffrey B. Bingenheimer, Junior Ovince, Mary Ellsberg, Manuel Contreras-Urbina
Published 14 May 2019
Based on secondary analysis of a larger study on VAWG in South Sudan, this article highlights the specific experience of conflict-affected adolescent girls resident in the Juba Protection of Civilian sites. Quantitative data from a cross-sectional household survey shows that the prevalence of non-partner sexual violence (NPSV) and intimate partner violence (IPV) was high among a cohort of girls who were of adolescent age during the 2013 crisis. Direct exposure to armed conflict increased the odds of respondents experiencing NPSV and IPV. Quantitative and qualitative data also showed that patriarchal practices, compounded by poverty and unequal power relationships within the home, remain some of the primary drivers of VAWG even in conflict-affected settings.
By Alexandra Blackwell, Jean Casey, Rahmah Habeeb, Jeannie Annan, and Kathryn Falb
Published 28 June 2019
The International Rescue Committee conducted an evaluation of a cash programme in Raqqa Governorate, Syria. The aim was to examine the effect of a cash for basic needs programme on outcomes of violence against women, and women’s empowerment. This article draws on qualitative data from interviews with 40 women at the end of the cash programme. It offers evidence of potential increased tension and abuse within both the community and the household for some women whose families received cash, as well as potential increased social protection through repayment of debts and economic independence for others. Both negative and positive effects could be seen. While the objective of the cash programme was not to influence underlying power dynamics, this research shows it is necessary to integrate gender-sensitive approaches into programme design and monitoring to reduce risk to women of diverse identities.
Adolescence is a crucial and defining stage in a girl’s life. However, girls around the world too often face unique risks of gender discrimination and gender-based violence (GBV), including sexual violence, human trafficking, forced marriage and sexual exploitation and abuse. This is particularly the case in humanitarian settings, where girls’ already-limited access to vital services and family and peer support networks are disrupted by crises and displacement. Despite this, humanitarian programmes and policies do not adequately address adolescent girls’ needs. Caught between childhood and adulthood, these girls are often not able or willing to access services designed for adult women or young girls.
This study examines the unique experience of adolescent girls by exploring the types of GBV and drivers of violence within the context of South Sudan, where women and girls experience high levels of gender inequality and subordination. Data was collected under the What Works programme, and secondary analysis of this data set focusing on the experiences of violence against adolescent girls was supported by the Gender and Adolescence: Global Evidence consortium. Key findings can inform policymakers and donors as they support programs that will effectively prevent and respond to violence against adolescent girls in conflict and humanitarian settings.
Developed with support from the US Department of State Bureau of Population, Refugees and Migration and the UK Department for International Development as part of the What Works programme, this manual aims to support researchers and members of the humanitarian community in conducting ethical and technically sound research, monitoring and/or evaluation on gender-based violence within refugee and conflict-affected populations.
Mixed-methods evaluation of intervention to prevent violence against women in Tajikistan
The Zindagii Shoista (Living with Dignity) project was implemented by International Alert, Cesvi and three local partners – ATO, Farodis and Zanoni Sharq – in four villages in Tajikistan with 80 families.
It aimed to reduce violence against women and girls (VAWG) through a combination of gender norm, behavioural change and income-generating activities (IGA) over a period of 15 months.
Violence against women and girls (VAWG) is common across the socioeconomic spectrum; a third of women experience violence from a partner in their lifetime. Poverty and VAWG are mutually reinforcing: poverty increases the risk of experiencing violence; VAWG increases poverty.
New evidence from four projects rigorously evaluated through DFID’s What Works to Prevent Violence against Women and Girls Global Programme (What Works) demonstrates that combining economic empowerment and gender-transformative interventions for women and families can reduce intimate partner violence and strengthen the economic position of individuals and families.
An innovative programme to reduce partner violence in rural Rwanda
Intimate partner violence (IPV), which includes physical and sexual violence, economic abuse and emotional aggression within intimate relationships, is the most common form of violence against women globally. IPV can lead to a wide range of negative health consequences including depression, suicide risk, post-traumatic stress disorder, drug and alcohol abuse, serious injuries, and death . IPV can also constrain women’s capacity to find employment, lead to higher levels of absenteeism and job turnover, lower earning capacity, and more limited occupational mobility . The Indashyikirwa programme in Rwanda sought to reduce experience of IPV among women and perpetration among men, and shift beliefs and social norms that drive IPV among couples and in communities. The programme also aimed to foster more equitable, non-violent relationships, and to ensure more supportive responses to survivors of IPV.
Corboz, J., Siddiq, W., Hemat, O., Chirwa, E. D., & Jewkes, R. (2019). What works to prevent violence against children in Afghanistan? Findings of an interrupted time series evaluation of a school-based peace education and community social norms change intervention in Afghanistan. PLoS one, 14(8), e0220614.
Violence against women and girls (VAWG) is a widely recognised human rights violation with serious consequences for the health and well-being of women, with ramifications for households, businesses, communities and society overall. Even though violence against women is widely accepted as a fundamental human right and public health issue, its wider impact on development is being recognised only recently. There are only few studies that estimate the costs of VAWG.
It is well established that violence against women and girls (VAWG) is a human rights violation and public health issue. Worldwide, one in three women report experiencing some form of physical and/or sexual violence, predominantly perpetrated by a partner or ex-partner, over their lifetime (WHO 2013). More recently, there is a growing recognition of the wider economic and social costs of VAWG for individuals, the community, businesses, society and the economy.
Violence against women and girls (VAWG) is a widely recognised human rights violation with serious consequences for the health and well-being of women and their families. However, the wider ramifications of violence against women for businesses, communities, economies and societies are only recently being recognised. Despite this recognition, there are few studies exploring how economic and social impacts of VAWG affect economic growth, development and social stability. In this paper, applying the social accounting approach, we outline the ripple effects of VAWG from the individual micro-level impacts to the macroeconomy.
Stern, E., & Mirembe, J. (2017). Intersectionalities of formality of marital status and women’s risk and protective factors for intimate partner violence in Rwanda. Agenda, 31(1), 116-127.
Findings from DRC project on Preventing Violence Against Women and Girls
The primary audience for this document is policymakers. Programme implementers working on preventing and responding to violence against women will also find it useful for designing, planning, implementing, and monitoring and evaluating innterventions and programmes.
Gibbs, A., Jewkes, R., Willan, S., Al Mamun, M., Parvin, K., Yu, M., & Naved, R. (2019). Workplace violence in Bangladesh's garment industry. Social Science & Medicine, 112383