Centre for Gender Violence and Health, London School of Hygiene and Tropical Medicine
This document reviews the empirical evidence of what works in low- and middle-income countries to prevent violence against women (VAW) by their husbands and other male partners. Its purpose is to help inform the future direction of the United Kingdom (UK)'s Department for International Development (DFID) programming on VAW, with an eye towards maximising its impact and ensuring the best use of scarce resources. The review concentrates on summarising, first, evidence that establishes the link between key factors and risk of partner violence, and second, what is known about the effectiveness of interventions to either reduce partner violence directly or indirectly by influencing these factors.
The report is grounded in a conceptual understanding of violence known as the ecological model of abuse, which posits that there is no single factor that "causes" partner violence. For example, the ecology includes messages and norms that friends, family members, and social institutions reinforce as appropriate behaviour for men and women, including the acceptability of violence within different contexts. These norms and expectations are in turn shaped by structural factors, such as religious institutions and ideology, as well as the distribution of economic power between men and women, which work to define beliefs and norms about violence and structure women's options for escaping violent relationships.
The bulk of the report consists of 6 substantive thematic chapters, each of which reviews the theoretical and empirical evidence linking the particular factor to partner violence and summarises what is known about the effectiveness of interventions at either the individual or the population level. For example, Chapter 2 focuses on changing social norms and behaviour because, as data included here show, "[t]here is evidence to suggest that efforts to the change rules or expectations governing behaviour can have a positive effect on reducing levels of physical and sexual violence." Among the strategies to shift norms, attitudes, and beliefs related to gender, the 2 that have been most rigorously evaluated are: 1) small group, participatory workshops designed to challenge existing beliefs, build pro-social skills, promote reflection and debate, and encourage collective action; and 2) larger-scale "edutainment" or campaign efforts coupled with efforts to reinforce media messages through street theatre, discussion groups, cultivation of "change agents", and print materials.
Many initiatives and evaluation data are described in this chapter of the report, but - to cite only one area of concentration, the chapter notes that the creative use of media and/or entertainment culture together with strategies to encourage dialogue and reinforce social change messages at a community level have been effectively carried out by groups such as:
- Soul City Institute for Health and Development in South Africa (now working regionally) - Series 4 of its edutainment television/radio programme focused on partner violence. It promoted new injunctive norms against abuse by portraying neighbours disapproving of the violence and modelled a new behavioural response by depicting neighbours banging on pots and pans to communicate their disapproval and disrupt the violence. An evaluation found "a consistent association between exposure to Soul City and both support-seeking (e.g. calling the helpline or writing down the number) and support-giving (e.g. did something concrete to stop domestic violence during the evaluation period). Eight months after being established, 41 percent of respondents nationally had heard of the helpline. Media coverage increased. Anecdotal reports indicated that at least some communities adopted the pot-banging strategy modelled in the series. Positive shifts were documented in knowledge, while impact on norms and attitudes related to domestic violence were mixed."
- Puntos de Encuentro in Nicaragua - From 2002 to 2005, this feminist non-governmental organisation (NGO) implemented Somos Diferentes, Somos Iguales (SDSI), which involved: a national "social soap" television series; a nightly youth talk call-in radio show; development and distribution of materials for use by local groups; and various community-based activities. "In both longitudinal and cross-sectional analysis, 'greater exposure' to SDSI was significantly associated with changes in a series of indicators related to the campaign. For example, participants with greater exposure to SDSI demonstrated a...33% greater probability of knowing a centre that provides attention for cases of domestic violence..."
- Breakthrough, an Indian women's rights organisation - The "Bell Bajao" (which means "ring the bell" in Hindi) campaign uses the twin strategy of multimedia (television, print, radio, internet, and a video van) with grassroots community mobilisation (trainings and workshops) to shift norms and behaviours around domestic violence and women living with HIV. The mass media component includes multiple television spots designed to model creative ways to "interrupt" incidents of abuse without having to directly confront the abuser. Surveys found, for example, that knowledge of the Protection of Women from Domestic Violence Act increased from 3.3% at baseline to 14.8% at endline, with significantly higher recognition among individuals from communities that received both campaign components (21.2% media + mobilisation; 8.3% media only). Endline respondents could also describe much more about women's rights under the law, including a woman's right to remain in her home if she takes legal action (25% baseline; 60% endline).
Chapter 7 assesses the evidence base itself. How adequate are current studies for making judgements about future investments? What limitations prevent us from being able to draw firm conclusions about effectiveness? What evaluation gaps should be prioritised in the next generation of research? The report concludes with a series of reflections on the way forward, including strategies to strengthen the existing evidence base, such as the following communication-related strategies:
- The creation of various "learning laboratories" where researchers, practitioners, and governments can work together to refine, pilot, and evaluate various intervention strategies into what approaches might work best to address partner violence and other forms of gender-based abuse. "The goal here would not be pristine impact studies, but learning and course corrections in real time, deriving lessons on impact and process along the way. Learning sites could be linked through a knowledge-sharing network. Common measures and methodologies could be adapted to make findings comparable across settings."
- Greater cross-fertilisation among communities such as domestic violence researchers and practitioners, academics from different disciplinary perspectives, and individuals working in related areas (e.g., child maltreatment, partner violence, youth violence and delinquency, and harmful traditional practices such as female genital cutting).
STRIVE website, May 22 2013; and email from Lori L. Heise to The Communication Initiative on June 21 2013.