A Community Health Volunteer facilitating a Men Group PM+ session (Photo: Jacinta Sila, World Vision Kenya)
SVRI World Bank Group Development Marketplace #16Days 2017 Blog Series
Written by Phiona Naserian Koyiet, World Vision Kenya
Globally an average of 119 women are killed every day by an intimate partner or family member. This translates to one woman killed every 12 minutes. Statistics indicate that Kenya has some of the highest rates of violence against women in the world. One in three Kenyan women experience sexual violence before the age of 18. Whilst almost half of all Kenyan women have experienced abuse from an intimate partner in their lifetime. Violence against women continues to be a major problem in Kenya.
Understanding men’s use of violence against women
In 2016, World Vision facilitated a rapid ethnographic assessment with men in urban Kenya. The study found linkages between significant stressors in the men’s lives and their perpetration of violence against their intimate partners. Significant stressors included unemployment, divorce, separation, unequal power relations, emotional abuse, physical/sexual violence, poverty, financial difficulties, and weak community sanctions. In response, many of the men reported unhelpful coping strategies such as excessive alcohol and substance use, which further exacerbated the violence perpetrated against women by men in their homes.
Men reported perceived sexual infidelity or transgressing gender norms as justification for beating and assaulting their intimate partners. Extended families, while sometimes supportive, more often encouraged women not to report the violence to protect the family image. The broader community also viewed intimate partner violence as normative and intractable - something about which little can be done. These findings resonate with global IPV research showing that factors beyond the individual - gender roles in intimate relationships, family dynamics and community norms - shape high rates of violence (KNBS 2010).
A Group PM+ session with male participants (Photo: Vane Nyamweya)
Based on these findings, World Vision is using the SVRI World Bank Development Marketplace Award funding to undertake a feasibility and acceptability study to adapt the evidence-based Problem Management Plus (PM+; WHO, 2016) intervention for use with men. PM+ is a brief cognitive and behavioural treatment program delivered by lay people (Community Health Volunteers) to support individuals with common mental health problems, including depression, anxiety and significant stress. World Vision Kenya is adapting PM+ for men, with a stronger emphasis on managing men’s harmful alcohol use. The group-based program will reach 320 men experiencing common mental health problems. In addition to Group PM+, the project will deliver community messages on IPV to see what, if any, additive benefits community messaging yields for reducing IPV in the wider community.
Measures of men’s perpetration (and experiences) of violence, as well as alcohol and substance use behaviours and symptoms of mental health problems (such as depression, anxiety and stress) will be assessed before and after the 6 week Group PM+ intervention; and again at 3 months post treatment. Wider community measures to assess incidences of IPV will also be evaluated, along with qualitative assessments of all those involved in the project, including some female partners of the men receiving PM+ treatment.
World Vision Clinical Supervisors facilitate a Community Health Volunteers supervision session
(Photo: Jacinta Sila, World Vision Kenya)
Why is this study important?
This study will help answer the question: If we support men with common mental health problems, particularly those linked with harmful alcohol and substance use, will their use of violence against their intimate partner be reduced?
In so doing, we hope this study will pave the way for further research that sensitively engages both male perpetrators and female survivors of violence and result in transformative long-term change.
Phiona Naserian Koyiet, World Vision Kenya National Coordinator Gender and Disability