This week I was at a presentation where Prof Jewkes (SVRI Secretary) shared evidence on What Works to Prevent Gender Based Violence. Our knowledge of what works is increasing, but there is very little implementation and scale up of effective prevention interventions. The aim of this presentation was to inform policy-makers and others, about the different forms of GBV, what is prevention, how it differs from response, how to track our prevention efforts and what we know works to prevent GBV, particularly in developing countries. This blog summarises some of the key messages from Prof Jewkes presentation.
Forms of GBV – extending our definition
In terms of GBV, Prof Jewkes highlighted the need for a broader definition of GBV that encompasses intimate partner violence (physical sexual and emotional); non-partner sexual violence as well as child abuse (sexual, physical and emotional). The inclusion of child abuse is a departure from more traditional definitions, but by including it we recognise child abuse as a key driver of later perpetration and victimisation of GBV.
So what is prevention and what is response?
We often conflate prevention and response. Although they are both incredibly important, they are not the same things. Prevention is stopping violence from happening in the first place. But if and when violence does occur, we must ensure the availability of effective and evidence based services to respond and prevent the recurrence of violence. Response programmes target individuals whilst prevention programmes target populations. If we are to get on top of this epidemic, we must include both prevention (population based programmes) and response efforts in our policy and programmes.
How do we track our prevention efforts?
A key indicator to track national level prevention efforts is GBV last year prevalence. This requires the availability of national level figures, which in many countries are not available. Some countries are fortunate to have good national level data from studies like the WHO Multi-country study; as well as National Demographic and Health Survey findings that can provide us with GBV last year prevalence.
One source of data we should not use to monitor prevention efforts is data on clients using services. A very small fraction of survivors ever access services. We have a huge problem of underreporting. In South Africa, a study found that only 1 in 25 rape victims reported their rape to a service or accessed a service. A national GBV prevention campaign may result in more people reporting so we won’t know if the campaign is working to reduce GBV. Also, many studies done on GBV are not done very well – there is a need to build capacity to improve research methods to ensure that the figures we have are based on good research.
What Works to Prevent GBV – what do we know right now?
A number of reviews and studies undertaken over the past few years provide us with good evidence of effective and promising programmes for the prevention of GBV in developing countries. These include:
- women’s economic empowerment & gender transformative interventions e.g IMAGE; Creating Futures and Stepping Stones combined intervention (Gibbs, 2013; Kim et al., 2007)
- workshop based programmes aiming to strengthen relationship skills and build gender equity e.g. Stepping Stones (Wagman et al., 2014)
- group education and community action and outreach e.g. SASA!(Abramsky et al., 2014)
- schools based interventions: in classroom or outside e.g PREPARE (Mathews C. et al., 2015)
- parenting interventions (Cooper et al., 2009)
- gender empowerment and self-defence in rape prevention among women (Senn, Desmarais, Verberg, & Wood, 2000)
There is no clear evidence or the evidence is conflicting on the effectiveness of bystander interventions and single component campaigns (among others).
In terms of responses, legalisation of GBV, protective orders / proactive arrests, shelters, provision of counselling and mental health care, comprehensive rape care and interventions for abused children are all critical and essential, however they do not have the ability to reduce perpetration at a population level.
In sum, economic empowerment and GBV transformative programmes, along with community action programmes and self-defence with gender empowerment for young women are all working to reduce GBV. These programmes must be complemented with quality services and responses for the care and support of survivors.
For the full presentation please click here.
[Picture source: SAMRC].
References
Wagman, J.A., Gray, R.H,. Campbell, J.C., Thoma, M., Ndyanabo, A., Ssekasanvu, J., Nalugoda, F., Kagaayi, J., Nakigozi, G., Serwadda, D., & Brahmbhatt, H. (2015). Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort. Lancet Glob Health. 3(1):e23-33. doi: 10.1016/S2214-109X(14)70344-4.
Abramsky, T., Devries, K., Kiss, L. et al. (2014). Findings from the SASA! Study: a cluster randomized controlled trial to assess the impact of a community mobilization intervention to prevent violence against women and reduce HIV risk in Kampala, Uganda. BMC Med 12, 122. https://doi.org/10.1186/s12916-014-0122-5
Improving quality of mother-infant relationship and infant attachment in socioeconomically deprived community in South Africa: randomised controlled trial. doi:10.1136/bmj.b974
Gibbs, A. (2013). Stepping Stones and Creating Futures intervention: Outcomes of a formative evaluation of behavioural and structural pilot intervention for young people. Paper presented at the SVRI Forum 2013: Evidence into Action, 14 – 17 October 2013, Bangkok, Thailand. http://www.svri.org/forum2013/Presentations/SteppingStones.pdf
Kim, J.C., Watts, C.H., Hargreaves, J.R., Ndhlovu, L.X., Phetla, G., Morison, L.A., Busza, J., Porter, J.D., & Pronyk, P. (2007). Understanding the impact of a microfinance-based intervention on women’s empowerment and the reduction of intimate partner violence in South Africa. Am J Public Health. Oct;97(10):1794-802. doi: 10.2105/AJPH.2006.095521.
Mathews C., Eggers S.M, Townsend L.J, Aarø L.E, de Vries P.J, Mason-Jones A.J, . . . H, D. V. (2015). The effects of the PREPARE school-based HIV and intimate partner violence prevention programme on adolescent sexual risk behaviour and intimate partner violence: Cluster randomized controlled trial. Paper presented at the SVRI Forum 2015, South Africa. http://www.svri.org/forum2015/presentations/PREPARE.pdf
Senn, C. Y., Desmarais, S., Verberg, N., & Wood, E. (2000). Predicting Coercive Sexual Behavior Across the Lifespan in a Random Sample of Canadian Men. Journal of Social and Personal Relationships, 17(1), 95–113. https://doi.org/10.1177/0265407500171005
Written by Elizabeth Dartnall, Sexual Violence Research Initiative
