“Change Really Does Need to Start From Home”: Impact of an Intimate Partner Violence Prevention Strategy Among Married Couples in Nepal

McGhee, Susi; Shrestha, Binita; Ferguson, Gemma; Shrestha, Prabin Nanicha; Bergenfeld, Irina; Clark, Cari J.

doi:10.1177/0886260519839422

Cited by 10 publications

(19 citation statements)

References 32 publications

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“…The Change trial did find that frequent LDG attendance was associated with decreases in many types of IPV, some of which persisted to endline. The benefits of the intervention concur with findings from the qualitative LDG cohort which found sustained changes in labor roles, communication, decision-making, alcohol abuse, roaming, conflict resolution, and experience of IPV within the cohort (McGhee et al, ). Study findings also concur with another recently conducted trial in Rwanda involving couples and communities which found couple-related improvements in IPV that went through an intensive, 6 month curriculum but no impact in the community sample in response to activism based activities (Chatterji, Stern, Dunkle, & Heise, 2019 under review).…”

Section: Discussionsupporting

confidence: 75%

“…If the respondent reported either 2 or 3, she was considered to have participated in decisions regarding sexual activity. Decision making regarding financial purchases and sexual decision making were particularly salient themes in mid-intervention qualitative transcripts (McGhee et al, ), so these items were singled out for the endline analysis.…”

Section: Methodsmentioning

confidence: 99%

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Impact of the Change Starts at Home Trial on Women's experience of intimate partner violence in Nepal

Clark

Shrestha

Ferguson

et al. 2020

SSM - Population Health

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Intimate partner violence (IPV) affects 1 in 3 women worldwide. Research in low- and middle-income countries suggests that multicomponent interventions incorporating media, group work, and community mobilization may be effective at changing social norms that enable such violence. Our study aimed to evaluate the impact of a radio programme plus community engagement versus radio programming alone on the 12-month prevalence of IPV. Using a cluster randomized, repeat cross-sectional, single-blinded approach, thirty-six village communities were pair-matched within three districts in Nepal and randomly assigned to either control or intervention. Both groups were exposed to social behaviour change communication through radio programming. In addition, weekly listening and discussion groups (LDGs) were formed in intervention communities to meet and discuss radio programming over the 40-week intervention period. Participants were also exposed to other community mobilization activities such as street theatre and messaging from local leaders who were engaged in intervention programming. IPV was measured at baseline, 12 months post-baseline at program conclusion, and 28 months post-baseline using a simple random sample of 40 married women per cluster (n = approximately 1440 at each time point) along with 382 women who participated in the LDGs. Although control and intervention groups were demographically similar, baseline rates of IPV were higher in control areas. The trend in IPV for both groups was nonlinear, largely declining at midline (control condition) and rising again at endline (control and intervention conditions), possibly reflecting greater reporting due to awareness-raising activities. Significant differences between the two groups were largely absent at endline. Higher LDG attendance was associated with decreases in several forms of IPV, some of which persisted to endline. These findings suggest that intensive community engagement over longer timespans or social network measurement may be necessary to detect significant changes at the community level (NCT02942433).

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Section: Discussionsupporting

confidence: 75%

Section: Methodsmentioning

confidence: 99%

Impact of the Change Starts at Home Trial on Women's experience of intimate partner violence in Nepal

Clark

Shrestha

Ferguson

et al. 2020

SSM - Population Health

Self Cite

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“…This article is also limited from not reporting dyadic analysis findings, which can beneficially identify particular overlaps and contrasts among couples as partners (Eisikovits & Koren, 2011). Dyadic analysis among couples has been conducted in Rwanda (Stern & Heise, 2018) and Nepal (McGhee, Shrestha, Ferguson, Shrestha, & Clark, 2019). The focus of this article was to unpack broader themes reported among couples, and how this compared between Nepal and Rwanda, and dyadic analysis was outside the scope of this article.…”

Section: Discussionmentioning

confidence: 99%

A comparative case study of couples programming to support relationship quality in Nepal and Rwanda

Stern

McGhee

Ferguson

et al. 2019

Journal of Social and Personal Relationships

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Although intimate partner violence (IPV) is the most common form of violence against women, there is limited understanding of best practices to prevent IPV through working directly with couples and supporting quality of relationships. There are valid concerns of safely conducting research and programming with couples. Yet couples programming responds to the fact that many couples may want to stay together but require support and skills to manage violence. This article compares evaluation data of two programs in Nepal and Rwanda that worked with couples to support relationship quality. The Indashyikirwa program in Rwanda implemented a 5-month curriculum with couples to support equitable, nonviolent relationships. Approximately 25% of trained partners of couples were further supported as community activists for an additional 2 years. Change Starts at Home in Nepal implemented a 9-month couples’ curriculum to promote equitable and violence free relationships through fostering mutual respect and understanding, alongside a weekly radio program. The last 3 months of the curriculum focused on community outreach and awareness. This article draws on longitudinal qualitative interviews conducted separately with 28 partners of couples before, immediately after and 1 year following the couples’ curriculum in Rwanda, and with 36 partners of couples before, 6 months into the curriculum, and at the end of the intervention in Nepal. Thematic analysis of couples’ accounts was conducted and compared across the two studies. Despite the different interventions and settings, the cross-comparative analysis suggests similar pathways of change among couples, including enhanced relationship quality and skills as mediators to prevent IPV. This article considers how both programs supported greater communication and conflict resolution skills and a sense of unity and shared power among couples. The findings suggest the value of couples programming within the context of an enabling environment, highly trained facilitators, and strong referral networks.

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“…Relevant sociodemographic variables included: current marital status (non-live-in, live-in partner only, married, widow, divorced) and wealth index (low, average, high). Other covariates of interest were selected according to the literature and their possible relationship with IPV; these included: age [ 20 , 21 , 22 ], partner's alcohol consumption [ 23 , 24 , 25 ], both women's and partner's educational levels [ 26 , 27 , 28 ], number of children (0, 1, 2, >2), family history of violence (the father used to beat the mother) [ 9 , 29 ] and geographical region [ 30 , 31 ] (Lima Metropolitan Area, rest of the coastline, highlands, jungle).…”

Section: Methodsmentioning

confidence: 99%

Intimate partner violence against reproductive-age women and associated factors in Peru: evidence from national surveys, 2015–2017

Burgos-Muñoz

Soriano-Moreno

Bendezú-Quispe

et al. 2021

Heliyon

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We aimed to evaluate the factors associated with intimate partner violence (IPV) against reproductiveage women in Peru. Methods: Secondary analysis of the ENDES 2015-2017. ENDES is a multi-stage survey with a probabilistic sampling design for the urban and rural areas of the 25 regions of Peru. A total of 62,870 women of reproductive age (15-49 years) were included. IPV was defined as any report of violence (physical, psychological or sexual) committed by the last partner of the women. Categorical variables were described using absolute frequencies and weighted proportions. We used generalized linear models with Poisson family and log link function to calculate prevalence ratios (PR) for the associated factors with their respective 95% confidence intervals. Results: The overall IPV was 38.7%. The prevalence of sexual, psychological and physical IPV was 6.9%, 26.8%, and 31.2%, respectively. The frequency of any IPV was lower in younger women, those living with their intimate partners or married, and those living in a coastal region different from Lima. IPV was more frequent among women with a low educational level, or with a partner with low educational level, with children, with a partner with alcohol habit, in women with a history of violence by the father against the mother and living in the highlands or the jungle. Conclusions: In Peru, IPV affects nearly four in ten women (physical and psychological types were the most frequent). The factors associated with IPV can be useful markers to identify the most vulnerable groups for implementing interventions intended to decrease the prevalence of IPV.

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“Change Really Does Need to Start From Home”: Impact of an Intimate Partner Violence Prevention Strategy Among Married Couples in Nepal

Cited by 10 publications

References 32 publications

Impact of the Change Starts at Home Trial on Women's experience of intimate partner violence in Nepal

Impact of the Change Starts at Home Trial on Women's experience of intimate partner violence in Nepal

A comparative case study of couples programming to support relationship quality in Nepal and Rwanda

Intimate partner violence against reproductive-age women and associated factors in Peru: evidence from national surveys, 2015–2017

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