Change Starts at Home: Baseline report of a trial to prevent intimate partner violence among married couples in Nepal

Abstract

<p>Husband-perpetrated intimate partner violence (IPV) against wives is highly prevalent in rural Nepal. Social inequities experienced by women and girls, compounded by norms characterized by male dominance increase risk of IPV. To address this problem, the Change Starts at Home Project employs a social behavior change communication strategy (SBCC) to shift behavior and norms related to IPV in 36 Village Development Committees in three districts (Chitwan, Kapilvastu, Nawalparasi) in Nepal. The project is being evaluated with a cluster randomized trial (NCT02942433). Data for the manuscript come from baseline surveys of reproductive-aged women randomly selected from the intervention and control communities (N=1440) and female intervention enrollees (N=360). Descriptive statistics were used to identify differences across and within intervention arms and among intervention enrollees and randomly selected participants from the same communities. A total of 1982 individuals were assessed for eligibility resulting in a response rate of 72.65%. The cooperation rate was 84.16%. Results indicate broad sociodemographic similarities on most variables, although a higher percentage of intervention participants were unemployed and a lower percentage had love marriages compared to both study conditions. A smaller percentage of women in the intervention communities reported physical and / or sexual IPV in the prior 12 months (23.89%) than control communities (31.81%) or intervention participants (15.00%). Participants reported favorably to questions inquiring about whether their rights as participants were upheld, however, a minority felt they could discontinue at any time suggesting the need for greater consideration of this aspect of participation in subsequent data collection.</p>

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

“…LDG participants, comprising the frame within which the interview sample was derived, were purposively selected based on geographic location and willingness to commit and therefore may not be representative of Nepali couples who live further away or were unable or unwilling to commit to weekly sessions. Prior baseline analyses found that the group members were comparable to the randomly selected survey respondents on most sociodemographic characteristics, but more group members were unemployed and fewer had love marriages (Clark et al, 2019). Furthermore, more group members reported contributing to decisions regarding sexual behavior and fewer reported abuse by their spouses (22% reported emotional abuse and 15% reported physical and/or sexual abuse at baseline; Clark et al, 2019).…”

“…Prior baseline analyses found that the group members were comparable to the randomly selected survey respondents on most sociodemographic characteristics, but more group members were unemployed and fewer had love marriages (Clark et al, 2019). Furthermore, more group members reported contributing to decisions regarding sexual behavior and fewer reported abuse by their spouses (22% reported emotional abuse and 15% reported physical and/or sexual abuse at baseline; Clark et al, 2019). By nature, qualitative findings are not intended to be broadly generalizable but instead aim for transferability.…”