Exploring Couples’ Processes of Change in the Context of SASA!, a Violence Against Women and HIV Prevention Intervention in Uganda

Abstract

There is now a growing body of research indicating that prevention interventions can reduce intimate partner violence (IPV); much less is known, however, about how couples exposed to these interventions experience the change process, particularly in low-income countries. Understanding the dynamic process that brings about the cessation of IPV is essential for understanding how interventions work (or don’t) to reduce IPV. This study aimed to provide a better understanding of how couples’ involvement with SASA!—a violence against women and HIV-related community mobilisation intervention developed by Raising Voices in Uganda—influenced processes of change in relationships. Qualitative data were collected from each partner in separate in-depth interviews following the intervention. Dyadic analysis was conducted using framework analysis methods. Study findings suggest that engagement with SASA! contributed to varied experiences and degrees of change at the individual and relationship levels. Reflection around healthy relationships and communication skills learned through SASA! activities or community activists led to more positive interaction among many couples, which reduced conflict and IPV. This nurtured a growing trust and respect between many partners, facilitating change in longstanding conflicts and generating greater intimacy and love as well as increased partnership among couples to manage economic challenges. This study draws attention to the value of researching and working with both women, men and couples to prevent IPV and suggests IPV prevention interventions may benefit from the inclusion of relationship skills building and support within the context of community mobilisation interventions.

Love matters: exploring conceptions of love in Rwanda and Swaziland and relationship to HIV and intimate partner violence

“…Indeed, Fielding-Miller and Dunkle’s (2017) research of transactional sex in Swaziland found that love was protective against IPV, in that women who reported having sex with a partner for reasons other than love or affection (such as poverty, money, hunger, fear of abandonment, or violence) had increased odds of emotional, physical, and sexual violence. Starmann and colleagues (2016) assessed processes of change among couples exposed to the SASA! IPV prevention programme in Uganda and suggested that SASA!’s focus on core relationship values such as love, respect and trust was essential to reducing violence and improving relationship quality.…”

“…The SASA! intervention in Uganda found that as IPV and conflict in relationships decreased, love and trust increased (Starmann et al, 2016). In a study of Ugandan HIV sero-discordant couples, some reported that love motivated them to continue the relationship and adhere to pre-exposure prophylaxis (PrEP) (Ware et al, 2012).…”

A Process Review of the Indashyikirwa Couples Curriculum to Prevent Intimate Partner Violence and Support Healthy, Equitable Relationships in Rwanda

“…The findings speak to the value of interviewing both partners of couples, which is relatively uncommon in IPV prevention research, although there have been recent calls for this (Davis et al 2012;Wadsworth and Markman 2012;Starmann et al 2017). The findings further identify the importance of interviewing curriculum implementers, perspectives that are often neglected by impact evaluations.…”

“…Other studies have found engaging couples can be more effective than separating men and women to equip change in relationships and reduce IPV (El-Bassel and Wechsberg 2012; Starmann et al 2017). Mixed-group educational efforts can model equitable gender relations, mobilise men's care for the women and girls in their lives, and enhance their accountability to women (Anderson and Whiston 2005).…”

“…This finding reinforces an assessment among a sub-set of couples exposed to SASA! in Uganda, which suggested the value of leaning relationship skills for conflict and IPV prevention (Starmann et al 2017). The concept of positive and negative types and uses of power appears to be fundamental to the process of change for couples to identify causes and consequences of various forms of IPV, and support their ability to prevent and respond to IPV in their own relationships and within their communities.…”