Systematic review of structural interventions for intimate partner violence in low- and middle-income countries: organizing evidence for prevention

Abstract

BackgroundDespite growing attention to intimate partner violence (IPV) globally, systematic evaluation of evidence for IPV prevention remains limited. This particularly is true in relation to low- and middle-income countries (LMIC), where researchers often organize evidence by current interventions strategies rather than comprehensive models of IPV. Applying the concept of structural interventions to IPV, we systematically reviewed the quantitative impact of such interventions for prevention of male-to-female IPV in LMIC in order to (a) highlight current opportunities for IPV research and programming and (b) demonstrate how structural interventions may provide an organizing framework through which to build an evidence base for IPV prevention.MethodsWe identified articles by systematically searching PubMed and Web of Science, reviewing references of selected studies, and contacting 23 experts. Inclusion criteria included original research, written in English, published between January 2000 and May 2015 in the peer-reviewed literature. Studies evaluated the quantitative impact of structural interventions for the prevention of male-to-female IPV in LMIC through (a) IPV incidence or prevalence or (b) secondary outcomes theoretically linked to IPV by study authors. After initial screening, we evaluated full text articles for inclusion and extracted data on study characteristics, outcomes, and risk of bias, using forms developed for the review.ResultsTwenty articles (16 studies) from nine countries met inclusion criteria, representing 13 randomized control trials and seven additional studies, all of which reported results from economic, social, or combined economic and social interventions. Standardized at p < 0.05 or 95 % confidence intervals not including unity, 13 studies demonstrated statistically significant effects for at least one primary or secondary outcome, including decreased IPV and controlling behaviors; improved economic wellbeing; enhanced relationship quality, empowerment, or social capital; reduced acceptability of IPV; new help seeking behaviors; and more equitable gender norms. Risk of bias, however, varied in meaningful ways.ConclusionsOur findings support the potential effectiveness of structural interventions for IPV prevention. Structural interventions, as an organizing framework, may advance IPV prevention by consolidating available evidence; highlighting opportunities to assess a broader range of interventions, including politico-legal and physical approaches; and emphasizing opportunities to improve evaluation of such interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2460-4) contains supplementary material, which is available to authorized users.

Women economic empowerment via cash transfer and microcredit programs is enough to decrease intimate partner violence? Evidence from a systematic review

“…On the other hand, the present study diverges with those from Bourey et al 20 , that indicate that economic interventions are satisfactory approaches to restrain violence against women. This lack of consensus may be caused by the fact that this previous study, as mentioned on the Introduction, had a narrower scope than our review as it was based on only sixteen original researches.…”

“…For instance, the literature suggests that the programs Oportunidades (conditional CTP/Mexico) and Juntos (unconditional CTP/Ecuador) work very differently 17,18 . The contrasting impacts of the initiatives in these countries may be related to their distinct implementation periods, as well as to the different moments the attached conditionalities were monitored 19,20 . An impact analysis that does not consider these discrepancies may lead to spurious results.…”

“…This lack of consensus has sparked a number of systematic reviews 19,20,21 . The first was published in 2009 and aimed to identify whether women's economic and social empowerment was associated with a lower risk of violence against women.…”

“…Although commendable for providing a first overview on the subject, this study involved only journals indexed in a single database (MEDLINE) and restricted to papers published in English. The second review was published in 2015 20 to assess the effect of economic and/or social interventions on IPV. Based on a qualitative summary of the literature, the authors found that overall, interventions lead to less IPV and controlling behaviors of partners.…”

Assessing a comprehensive approach to prevent sexual violence on campus: Implications for program improvement

“…Population-based surveys show that sexual violence (used here interchangeably with sexual assault), including rape, remains a global problem (Bourey, Williams, Bernstein, & Stephenson, 2015;Michau, Horn, Bank, Dutt, & Zimmerman, 2015; World Health Organization/London School of Hygiene and Tropical Medicine, 2010) with intense harmful effects on the health and affluence of individuals, their families, their community, and society (Taft & Small, 2014). Although anyone can be affected, women bear the overwhelming burden of sexual violence (Garcia, Lechner, Frerich, Lust, & Eisenberg, 2012), much of which is perpetrated by family members or partners (Breiding et al, 2014).…”