What can we learn from What Work’s school-based programmes?

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Photo by MI PHAM on Unsplash

London School of Hygiene and Tropical Medicine student, Ummi Bello, reports from the What Works to Prevent Violence Against Women & Girls learning event during the 16 Days of Activism campaign 2018.

We live in a world where our women are being broken and torn apart by violence, and where they begin to lose their sense of identity worth. And in that same world, they co-exist with our children. These children symbolize our hope, but they too are exposed to violence and subconsciously internalizing its negative effects. Violence against women (VAW) and against children (VAC) are major violations of human rights and a great public health concern.

Around 1 in 3 women have experienced physical and/or sexual violence in their lifetime, and children’s exposure to these forms of violence in the home and punishment in schools have been linked to children’s perpetration of the violence against their fellow peers, says the latest evidence from What Works to Prevent Violence against Women and Girls, a global programme, funded by UKAID working in 13 countries across the world building the evidence base on What Works to prevent violence in low-middle income settings. Preventing violence against children is integral to the long-term prevention of violence against women, and to breaking the cycle of violence.

I was glad to have attended an event at the London School of Hygiene and Tropical Medicine where What Works shared their projects, evaluations, and findings. I would like to share a few of these findings with you specifically those from the school-based intervention programmes.

Right to Play (School-based Intervention, Pakistan)

Atta Somaroo, the Programme Manager of Right to Play, beautifully set the scene on what the Right to Play is and the main aim of the intervention. The intervention was conducted in Hyderabad district in Pakistan. This intervention tested the potential of schools as a platform for preventing both VAW and VAC. The power of sport and play were used in the programme. Children were empowered to reduce peer violence and to change their social norms in order to support non-violence and gender equality. Through interactive play activities, these children learned and understood the different perspectives on gender equality and social norms. Confidence, empathy, leadership and how to deal with negative emotions are only a few of the life skills these children learned. How did this impact on the prevention of violence? Findings showed that peer victimization and perpetration significantly reduced. Corporal punishment in schools also significantly decreased by 45% in boys and 66% in girls. What was amazing was the fact that witnessing domestic violence at home and physical punishment at home also significantly reduced by more than half for both genders. This shows that not only do these school-based interventions create a safe space in schools, but this extends to creating a safe and non-violent space at home. What’s more, depression scores have decreased.

Help the Afghan Children (School-Based Peace Education, Afghanistan)

This programme was implemented over a two-year period reaching about 3,500 children. It was delivered in lessons which taught peace education and peaceful conflict resolutions. It was interesting to see similar results from the Right to Play. Children’s experiences in violence at school decreased by up to 50%. Punishment at school also decreased. At home, the number of boys and girls reporting physical violence also dropped quite significantly. Depression levels reduced. Children’s attitudes regarding gender also shifted to a more equitable thinking. Children were less and less supporting violent attitudes. They began to understand and believe that physical punishment by their parents, teachers or even their peers was wrong.

These findings I believe are important for government and non-governmental organisations to acquire as evidence of what works to prevent violence against women and children. By understanding this they can implement these evidence-based findings into the community. I believe preventing violence against children is a necessity and one of the critical first steps to ending the ongoing cycle of violence later on in life and against women.

“I hope that together with the power of this knowledge and evidence as well as ongoing commitment and effort we can move that bit closer to a world where no woman has to live in fear of violence and every girl can grow up knowing she is safe.” –Emily Esplen (DFID Social Development Advisor)

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Inclusive gender-based violence prevention: “They taught us that though we are disabled, no one has the right to commit violence against us” (Ghana, woman with a disability)

Ingrid Van Der Heijden, Senior Researcher – Gender and Health, African Medical Research Council

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Violence against women with disabilities is a human rights issue. On Human Rights Day, 10 December 2018, we reflected on the #16 Days of Activism campaign and considered how violence can happen to any woman, regardless of age, place, economic status, culture, or disability status.

Despite freedom from violence being enshrined in the Convention on the Rights of Persons with Disabilities, the rights of persons with disabilities remain unrealized. While the International Day of Disability, commemorated on the 3rd December 2018, highlighted the marginalization and human rights violations of people with disabilities worldwide, the #16 Days campaign did not fully shine the spotlight on the lives and violence experiences of women and girls with disabilities, and/or what is being done to protect them.

We know that women and girls with disabilities are marginalized and at greater risk of violence because of their gender as well as their disability. Perceptions of women with disabilities as passive, weak, and defenseless exaggerates their risk. They also experience many more barriers to help-seeking and resources for protection and justice, than women without disabilities.

Data of increased risk for women and girls with disabilities is largely based on research from developed country contexts, but little is known about the violence prevalence and experiences of those living in developing countries, or what we can do to prevent violence. Understanding that 80% of women with disabilities live in low and middle-income countries (LMICs) (World Bank, 2011), the What Works programme is the first global violence prevention initiative with a focus on women and girls with disabilities across multiple settings in LMICs (see link at the end of the article).

Over the past five years, the UKAID funded What Works programme conducted global research with over 6,000 women with disabilities who were living in poor, under-resourced communities across multiple countries in Africa, the Middle East and Asia, and who were participating in a range of different mainstream violence prevention interventions.

The inclusion of disability questions in the What Works research enabled What Works to track the participation of women with disabilities in its interventions, assess their risk of intimate partner violence and non-partner sexual violence, and assess the barriers and enablers of their participation in violence prevention efforts.

Three key findings have emerged from this research, that women with disabilities in LMICs are:

  1. FOUR times more likely to experience intimate partner violence (IPV) than women without disabilities (age adjusted).
  2. Twice more likely to experience non-partner sexual violence.
  3. Severity of disability is associated with an increased risk of experiencing violence (IPV & non-partner sexual violence).

What Works’ research also revealed that stigma and prejudice around their disability status underpinned many women’s accounts of IPV:

Emotional IPV: [My husband] does not call me by my name, he calls me lame. He calls me lame every day. I cry and feel sad. (Tajikistan, woman living with a disability)

Neglect and physical IPV: My husband saw that I was ailing and would not look after me. He would not take me to hospital…he began beating me, and calling me sick… He ruptured my eardrum, I was all in blood when I came up, and had to stay for ten days in the hospital. (Tajikistan, woman living with a disability)

Abandonment and physical IPV: My husband’s attitude changed toward me, when I became sick, he brought and left me here alone. He would not visit me. I remember when he beat me so hard. (Tajikistan, woman living with a disability)

IPV leads to further injury and impairment, and resulted in shame, depression, and anger amongst female participants, highlighting how IPV impacts on mental health:

He tells me he doesn’t want to live with a sick person. He insults and tells me I am a dirty woman. That my disabled fingers look like an animal and that he is ashamed to walk with me. When he says that I also get angry (Ghana, woman living with a disability).

Do Violence Against Women and Girls (VAWG) prevention interventions differentially impact women and girls with disabilities?

Reflecting on the emerging evidence from What Works, there were no statistically significant differences in programme benefit, suggesting that existing mainstream interventions may benefit all women, regardless of disability status.

What are the barriers for women living with disabilities to access VAWG prevention interventions? Participants with disabilities explained how lack of outreach to people with disabilities, lack of specialised transport, physical access issues, disability-related stigma, and shame about their impairments meant they could not participate equally in the intervention. Lack of self-esteem and feeling embarrassed about their impairments undermined their confidence to actively participate in the interventions:

I participated in all sessions, but I did not participate in the scenes because my lip stretched, and I was ashamed…I would have participated if not ashamed (Tajikistan, woman living with a disability).

What are the benefits to women living with disabilities who participate in VAWG prevention interventions?

For some participants, their inclusion in the interventions increased their self-esteem, increased their access to social support, and helped raise awareness and challenged social norms around disability. For those participating in income-generating interventions, the benefits of economic empowerment allowed them to contribute to the household and toward the purchase of assistive devices.

People started treating us differently. (Tajikistan, woman with a disability)

They taught us that though we are disabled, no one has the right to commit violence against us. (Ghana, woman with a disability)

How can we start to build inclusive programmes to prevent violence against women and girls with disabilities?

Disability inclusion means that people living with disabilities are accommodated and given opportunities to participate in all aspects of life, including interventions and strategies that could protect them from violence.

  • Service providers and programming staff must commit to understanding the unique ways that women and girls with different disabilities experience IPV. This understanding is a critical first step to being able to adapt and develop programmes that effectively serve women and girls with disabilities.
  • GBV prevention programmes should facilitate appropriate disability-sensitive selection, outreach (such as home visits), and ensure physically accessible and supportive programming that addresses the unique risks and needs for a range of women with disabilities.
  • Social norms change: Programming should be both gender and disability transformative in terms of challenging stigma and discrimination related to both identities. Prevention of violence against women and girls with disabilities should not focus on functioning difficulties, but rather challenge disability-related stigma and social norms associated with being a woman with a disability.
  • Raising awareness: Programming should incorporate disability awareness training among participants with disabilities, programme staff, community members and service providers.
  • Economic empowerment: Programmes should foster resilience, capabilities, and economic empowerment of women with disabilities.
  • Safe spaces: Program staff must identify accessible places of safety that can accommodate the needs of women with disabilities.
  • Couples: Couples programming where one of the partners has a disability can help foster healthy and safe relationships.
  • Inclusive materials: Programming materials and approaches should be designed in collaboration with women with disabilities and disabled peoples’ organisations and advocates, to complement existing guidelines, protocols, and tools for VAWG prevention and response.

For violence prevention to be inclusive, input is required from people with disabilities and those organisations that represent them.

  • Monitoring: Programmes should monitor inclusion of and accessibility to people with disabilities, and make adjustments based on lessons from monitoring data.
  • Evaluation: evaluate programmes to see how, and if, they effectively serve women and girls with disabilities
  • Funding: Donors should prioritize disability inclusive VAWG programming and provide funding opportunities for disability-inclusive programme development, costing, provider training, implementation, monitoring, evaluation and scale up.

We have reached the end of this year’s #16 Days of Activism campaign, and if we truly want to prevent violence against women and girls and leave no one behind, we should meaningfully explore and understand the lives of women and girls with disabilities globally. What Works is a unique opportunity to ask questions and build evidence that will have a meaningful impact on our understanding around how to effectively include women and girls with disabilities in LMICs in violence prevention and ensure they benefit.

https://whatworks.co.za/resources/evidence-reviews/item/444-disability-and-violence-against-women-and-girls

“I do not come to school because the teachers do not teach us”, deaf and mute school girl, Pakistan

Today, the International Day of Persons with Disability, Yasmeen H. Somani, Researcher from Aga Khan University, Pakistan, asks, “do you know a child with disabilities?”

Edited by: Dr. McFarlanec

photo credit: whatworks.co.za

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Do you know a child with disabilities? Over five million people in Pakistan have a disability. Many of these people are children, who are frequently kept in homes and removed from play and important interaction with other children. Does our government provide programs for these disabled youth and the parents who care for them? To learn more about these special youth with disabilities, I spoke to disabled youth in Hyderabad, Sindh. I visited 3 schools for blind and deaf and mute disabled youth. The schools were operated under the Director of Social Welfare Department, Government Service Center for Blind School and Government College for Special Education.

I felt the children were deprived of needed teachers and resources for successful study. I talked to boys and girls of 12 to 18 years of age. I learned their lives are very limited to home and school only. They are not included in our neighborhoods and society. They live very isolated lives with limited access to information and knowledge. How can they receive needed education and social services when systems are not in place? I met blind students who learn through brail and are required to appear at a written board exam with sighted students.

A girl who is deaf and mute said, “I do not come to school because the teachers do not teach us”. A boy who is also deaf and mute reported; “my teacher does not understand sign language, so how can he teach me?” Another boy who is blind said “Teachers just sit, listen to students talk, and later blame us for not learning” Despite learning limitations, the disabled youth were happy to go to school as their world is limited to home and school, especially for blind girls. One youth mentioned, “I was happy when I was a child at least I can go play outside my house but now that I’m older, I am not allowed to go outside alone, and I do not have any friends.”

When we hear the word school, we automatically think of friends, books, library, playground, teachers and most important learning to gain knowledge and prepare for a future path. Our disabled children in Pakistan also want to have fond memories of school. They want to learn and develop skills for making a future for themselves. However, the children I spoke with are not being challenged at school. The children report harassment at school, with stones thrown at them, and one child reported being locked in the washroom. The children were not safe at their home. One girl reported being harassed by neighbors when left alone by her parents.

In Pakistan, only 14 percent of persons with disabilities are employed. The remaining disabled persons depend on family members for financial support. The Directorate General of Special Education & Social Welfare has developed institutions for the disabled. These institutions are not sufficient. Disabled children and adults need quality education for skill building for career paths. Teachers of the disabled need capacity building to learn strategies for effectively teaching the disabled. Government schools need application of new technology to mainstream disabled youth to learn and interact with non-disabled youth. All youth in Pakistan deserve schooling to learn and develop to their fullest.

The What Works to Prevent Violence Against Women and Girls programme is working to understand the status of disability in lower and middle-income countries, find out more here: https://whatworks.co.za/resources/film-and-audio

 

 

 

 

The reflection sessions that changed a narrative in Rwanda

 

Indashyikirwa (Agents for Change) is an intimate partner violence (IPV) prevention project being implemented across seven Districts in the Western, Northern and Eastern provinces of Rwanda. The programme targets both partners of couples through a series of reflection sessions that challenge drivers of gender based violence (GBV) and promote equality.

Ndabaruta Beatrice and Ndayambaje Godefroid are one of the couples that were selected to be a part of the five-month, weekly curriculum.

Beatrice spoke about the difference in her life and relationship before and after participating in the curriculum: “When we got married we didn’t own much, but as time went on, it got worse. We barely had any food in the home because even the little earnings we had my husband spent on alcohol. He always came home late and drunk and he often kicked the door open while hurling insults at me and the children. I became such a miserable person to the extent that I didn’t care whether I took a bath or not, I was not even bothered about body hygiene. I lived in that hopeless situation for seven years”.

The Start of a Transformational Journey
My husband and I were invited to be part of a five-month couple curriculum with the Indashyikirwa Project. When the training started the facilitator introduced my husband and I, together with a group of other selected couples, to a series of dialogue sessions.

These sessions were aimed at triggering self-reflection on our relationships as married couples but all this was but a dream to me. I thought to myself, “this is not for us it’s for the rest of the couples in the room, who are living in harmony but not us”. I asked myself whether it was even possible for me to ever sit down to hold a reasonable conversation with my husband, without him calling me “fool” or telling me that I looked like a “gorilla”, which was the way he often referred to me, he did not value me let alone consider me as his wife.

Every child we had together he despised. When the five-month couple curriculum began I often asked myself “whether this man will ever love me or even talk to me just like the other married couples do.”

Beatrice appreciated the relationship skills development and take-home exercise approach encouraged by the curriculum, and how through trying something new, their relationship slowly changed:

One day the training facilitator gave us a take-home exercise, which required us to talk and reflect on how we can spend quality time together as a couple. It all seemed like a joke to me because at this point even though we were living in the same house, we were both living in separate rooms, and this had been going for about three months and so the idea of us sitting together to talk was a far cry from our situation at home. As we went on with the training he started surprising me with acts of kindness, which implied that he was trying to make an effort to do right by me.

Beatrice also shared the longer-term impacts of the couple’s curriculum on her relationship:

After a number of curriculum sessions, I started to notice a change of heart in my husband, he started taking responsibility for the family needs, like buying clothes for the children and myself. Before this, the entire time we had been married he had never bought the children any clothes. He even went ahead to open up a joint account for us – for the longest time he had denied me access to financial resources. By opening up this account he was giving me the right to access our income. From that day, he started being intentional about helping me with household chores and whenever I was not home he would take care of the children.

Beatrice also shared the positive impacts of the curriculum, especially around making joint decisions, on their household development:

As a result of the training we made the decision to start planning for our family as a couple, we renovated our house to make it more habitable, we also bought a small plot of land. My husband started helping me to cultivate the land which he never did before, we now have a harvest that we never had before in all our seven years of marriage. Ndayambaje shared how he and his mother rarely communicated because she did not approve of his behavior towards his wife.

“I didn’t want to heed her advice, and I never visited her but now we talk and she also testifies to the change she sees in me and in my relationship with my wife and family.”

He noted that as a result of the curriculum, he now has a better relationship with his wife and family:

“I am now accepted in my neighborhood, before the training I was known as a rebellious person not only by my neighbors but also by the Local Authorities, now everyone wants to know what caused the sudden change. I now feel a sense of belonging in my community and in my own family as a result of my individual change. I am now a respected man in my community and my family’s well-being has been boosted, thanks to the Indashyikirwa project.”

My name is Rachel Kwizera, I have been working with CARE for the last three years as a Monitoring and Evaluation Coordinator for the Indashyikirwa Project. This story is just one of the many other amazing stories that I have witnessed from a number of couples who testify to the intentional changes they made as couples as result of being part of the Couples Curriculum. Several times, these couples have acknowledged that being aware of “Power and Power Use” has changed their entire outlook on how they treat each other as couples, towards a more respectful and positive manner.

The Indashyikirwa Footprint: Personal reflections from working with an intimate partner violence programme in Rwanda

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Intimate partner violence (IPV) is still a persistent reality for many women in Rwanda and this has physical and emotional consequences, which impacts all of us as a community.  Indashyikirwa is an IPV prevention program being implemented by CARE International Rwanda, Rwanda Women’s Network (RWN) and Rwanda Men’s Resource Centre (RWAMREC) in Rwanda, and funded by DFID-Rwanda. Indashyikirwa is being evaluated externally as part of the What Works to Prevent Violence against Women and Girls Programme. As we enter into the last phase and completion of Indashyikirwa, I would like to share my personal takeaways from this four-year program.

My name is Annette N. Mukiga. As the project coordinator of the RWN activities, Indashyikirwa has created a huge shift in my understanding and perception of Gender Based Violence (GBV) programming in the following ways: –

  1. The first Indashyikirwa Baby: Importance of Building Personal Relationships

I had my now 2.6 year old baby as we were entering the program implementation phase and I remember colleagues from the project coming to visit and welcome the 1st “Indashyikirwa baby”. For me, it was a reaffirmation of the trainings we had and emphasized the need to build and invest in personal relationships with the community members we would be working with, such as the Women’s Space Facilitators and Community Activists.

  1. Personal Reflection: It starts with me

Before Indashyikirwa, my experience with prevention of GBV was working with communities with the implied assumption that this is not my problem, but I am rather going to assist other people to overcome their problems. With Indashyikirwa, the process encouraged continuous personal reflection as an integral part of the change that we wanted to see. I think this is key for working to change social norms; we need to constantly reflect on our own personal attitudes and behaviours, and how we are also influenced by societal norms.

  1. Talking About Triggers instead of Causes of GBV

The Indashykirwa program helped me to learn about triggers, rather than essentializing causes of GBV. For instance, the program emphasizes how power imbalances between men and women, poverty and alcohol abuse are not necessarily causes (i.e. not all people in these circumstances will resort to GBV) but can be triggers or contributing factors of GBV. With this lens, we need to come up with ways and tools of managing these triggers, which was a key focus of the Indashyikirwa program.

  1. Challenging Social Norms: Change is a process

Reflecting on the harmful social norms that we need to change and patriarchy as a system that needs to be eliminated (my personal hope as a feminist), I recognize that there are low hanging fruit (quick wins) and high hanging fruits, which is why we need different strategies to promote positive and sustainable change. As we began the program, I remember the heated and controversial debates around the possibility of a household being headed by both spouses and a colleague having issues with the idea of her husband carrying a child on his back. Throughout the program, many of us as staff developed different attitudes towards gendered norms, encouraged through the participatory approach of the programme trainings and activism activities. The fact that we were even questioning, discussing and visioning a different way of doing things is a powerful step towards changing the norms that we know.

  1. Research and Knowledge Generation: Integral to informing programming

The Indashykirwa program was a first for me in relation to working in partnership with a research team responsible for evaluating the project. My previous experience had been evaluators coming as external experts to impress upon the results of our work. At first, the research was an intimidating experience but as we engaged through mutual respect as partners, with capacity building and regular feedback of the data from both the qualitative and quantitative evaluation activities, I realized the importance of this kind of study to inform the quality and impact of our work. With this understanding and appreciation, I personally cannot look at evaluation research the same way; I am born again. The critical need for research and development practitioners to work in partnership to show what works and how it works cannot be ignored. I would like to call upon funding partners to recognize this mutual reinforcement, support and encourage such collaborations.

  1. Funding Flexibility: Value Addition for Impact

I have experienced many firsts with Indashyikirwa including a 9-month inception period for preparing the ground for the project implementation including; developing the intervention, pretesting of curricula and staff training. Flexibility of funding also allowed for new activities to address the gaps and challenges identified from the monitoring and evaluation research data. For long term projects, especially those piloting programmes as was the case with Indashyikirwa, this is very important, as it enhances the overall quality of the program and its impact. My negotiation agenda with funding partners in the future will definitely take this into consideration.

As we look to the future of Indashyikirwa as a program as well as to prevent and respond to GBV broadly, I hope that the learning we have gained from this program continues to inform us going forward. La Lutte Continua.

 

 

 

A day in the life Miriam’s Diary: Through the eyes of a young woman giving others a helping hand

Read about an ordinary day for an extraordinary woman living in one of the world’s largest refugee camps.

February 26, 2018

My name is Miriam. I was born in Somalia. My family fled the war in 1992 when I was one year old, and I have lived in Dadaab refugee camp—one of the largest in the world—since then.

Now, I work for the International Rescue Committee. Every day, I work to protect women and girls from violence.

6 am

The first thing I do is pray. I live with my mother. I make us both breakfast and then clean our home. My mother has always supported me. She encouraged my education as a young girl and is just so happy watching me go off to work every day.

7.30 am

I set off for the women’s support centre. It’s quite a long walk and sometimes I get harassed on the street. Some people in the community think that I am wasting my time, that I should just get married. But I know others, including many young girls, look up to me as a role model.

8 am

The team gathers outside under the trees for a daily meeting to discuss any challenges we have encountered in our work and ask each other for advice. Then I sit outside the centre and wait for women to arrive. I want mine to be the first face they see — someone smiling and welcoming them.

Women and girls come to the centre for many different reasons; the camp is not an easy place to live. There is a lot of domestic violence, early or forced marriages, girls are denied education, and there is sexual assault.

When a woman arrives I take her into a private room and ask her about her situation. If she is a survivor of sexual violence, I ask if she is willing to see a doctor and then immediately call them. We have a shortage of medical staff so it can be hours until someone arrives. Sometimes I end up staying with a survivor into the evening waiting for a medical exam.

12:30 pm

When the doctor arrives, I explain everything that is happening, act as a translator and assist as the doctor performs the exam and gives her treatments, including to prevent HIV.

If she wants her case to be forwarded to the police, I help gather evidence, such as her clothes, and find her new, comfortable clothing. I reassure her that this is not her fault and that she is not alone, that I will be here to support her and listen.

4 pm

I start the walk home. To be honest, it is not an easy time of the day – my head is filled with the stories and experiences of the women I have seen and their suffering. It is heavy. When I get home, I prepare supper for my mother and myself. Sometimes I read – I love reading the news and fiction – but normally I try to get to sleep as early as possible.

I’m proud of what I do. Women come to see us traumatised, and scared, and sobbing. They leave knowing that they will be ok and that there are people who will help them and support them.

Violence against women and girls exists all over the world – not just in Somalia, not just here in Dadaab. If I go back to Somalia I want to continue to educate people and continue to protect women and girls. They are the backbone of humanity. The world cannot become beautiful without their leadership.

Miriam is a community worker working with the IRC’s Women’s Protection and Empowerment team to help women and girls who have experienced violence in Dadaab refugee camp in Kenya. She is also a refugee.

Miriam’s name has been changed to protect her identity. These are her words.

Illustrations by Matt Murphy.

The What Works to Prevent Violence Against Women and Girls in Conflict and Humanitarian Crises research programme, funded by the UK Government’s Department for International Development, is building evidence on how to prevent and respond to violence against women and girls in fragile and conflict settings. As part of its recent project in Dadaab, refugee community workers like Miriam were interviewed to understand the specific risks, challenges, opportunities and rewards experienced by refugees working to change their own communities.

Working with couples to address intimate partner violence: Lessons from Rwanda

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Jean Felix Havumiragira and Kristina Uwamahoro, who participated in the couples curriculum in Rwanda

Research shows that addressing intimate partner violence (IPV) requires working at society, community, household and individual levels to promote relationships built on respect, equality and peace. This blog shares the emerging learnings of working specifically with couples to address IPV in the context of Rwanda and speaks to the findings of the qualitative research conducted by Dr Erin Stern from London School of Hygiene and Tropical Medicine (read more in this article by Dr Erin Stern and Ritha Nyiratunga).

The Indashykirwa programme, which is funded by UK aid and implemented by CARE, the Rwanda Women’s Network and Rwanda Men’s Resource Centre (RWAMREC) in collaboration with the London School of Hygiene and Tropical Medicine, has been an innovative partnership bringing together practitioners and researchers to better understand what works to address IPV. Indashyikirwa consists of a package of interventions designed to work at individual, family and community levels to shift attitudes, practices and social norms that perpetuate gender inequality and GBV. So what have we learned so far about working with couples to address intimate partner violence?

What couples valued in the curriculum

The qualitative research undertaken with couples before, after the curriculum and one year later showed that the majority of couples immensely valued the Indashyikirwa couples curriculum. The retention and participation rate has been consistently high with strong commitment from both partners in a couple to attend three-hour sessions on a weekly basis for five months.

Couples appreciated being able to go through the curriculum with their respective partners. For some of the couples, the programme offered a rare opportunity to freely express themselves and share what they intimately felt about certain issues. The different notions of power (power over, with, to and within) and specifically the link between ‘power over’ and different forms of violence was an important step in couples understanding IPV. Some couples were unaware that they were living in violent relationships. As one woman said: “I thought that the way my husband talked to me was the way all husbands talked. When I started attending the couples’ training through the Indashyikirwa project, I realised I was experiencing gender-based violence.”

Awareness-raising was supported by skills-building sessions where couples learned and practised certain areas to support non-violent relationships, such as how to provide constructive communication and criticism or resolve conflicts within their relationship.

What couples resisted

Where the curriculum challenged privileges of men as sole decision-makers and breadwinners, resistance especially from men was noticeable during the sessions. As one field officer noted: “Men were asking negatively, ‘What is this? They want women to be above us.’ But after every single session, you see men start to be open and realise how they were using power over, they thought it was their right as men to give directions to their families, go out and drink, do whatever they want, and come home late.”

Consideration of men’s sexual entitlement in relationships/marriage was also initially resisted by many participants. The idea that women could initiate sex was for many taboo and uncomfortable. Those discussions were however essential to challenging entrenched ideas and norms about couples’ dynamics that ultimately were underpinning unequal power relations. Couples were encouraged to adopt different behaviours at home using some of the newly acquired skills.

What the process of change looked like

After some time, changes were noticeable with couples embracing new roles within the household. Couples reported through the qualitative interviews, including a year after the curriculum, changes around household and property decisions, chores at home, sex or quality time spent together. The solidarity and closeness created among couples within each session and with the RWAMREC facilitators was also an important factor to encourage and support this process of change. The reflective and participatory approach of the curriculum and the take-home activities encouraged couples to try new ways of interacting and engaging with each other.

An unexpected change has been the number of couples trained who had been living together and decided to legally marry. Legal marriage in Rwanda provides greater status to women and gives women legal rights that they are not otherwise guaranteed to access, such as to property. This finding is very important in better understanding risk and protective factors for IPV.

Initial recommendations                

  1. This research, conducted as part of the What Works to Prevent Violence against Women and Girls programme, indicates that it is possible to conduct research with couples on IPV in an ethical manner. It also demonstrates the added value of interviewing couples over time to get their insights into what works well for transforming relationships and reducing IPV. Research under this intervention has provided invaluable findings that have contributed to better understanding and refining the intervention in a way that wouldn’t have been possible with only an impact evaluation.

 

  1. The Indashyikirwa couples approach speaks to the effectiveness of engaging both partners in a heterosexual couple at the same time. Research suggests that working with heterosexual couples is more effective to change relationships and reduce IPV than engaging men and women separately.

 

  1. Deconstructing the concept of power was essential in couples’ understanding of violence, especially the link between negative use of power (power over) and different forms of IPV (economic, emotional, physical, sexual). The concept of positive power (power within, to and with) was also inspiring for couples to address IPV in their communities, and to strengthen especially women’s self-confidence.

 

  1. Legal marriage was identified as a factor influencing women’s access to rights and as a potential protective factor for IPV. Informal marriage could increase the risk of IPV while limiting institutional responses to violence experienced by women. This reinforces the importance of taking an intersectional lens when working with women to reduce IPV. Further evidence on this critical issue is available in this paper Intersectionalities of marital status and women’s risk and protective factors for IPIV.

 

Read more: A critical aspect of the Indashyikirwa programme is safe spaces for women, which were established to help women feel comfortable discussing IPV and gender inequality, help educate women about their rights, and refer or accompany women for health, social or criminal justice services. Read Eugenia’s story on the What Works website to find out more about the impact of the women’s safe spaces.

 

 

 

It’s not just the women that want to stop Intimate Partner Violence in Zambia, it’s the men too

Screenshot 2017-12-04 13.08.25

Saphira Mulemba, on Violence Alcohol Treatment Zambia (VATU)

VATU means ‘ours’ in Nyanja, one of the main local languages spoken in Zambia. This programme is for our Zambian families, in fact, all families who live in similar settings, as violence against women and children is a daily reality for many in Zambia.

No single “risk factor” can explain why some individuals behave violently towards women or children or why violence against women and girls appears to be more prevalent in certain communities than in others, however, it is clear that alcohol abuse is a significant contributor. Alcohol can be both a cause and a consequence of interpersonal violence. My name is Saphira Mulemba and I am the Project Manager on the What Works project in Zambia. Our intervention programme, the Common Elements Treatment Approach (CETA), is trying to reduce and prevent the perpetration and experience of interpersonal violence in part by addressing alcohol use problems in Zambia. CETA addresses a wide range of mental and behavioural health problems that affect the family dynamics surrounding violence exposure (e.g., depression, anxiety, trauma, behavioural problems, and substance abuse).

Our CETA programme involves locally trained counsellors conducting weekly group or individual therapy sessions with their clients. Sessions are typically 1-2 hours in length and treatment lasts for 8-12 weeks. The clients in our study are families living in three peri-urban communities in Lusaka. The family group that we work with consists of three individuals: an adult woman, her husband or partner, and one identified child (boys and girls, ages 8-17). All individuals of a family received CETA if randomized to this study arm. Although we won’t know the true effectiveness of CETA until the end of the study, counsellors on our team have reported significant positive feedback from their male clients. For example, one male client reported that “This programme has helped me realize that I need not to force my wife to have sex but instead talk to her about it”. Men who have struggled with alcohol use problems have informed their counsellors about positive changes in their relationships with their wives and how their overall family dynamics have dramatically improved. They have also reported that they feel healthier, are able to go to work more consistently, and have even told their friends and neighbours who are experiencing similar alcohol problems about the benefits of our CETA programme.

Conversely, men enrolled in our study who have not yet received CETA have expressed to our team the need for services to help not only themselves but their family as well. We are encouraged by the response to our programme by men in the community and believe that engagement of the entire family unit in CETA increases the likelihood that alcohol use and interpersonal violence will decrease.

What the Stepping Stones Creating futures intervention meant to women

Casper leading group discussion

by Nolwazi Ntini

As the Stepping Stones and Creating Futures intervention data collection draws to a close for the year, I would like to reflect on the experiences of some of the women who attended the intervention workshops. The intervention, funded by the What Works to Prevent Violence against Women and Girls Global Programme via UKAID, sought to reduce intimate partner violence (IPV) and improve livelihoods amongst youth aged 18- 30 years living in urban informal settlements, in Durban, South Africa. By conducting participatory peer-led workshops, participants met twice a week and discussed different issues pertaining to their lives, under the guidance of the Stepping Stones and Creating Futures combined curriculum. Urban informal settlements are often characterized by high prevalence of violence. At baseline, 65% of women reported having experienced IPV in the past 12 months. This blog highlights reflections from conversations with women who attended the intervention and were part of the qualitative research.

When I asked women about their thoughts and feelings about participating in the intervention, they responded positively to the experience and shared their favorite and most memorable sessions. For instance, the mentioned “River of Grief” as a favourite yet, difficult session for the women, because it gave them an opportunity to share their life stories. The aim of this particular session was to assist participants to talk about past trauma and grief and the different ways to process feelings of loss. Through the narration of their experiences, participants were able to identify similarities between their own stories, and those of other women, making them feel less alone and isolated.

Another session women enjoyed was the “menstrual cycle”. Women found learning about how their bodies work, empowering, as for some they had typically learned this only in limited ways at school. For others, it was also important to learn about how to conceive children, which gave them some ability to start making decisions about their reproductive choices.

In addition to the topics discussed in the workshops, the women also always looked forward to attending sessions as it was something different from their daily routines. They described their typical days as uneventful; where they mainly did house chores, looked after family members and occasionally went out to look for work, with limited interaction with people who are not kin, close friends or partners. The chance to be somewhere where they did not have to invest a lot of personal effort or labour, and could engage with different people about topics of importance to them, was just as important as what they were ‘learning’.

The Stepping Stones and Creating Futures intervention provided an opportunity for the women to build, expand and strengthen their networks. However, the spaces convened were not always harmonious and problem free. In a context of socio-economic scarcity such as urban informal settlements, there was high competition for employment opportunities and intimate partners; such tensions and fights would often spill over into the workshops and therefore had to be resolved in them.

Despite the challenges, women claimed the only thing they would change about the intervention would be to add more sessions, as they felt the standard 21 sessions were not enough; or have more sessions but targeting different people in the communities, such as the elderly or young children. The sessions functioned in multiple ways for women, moving beyond simple learning spaces to ones where they could start to build social relationships, reduce isolation and start to think about their lives in different ways.

Nolwazi Ntini is an ethnographer and fieldwork co-ordinator within the Gender Equality and Health Programme, HEARD

 

Trauma, men and mental health

Andrew Gibbs on men and intimate partner violence in informal settlements in South Africa

Participant acting a scene

Men’s use of violence against women is driven by gender inequalities, and men’s attempts to maintain power over women. Yet men also experience exceedingly high levels of trauma themselves. Despite people connecting these two for many years and suggesting that men’s experiences of trauma increase their use of violence against women, research on this has remained qualitative. In a new, exploratory, analysis the Stepping Stones and Creating Futures [1]team use quantitative data to unpick how men’s experiences of trauma shape and drive their use of violence.

Working in urban informal settlements in Durban, South Africa, the Stepping Stones and Creating Futures team were acutely aware of the generalized high levels of violence that young women and men experience in their daily lives. The study found that men living in urban informal settlements do experience a high level of trauma in their lives: 25% of men in the study reported witnessing the murder of a family member of friend, 43% had witnessed an armed attack, and just over half (52%) had been robbed at knife or gunpoint.

But how does this impact on their use of violence against women? We used structural equation modeling to explore the pathways through which these experiences of trauma led to increased IPV perpetration. We found three pathways for this relationship. First, there is a direct relationship between these two factors – men who experience trauma are more likely to use violence. Second, men’s gender inequitable masculinities are incredibly important in their perpetration of violence, the experience of trauma led to men holding more inequitable masculinities and this then led to greater use of violence. Third, men who experienced trauma had greater mental health challenges, including depression and use of alcohol. These mental health challenges increased men’s perpetration of violence.

So what does this mean? First, men’s gender inequitable masculinities remain central to any analysis of men’s use of violence. The analysis clearly demonstrated that this is an important driver of violence. Second, the importance of traumatic experiences cannot be discounted in understanding men’s use of violence. This is not to justify violence at all, but to recognize that violence begets violence, and an important component of working to reduce violence against women, must be to reduce the overall levels of violence and trauma within any community. Finally, interventions working to reduce men’s use of violence need to think about how to work on improving men’s mental health and reducing their use of alcohol.

Overall, working to reduce IPV by men needs to think about the multi-level components driving IPV. Transforming men’s gender norms needs to be the main component of effective prevention interventions, but these need to be combined with wider interventions to reduce overall levels of community violence and support men’s mental health.

[1] Stepping Stones and Creating Futures is a programme which aims to decrease the rate of intimate partner violence in urban informal settlements in South Africa via interactive and participatory peer-led sessions in which participants reflect on gender norms, conflict in relationships and developing livelihoods strategies.