Ecological pathways to prevention: How does the SASA! community mobilisation model work to prevent physical intimate partner violence against women?

BMC Public Health

Research Article

Tina Musuya¹  Tanya Abramsky²  Ligia Kiss²  Karen M. Devries²  Charlotte Watts²  Nambusi Kyegombe²  Janet Nakuti³  Lori Michau³ 

[1] Centre for Domestic Violence Prevention, 16 Tufnell Drive, Kamwokya, P.O Box 6770, Kampala, Uganda;Gender Violence and Health Centre, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK;Raising Voices, 16 Tufnell Drive, Kamwokya, P.O Box 6770, Kampala, Uganda;

关键词: Violence prevention;    Impact evaluation;    Community mobilisation;    Intimate partner violence;    Uganda;    Pathways analysis;    Gender based violence;    East Africa;   

DOI  :  10.1186/s12889-016-3018-9

 received in 2015-09-15, accepted in 2016-04-08,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIntimate partner violence (IPV) against women is a global public health concern. While community-level gender norms and attitudes to IPV are recognised drivers of IPV risk, there is little evidence on how interventions might tackle these drivers to prevent IPV at the community-level. This secondary analysis of data from the SASA! study explores the pathways through which SASA!, a community mobilisation intervention to prevent violence against women, achieved community-wide reductions in physical IPV.MethodsFrom 2007 to 2012 a cluster randomised controlled trial (CRT) was conducted in eight communities in Kampala, Uganda. Cross-sectional surveys of a random sample of community members, aged 18–49, were undertaken at baseline (n = 1583) and 4 years post intervention implementation (n = 2532). We used cluster-level intention to treat analysis to estimate SASA!’s community-level impact on women’s past year experience of physical IPV and men’s past year perpetration of IPV. The mediating roles of community-, relationship- and individual-level factors in intervention effect on past year physical IPV experience (women)/perpetration (men) were explored using modified Poisson regression models.ResultsSASA! was associated with reductions in women’s past year experience of physical IPV (0.48, 95 % CI 0.16–1.39), as well as men’s perpetration of IPV (0.39, 95 % CI 0.20–0.73). Community-level normative attitudes were the most important mediators of intervention impact on physical IPV risk, with norms around the acceptability of IPV explaining 70 % of the intervention effect on women’s experience of IPV and 95 % of the effect on men’s perpetration. The strongest relationship-level mediators were men’s reduced suspicion of partner infidelity (explaining 22 % of effect on men’s perpetration), and improved communication around sex (explaining 16 % of effect on women’s experience). Reduced acceptability of IPV among men was the most important individual-level mediator (explaining 42 % of effect on men’s perpetration).ConclusionsThese results highlight the important role of community-level norm-change in achieving community-wide reductions in IPV risk. They lend strong support for the more widespread adoption of community-level approaches to preventing violence.Trial registrationClinicalTrials.gov, NCT00790959. Registered 13th November 2008.The study protocol is available at: http://www.trialsjournal.com/content/13/1/96

【 授权许可】

CC BY   
© Abramsky et al. 2016