Effective Prevention of Intimate Partner Violence Through Couples Training: a Randomised Controlled Trial of in Rwanda

Overview

Journal BMJ Glob Health

Specialty Public Health

Date 2020 Dec 23

PMID 33355268

Citations 37

Authors

Kristin Dunkle

Erin Stern

Sangeeta Chatterji

Lori Heise

Affiliations

Soon will be listed here.

Abstract

Background: Between 2015 and 2018, three civil society organisations in Rwanda implemented , a four-part intervention designed to reduce intimate partner violence (IPV) among couples and within communities. We assessed the impact of the programme's gender transformative curriculum for couples.

Methods: Sectors (n=28) were purposively selected based on density of village savings and loan association (VLSA) groups and randomised (with stratification by district) to either the full community-level programme (n=14) or VSLA-only control (n=14). Within each sector, 60 couples recruited from VSLAs received either a 21-session curriculum or VSLA as usual. No blinding was attempted. Primary outcomes were perpetration (for men) or experience (for women) of past-year physical/sexual IPV at 24 months post-baseline, hypothesised to be reduced in intervention versus control (ClinicalTrials.gov: NCT03477877).

Results: We enrolled 828 women and 821 men in the intervention sectors and 832 women and 830 men in the control sectors; at endline, 815 women (98.4%) and 763 men (92.9%) in the intervention and 802 women (96.4%) and 773 men (93.1%) were available for intention-to-treat analysis. Women in the intervention compared with control were less likely to report physical and/or sexual IPV at 24 months (adjusted relative risk (aRR)=0.44, 95% CI 0.34 to 0.59). Men in the intervention compared with control were also significantly less likely to report perpetration of physical and/or sexual IPV at 24 months (aRR=0.54, 95% CI 0.38 to 0.75). Additional intervention benefits included reductions in acceptability of wife beating, conflict with partner, depression, and corporal punishment against children and improved conflict management, communication, trust, self-efficacy, self-rated health, household earnings, food security and actions to prevent IPV. There were no study-related harms.

Conclusions: The couples' training curriculum was highly effective in reducing IPV among male/female couples in rural Rwanda. Scale-up and adaptation to similar settings should be considered.

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