The challenge
In the 2005 WHO multi-country study, Ethiopia reported the highest prevalence of intimate partner violence of any country surveyed, with over 70% of women reporting lifetime physical and/or sexual violence by a partner.
The case
Unite for a Better Life (UBL) is a participatory programme of 14 sessions, delivered twice weekly by trained facilitators in the context of the Ethiopian coffee ceremony, a traditional forum for community discussion, to build skills for healthy, non-violent, equitable relationships. The trial was implemented by J-PAL at MIT with Addis Ababa University's School of Public Health, the Ethiopian Public Health Association and EngenderHealth: 64 villages in four districts of southern Ethiopia were randomly allocated to a control group or to UBL for men, women or couples, covering 6,770 households, and the intervention ran from April to October 2015. About 24 months later, Vandana Sharma and colleagues found no effect of any UBL arm on women's past-year experience of physical or sexual intimate partner violence, the primary outcomes. The men's programme significantly reduced men's self-reported perpetration of past-year sexual violence (adjusted odds ratio 0.73) and was associated with a reduction in women's experience of past-year physical and/or sexual violence (0.81). The programmes for women and couples did not reduce violence but increased reported condom use.
Why the results were mixed
The researchers conclude that the programme 'delivered to men was effective in reducing self-reported perpetration of sexual IPV but did not reduce IPV when delivered to couples or women', and note reliance on self-reported data as the main limitation. A cost analysis put the annualised cost at about US$74 per direct participant.
Sources
- Sharma, V., Leight, J., Verani, F., Tewolde, S., & Deyessa, N. (2020). Effectiveness of a culturally appropriate intervention to prevent intimate partner violence and HIV transmission among men, women, and couples in rural Ethiopia: Findings from a cluster-randomized controlled trial. PLoS Medicine, 17(8), e1003274.
- Leight, J., Deyessa, N., & Sharma, V. (2021). Cost-effectiveness analysis of an intimate partner violence prevention intervention targeting men, women and couples in rural Ethiopia. BMJ Open, 11(3), e042365.
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