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Open Access 01-12-2018 | Study protocol

An individually randomized controlled trial to determine the effectiveness of the Women for Women International Programme in reducing intimate partner violence and strengthening livelihoods amongst women in Afghanistan: trial design, methods and baseline findings

Authors: Andrew Gibbs, Julienne Corboz, Mohammed Shafiq, Frozan Marofi, Anna Mecagni, Carron Mann, Fazal Karim, Esnat Chirwa, Charlotte Maxwell-Jones, Rachel Jewkes

Published in: BMC Public Health | Issue 1/2018

Abstract

Background

Intimate Partner Violence (IPV) is the most common form of violence in conflict and post-conflict settings, but there are few evaluations of interventions to prevent IPV in such settings.

Methods

The Women for Women International (WfWI) intervention is a year-long combined economic and social empowerment intervention for marginalized women survivors of conflict. Primarily, it seeks to support women to achieve four key outcomes: women earn and save money; women improve their health and well-being; women influence decisions in their homes and communities; women connect to networks for support. The organization recognizes Violence Against Women and Girls (VAWG) as a significant barrier to women’s empowerment and expects to see reduction in VAWG, and specifically IPV, as part of building women’s social and economic empowerment. This program is being quantitatively evaluated through an individually randomized control trial amongst women in Afghanistan, with a 24-month follow up. A comparison of baseline characteristics of participants is also included as well as a discussion of implementation of the baseline research.

Discussion

There is a high demand amongst Afghan women for such interventions, and this posed challenges in completing the randomization and baseline. In addition, the complex security situation in Afghanistan also posed challenges. However, despite these issues, recruitment was successfully achieved and the arms were balanced on socio-demographic measures. The evaluation will contribute to the limited evidence base on interventions to prevent IPV in conflict-affected settings.

Trial registration

NCT03236948. Registered 28 July 2017, retrospectively registered.

Bride price (walwar in Pashto and sherbaha in Dari) should not be confused with the dowry (mahr), the former which is a sum of money paid to the father or other male family member of a bride, and the latter a sum of money paid directly to the bride to provide economic security in case her husband dies or divorces here. Although mahr is enshrined in Islamic Sharia law, it is rarely implemented in Afghanistan with bride price being the most common practice.

This has been well documented by human rights organisations, for example: UN SCR 1325 Implementation in Afghanistan (AWN, 2011) http://www.awn-af.net/index.php/cms/content/501; AWN Annual 2nd Report on CEDAW in Afghanistan (AWN, June 2016); http://www.awn-af.net/index.php/cms/content/501; https://www.hrw.org/news/2016/05/25/afghanistan-end-moral-crimes-charges-virginity-tests; Their lives on the line: women human rights defenders under attack in Afghanistan (Amnesty International, April 2015) https://www.amnesty.org/en/documents/asa11/1279/2015/en/

See: www.whatworks.co.za

Hossain M, Zimmerman C, Watts C. Preventing violence against women and girls in conflict. Lancet. 2014;383(9934):2021–2.CrossRefPubMed

Stark L, Ager A. A systematic review of prevalence studies of gender-based violence in complex emergencies. Trauma, Violence, & Abuse. 2011;12(3):127–34.CrossRef

Vinck P, Pham P. Association of exposure to intimate-partner physical violence and potentially traumatic war-related events with mental health in Liberia. Soc Sci Med. 2013;77:41–9.CrossRefPubMed

Sriskandarajah V, Neuner F, Catani C. Predictors of violence against children in Tamil families in northern Sri Lanka. Soc Sci Med. 2015;146:257–65.CrossRefPubMed

Hossain M, Zimmerman C, Kiss L, Kone D, Bakayoko-Topolska M, Manan DKA, Lehmann H, Watts C. Men’s and women’s experiences of violence and traumatic events in rural Côte d’Ivoire before, during and after a period of armed. Conflict. 2014;4:e003644.

Saile R, Ertla V, Neunera F, Catani C. Does war contribute to family violence against children? Findings from a two-generational multi-informant study in Northern Uganda. Child Abuse Negl. 2014;38:135–46.CrossRefPubMed

Clark CJ, Everson-Rose SA, Suglia SF, Btoush R, Alonso A, Haj-Yahia M. Association between exposure to political violence and intimate partner violence in the occupied Palestinian territory: a crosssectional study. Lancet. 2010;375:310–6.CrossRefPubMed

Jewkes R, Jama-Shai N, Sikweyiya Y. Enduring impact of conflict on mental health and gender-based violence perpetration in Bougainville, Papua New Guinea: a cross-sectional study. Plos One. under review

Green EP, Blattman C, Jamison J, Annan J. Women's entrepreneurship and intimate partner violence: a cluster randomized trial of microenterprise assistance and partner participation in post-conflict Uganda (SSM-D-14-01580R1). Soc Sci Med. 2015;133:177–88.CrossRefPubMed

10.

Beath A, Christia F, Enikolopov R. Empowering women through development aid: evidence from a field experiment in Afghanistan. Am Polit Sci Rev. 2013;107(03):540–57.CrossRef

11.

Gupta J, Falb KL, Lehmann H, Kpebo D, Xuan Z, Hossain M, Zimmerman C, Watts C, Annan J. Gender norms and economic empowerment intervention to reduce intimate partner violence against women in rural cote d'Ivoire: a randomized controlled pilot study. BMC Int Health Hum Rights. 2013;13(1):46.CrossRefPubMedPubMedCentral

12.

Ellsberg M, Arango DJ, Morton M, Gennari F, Kiplesund S, Contreras M, Watts C. Prevention of violence against women and girls: what does the evidence say? Lancet. 2015;385(9977):1555–66.CrossRefPubMed

13.

Gibbs A, Kerr-Wilson A, Jacobson J. A Global Comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours. Glob Health Action. 2017;10(Sup2):1–15.

14.

Central Statistics Organization. Afghanistan Living Conditions Survey 2013–14. National Risk and Vulnerability Assessment. In. Kabul: Central Statistics Organisation; 2016.

15.

Central Statistics Organization. Afghanistan Demographic and Health Survey 2015. In Kabul: Central Statistics Organisation; 2017.

16.

Nijhowne D, Oates L. Living with violence: a National Report on domestic abuse in Afghanistan. In. Kabul: Global Rights – Partners for Justice; 2008.

17.

Chan A-W, Tetzlaff JM, Gøtzsche PC, Altman DG, Mann H, Berlin JA, Dickersin K, Hróbjartsson A, Schulz KF, Parulekar WR. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586.CrossRefPubMedPubMedCentral

18.

Jewkes R, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N. Impact of stepping stones on incidence of HIV, HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial. Br Med J. 2008;337:a506.CrossRef

19.

Pronyk P, Hargreaves JR, Kim JC, et al. Effect of a structural intervention for the prevention of intimate partner violence and HIV in rural South Africa: a cluster randomised trial. Lancet. 2006;368:1973–83.CrossRefPubMed

20.

Wagman J, Gray RH, Campbell JC, Thoma M, Ndyanabo A, Ssekasanvu J, Nalugoda F, Kagaayi J, Nakigozi G, Serwadda D, et al. Effectiveness of an integrated intimate partner violence and HIV prevention intervention in Rakai, Uganda: analysis of an intervention in an existing cluster randomised cohort. Lancet Glob Health. 2015;3(1):e23–33.CrossRefPubMed

21.

Hegarty K, O'Doherty L, Taft A, Chondros P, Brown S, Valpied J, Astbury J, Tacket A, Gold L, Feder G, et al. Effect of screening and brief counselling for abused women on quality of life, safety planning and mental health: a primary care cluster randomised controlled trial (weave). Lancet. 2013;382(9888):249–58. https://doi.org/10.1016/S0140-6736(13)60052-5.

22.

Hayes R, Moulton L. Cluster Randomised Trials. London: Taylor and Francis; 2009.

23.

Wears R. Advanced statistics: statistical methods for analyzing cluster and cluster-randomized data. Acad Emerg Med. 2008;9(4):330–41.CrossRef

24.

Ellsberg M, Heise L. Putting women’s safety first: ethical and safety recommendations for research on domestic violence against women. In.: Geneva, Switzerland: World Health Organization; 1999.

25.

Garcia-Moreno C, Jansen HAFM, Ellsberg M, Heise L, & Watts CH. Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence. Lancet. 2006:368(9543):1260–69.

26.

Radloff L. The CES-D scale a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;(3):385–401.

27.

Coates J, Swindale A. & Bilinsky P. Household Food Insecurity Access Scale (HFIAS) for measurement of food access: indicator guide. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development; 2007.

28.

Diener ED, Emmons R, Larsen R, & Griffin, S. The satisfaction with life scale. J Pers Assess. 1985;49(1):71–75.

29.

Fulu E, Jewkes R, Roselli T, Garcia-Moreno, C. & UN Multi-Country Cross Sectional Study on Men Violence, Prevalence of and factors associated with male perpetration of intimate partner violence: findings from the UN Multi-country Cross-sectional Study on Men and Violence in Asia and the Pacific. Lancet Glob Health. 2013;1(4):e187–e207

Title: An individually randomized controlled trial to determine the effectiveness of the Women for Women International Programme in reducing intimate partner violence and strengthening livelihoods amongst women in Afghanistan: trial design, methods and baseline findings
Authors: Andrew Gibbs
Julienne Corboz
Mohammed Shafiq
Frozan Marofi
Anna Mecagni
Carron Mann
Fazal Karim
Esnat Chirwa
Charlotte Maxwell-Jones
Rachel Jewkes
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-018-5029-1

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An individually randomized controlled trial to determine the effectiveness of the Women for Women International Programme in reducing intimate partner violence and strengthening livelihoods amongst women in Afghanistan: trial design, methods and baseline findings

Abstract

Background

Methods

Discussion

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

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