Department of Chronic Disease Epidemiology, Division of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06520, USA.
BMC Int Health Hum Rights. 2013 Nov 1;13:46. doi: 10.1186/1472-698X-13-46.
Gender-based violence against women, including intimate partner violence (IPV), is a pervasive health and human rights concern. However, relatively little intervention research has been conducted on how to reduce IPV in settings impacted by conflict. The current study reports on the evaluation of the incremental impact of adding "gender dialogue groups" to an economic empowerment group savings program on levels of IPV. This study took place in north and northwestern rural Côte d'Ivoire.
Between 2010 and 2012, we conducted a two-armed, non-blinded randomized-controlled trial (RCT) comparing group savings only (control) to "gender dialogue groups" added to group savings (treatment). The gender dialogue group consisted of eight sessions that targeted women and their male partner. Eligible Ivorian women (18+ years, no prior experience with group savings) were invited to participate. 934 out of 981 (95.2%) partnered women completed baseline and endline data collection. The primary trial outcome measure was an overall measure of past-year physical and/or sexual IPV. Past year physical IPV, sexual IPV, and economic abuse were also separately assessed, as were attitudes towards justification of wife beating and a woman's ability to refuse sex with her husband.
Intent to treat analyses revealed that compared to groups savings alone, the addition of gender dialogue groups resulted in a slightly lower odds of reporting past year physical and/or sexual IPV (OR: 0.92; 95% CI: 0.58, 1.47; not statistically significant). Reductions in reporting of physical IPV and sexual IPV were also observed (not statistically significant). Women in the treatment group were significantly less likely to report economic abuse than control group counterparts (OR = 0.39; 95% CI: 0.25, 0.60, p < .0001). Acceptance of wife beating was significantly reduced among the treatment group (β = -0.97; 95% CI: -1.67, -0.28, p = 0.006), while attitudes towards refusal of sex did not significantly change Per protocol analysis suggests that compared to control women, treatment women attending more than 75% of intervention sessions with their male partner were less likely to report physical IPV (a OR: 0.45; 95% CI: 0.21, 0.94; p = .04) and report fewer justifications for wife beating (adjusted β = -1.14; 95% CI: -2.01, -0.28, p = 0.01) ; and both low and high adherent women reported significantly decreased economic abuse (a OR: 0.31; 95% CI: 0.18, 0.52, p < 0.0001; a OR: 0.47; 95% CI: 0.27, 0.81, p = 01, respectively). No significant reductions were observed for physical and/or sexual IPV, or sexual IPV alone.
Results from this pilot RCT suggest the importance of addressing household gender inequities alongside economic programming, because this type of combined intervention has potential to reduce levels of IPV. Additional large-scale intervention research is needed to replicate these findings.
NCT01629472.
针对妇女的基于性别的暴力，包括亲密伴侣暴力（IPV），是一个普遍存在的健康和人权问题。然而，针对如何在受冲突影响的环境中减少 IPV ，相对较少有干预研究。本研究报告了评估在经济赋权团体储蓄计划中增加“性别对话小组”对 IPV 水平的增量影响的结果。本研究在科特迪瓦北部和西北部农村地区进行。
在 2010 年至 2012 年期间，我们进行了一项双盲随机对照试验（RCT），比较了仅团体储蓄（对照组）与“性别对话小组”添加到团体储蓄（治疗组）的效果。性别对话小组由八次会议组成，针对妇女及其男性伴侣。合格的科特迪瓦妇女（18 岁以上，无团体储蓄经验）被邀请参加。981 名符合条件的伴侣妇女中有 934 名完成了基线和终点数据收集。主要试验结果测量是过去一年身体和/或性 IPV 的综合指标。还分别评估了过去一年的身体 IPV、性 IPV 和经济虐待，以及对妻子殴打的正当化和妇女拒绝与丈夫发生性关系的能力的态度。
意向治疗分析表明，与仅团体储蓄相比，增加性别对话小组导致报告过去一年身体和/或性 IPV 的几率略有降低（OR：0.92；95%CI：0.58，1.47；无统计学意义）。也观察到身体 IPV 和性 IPV 报告的减少（无统计学意义）。与对照组相比，治疗组的妇女报告经济虐待的可能性明显降低（OR = 0.39；95%CI：0.25，0.60，p <.0001）。治疗组对妻子殴打的接受程度显著降低（β = -0.97；95%CI：-1.67，-0.28，p = 0.006），而对拒绝性行为的态度没有显著变化。方案分析表明，与对照组妇女相比，接受超过 75%的伴侣参与干预会议的治疗妇女报告身体 IPV 的可能性较低（aOR：0.45；95%CI：0.21，0.94；p = 0.04），并且报告的妻子殴打理由较少（调整后的β = -1.14；95%CI：-2.01，-0.28，p = 0.01）；而且低和高依从性的妇女报告经济虐待的显著减少（aOR：0.31；95%CI：0.18，0.52，p < 0.0001；aOR：0.47；95%CI：0.27，0.81，p = 0.01）。没有观察到身体和/或性 IPV 或性 IPV 单独减少。
这项试点 RCT 的结果表明，解决家庭性别不平等问题与经济规划同样重要，因为这种综合干预有潜力降低 IPV 水平。需要开展更多的大型干预研究来复制这些发现。
NCT01629472。
