Ekjut, Chakradharpur, Jharkhand, India.
Society for Nutrition, Education and Health Action, Mumbai, Maharashtra, India.
BMC Int Health Hum Rights. 2020 Mar 25;20(1):6. doi: 10.1186/s12914-020-00224-0.
Almost one in three married Indian women have ever experienced physical, sexual, or emotional violence from husbands in their lifetime. We aimed to investigate the preliminary effects of community mobilisation through participatory learning and action groups facilitated by Accredited Social Health Activists (ASHAs), coupled with access to counselling, to prevent violence against women and girls in Jharkhand, eastern India.
We piloted a cycle of 16 participatory learning and action meetings with women's groups facilitated by ASHAs in rural Jharkhand. Participants identified common forms of violence against women and girls, prioritised the ones they wanted to address, developed locally feasible strategies to address them, implemented the strategies, and evaluated the process. We also trained two counsellors and two ASHA supervisors to support survivors, and gave ASHAs information about legal, health, and police services. We did a before-and-after pilot study involving baseline and endline surveys with group members to estimate preliminary effects of these activities on the acceptability of violence, prevalence of past year emotional and physical violence, and help-seeking.
ASHAs successfully conducted monthly participatory learning and action meetings with 39 women's groups in 22 villages of West Singhbhum district, Jharkhand, between June 2016 and September 2017. We interviewed 59% (679/1149) of women registered with groups at baseline, and 63% (861/1371) at endline. More women reported that violence was unacceptable in all seven scenarios presented to them at endline compared to baseline (adjusted Odds Ratio [aOR]: 1.87, 95%: 1.39-2.52). Fewer women reported experiencing emotional violence from their husbands in the last 12 months (aOR: 0.55, 95% CI: 0.43-0.71), and more sought help if it occurred (aOR: 2.19, 95% CI: 1.51-3.17). In addition, fewer women reported experiencing emotional or physical violence from family members other than their husbands in the last 12 months (aOR: 0.41, 95% CI: 0.32-0.53, and aOR: 0.36, 95% CI: 0.26-0.50, respectively).
Combining participatory learning and action meetings facilitated by ASHAs with access to counselling was an acceptable strategy to address violence against women and girls in rural communities of Jharkhand. The approach warrants further implementation and evaluation as part of a comprehensive response to violence.
印度约有三分之一的已婚女性在一生中曾遭受过丈夫的身体、性或情感暴力。我们旨在研究通过有认证的社会卫生活动家（ASHA）促进的参与式学习和行动小组，再加上获得咨询服务，在印度东部恰尔肯德邦预防针对妇女和女童的暴力的初步效果。
我们在恰尔肯德邦农村地区，用 ASHA 为妇女小组举办了一轮 16 次的参与式学习和行动会议。参与者确定了常见的针对妇女和女童的暴力形式，将她们希望解决的问题列为优先事项，制定了在当地可行的解决策略，实施了这些策略，并评估了这一过程。我们还培训了两名咨询师和两名 ASHA 主管，以支持幸存者，并向 ASHA 提供有关法律、健康和警察服务的信息。我们进行了一项前后试点研究，在基线和终点调查中对小组成员进行了评估，以估计这些活动对暴力可接受性、过去一年情感和身体暴力的发生率以及寻求帮助的初步影响。
2016 年 6 月至 2017 年 9 月期间，ASHA 在西辛格布姆区的 22 个村庄成功地与 39 个妇女小组每月举办一次参与式学习和行动会议。我们在基线时对登记的小组中的 59%（679/1149）的妇女进行了访谈，在终点时对 63%（861/1371）的妇女进行了访谈。与基线相比，在终点有更多的妇女报告说在所有七种情景下暴力都是不可接受的（调整后的优势比[aOR]：1.87，95%CI：1.39-2.52）。在过去的 12 个月中，报告遭受丈夫情感暴力的妇女人数减少（aOR：0.55，95%CI：0.43-0.71），如果发生这种情况，寻求帮助的妇女人数更多（aOR：2.19，95%CI：1.51-3.17）。此外，在过去的 12 个月中，报告遭受丈夫以外的家庭成员情感或身体暴力的妇女人数减少（aOR：0.41，95%CI：0.32-0.53，和 aOR：0.36，95%CI：0.26-0.50）。
将 ASHA 促进的参与式学习和行动会议与获得咨询服务相结合，是解决恰尔肯德邦农村社区针对妇女和女童暴力问题的一种可接受的策略。这种方法值得进一步实施和评估，作为对暴力问题全面应对的一部分。
