Zethembe: a co-developed couples intervention for young heterosexual couples in informal settlements in South Africa.

Effective interventions to address violence against women and girls in urban informal settlements are limited. To address this gap, we undertook an intervention co-development process, bringing together four young women (aged 18-25 years) living in an urban informal settlement, academics and NGO partners. Following the 6 Steps in Quality Intervention Development (6SQuID) approach we collaboratively worked through the steps using participatory methods, supporting the young women to think critically and interrogate their lived reality, identify the causes of violence in their lives, and where they felt change was possible. We co-created Zethembe Couples Care, and 'pre-tested' this with 17 participants (some were couples). Finally, the academics and practitioners revised the intervention and theory of change. The co-development process led to a series of learnings: the process of building trust and supporting young women to reflect and understand their lived realities took a long time (12 of 15 months), limiting intervention development time. The process also enabled young women to push back against received academic/practitioner wisdom, leading to a couples intervention focused on addressing communication and problem solving, where they felt change was possible, but potentially they could not adequately consider addressing structural drivers of violence. The Zethembe Couples Care intervention now requires piloting at a larger scale to develop it further and formally evaluate it.