Monitoring and evaluation of IPV prevention programmes:

lessons from the IMAGE and SASA! studies

Charlotte Watts Ph.D.

Department of Public Health and Policy

London School of Hygiene and Tropical Medicine

Outline

Gender, Violence & Health Centre, LSHTM Need for evidence on effective interventions Evaluation research by Gender Violence & Health

Centre, LSHTM Lessons learned Challenges Conclusion

Gender, Violence & Health Centre

Multi-disciplinary research team

Charlotte Watts – social epidemiologist Cathy Zimmerman – behavioural scientist Julia Kim – clinician, social scientist Anna Foss - mathematician Loraine Bacchus – social scientist Seema Vyas - economist Tanya Abramsky - epidemiologist Mazeda Hossain – social epidemiologist Karen Devries - epidemiologist Ligia Kiss – social scientist Manuela Colombini – policy analyst Jo Nurse – clinician, policy analyst

Focus on identifying how to respond effectively

What interventions are effective at preventing future violence against women?

What puts some women at greater risk than others?

What services are needed to help women recover from violence?

What may be the health sectors role in addressing violence?

Does economic development reduce women’s vulnerability to violence or enable them to leave violent partnerships?

What works?: building an evidence base Strong evidence globally on scale and impacts of GBV Key policy question – what can we do? Limited evidence base from LMICs

Prevention of violence Effective responses to violence

Many promising interventionsPrevention Youth programmes PROMUNDO / Program H – Brazil / India Men as Partners Stepping Stones – 40+ countries Soul City – educainment - strong messages about the

unacceptability of violenceResponse Legal & counseling services Health services, including post-rape care Women only police stations

Many important and interconnected aspects of prevention

Broad scope of monitoring & evaluation

Important questions for evaluation

Is the intervention feasible and acceptable? Did it have an impact?

why / why not? are the result credible?

Is it affordable / cost-effective? in comparison to alternatives to investment

Is it replicable to other settings? where? are the results likely to be generalisable?

Can it be scaled up?

IMAGE study, South Africa

Provision of micro-finance plus participatory training on gender, violence & HIV to poor rural women

Assess impact on recipients: economic and social empowerment past year risk of physical and/or sexual violence explore impact on HIV risk behaviours

Project status Completed Showed 55% reduction past year IPV Significant impact on reported HIV risk behaviours among young

recipients Ongoing research linked to scale-up

SASA! Study Uganda

SASA! intervention Community mobiliization intervention to address women’s vulnerability

to HIV and violence Engages with men, women & local stakeholders Developed by Raising Voices, implemented by Centre for Domestic

Violence PreventionSASA! study objectives Measure impact on attitudes, skills and behaviors in community Investigate processes and causal pathways Document economic costs of intervention Use study to identify key indicators for future monitoring.Project status Baseline data collection completed Intervention being implemented

IRC/MRI masculinities, intervention, Cote D’Ivoire

IRC / MRI Intervention Aims to challenge and change masculinities that perpetrate

violence Intervention developed by Men’s Resources International Implemented by International Rescue CommitteeEvaluation objectives Measure impact on gender attitudes and behaviors – including

perpetration of violence by men – among intervention participants and wider community

Project status Baseline data collection ongoing

Evaluation study designs in South Africa, Uganda & Cote d’Ivoire

Small cluster randomised controlled trials Intervention implemented in 4-6 villages given intervention. Comparable 4-6 villages given intervention at end of study Quantitative surveys at baseline and following implementation of

intervention Complementary ongoing qualitative research

Participants Project staff Community members Key stakeholders

In South Africa and Uganda, economic costings of interventions

Integrating quantitative and qualitative research approaches

Quantitative Routine monitoring

of activities Mini-surveys Economic costing Large scale

surveys

Qualitative Participatory

evaluation methods Timelines Most significant

change ‘Rosita’s story’

Developing approaches to document insights from qualitative research

Qualitative data provides rich insights

Focus on trying to keep workable, linked to main questions

In Uganda, testing methods to ensure that data collected can be easily summarized

Fed quickly back into programming

Knowledge 1 2 3

4Negative Statements / Resistant to SASA! ideas

Positive Statements /Accepting of SASA! ideas

Participants tend to say that: Participants tend to say that:

- violence is only physical - violence may be physical, emotional, sexual, economic

- violence against women does not have negative consequences

- violence against women has negative consequences

- women who experience violence are not at risk for HIV/AIDS

- women who experience violence are at risk for HIV/AIDS

 Attitude 1 2 3

4

 - some forms of violence against women are acceptable

- violence against women is never acceptable

 - men should have power over women in relationships

- women and men should balance power in a relationship

 - women and men should not share roles in their family and community

- women and men should share roles in their families and community

 

  Skills 1 2 3

4

 

- men who use violence cannot changemen who use violence should be publicly shamed

- men who use violence can be supported to change

 

- women who experience violence should be ignored- we should keep quiet if we know women experiencing violence

- we should reach out to and support women experiencing violence

 - activists speaking out should be shunned

- activists speaking out should be supported

 

  Behaviors 1 2 3

4

 - they cannot balance power in their relationship

- that they do balance power in their relationships

 - they must use / experience violence – it is unavoidable

- they do not use / experience violence

 - they do not promote non-violence in the community

- they promote non-violence in their community.