Denise Kpebo

Gender norms and economic empowerment intervention to reduce intimate partner violence against women in rural Côte d’Ivoire: a randomized controlled pilot study

BackgroundGender-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.MethodsBetween 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.ResultsIntent 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.ConclusionsResults 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.Trial registrationRegistration Number: NCT01629472.

Associations between Exposure to Intimate Partner Violence, Armed Conflict, and Probable PTSD among Women in Rural Côte d’Ivoire

Background Objectives were to assess associations between intimate partner violence (IPV), violence during armed conflict (i.e. crisis violence), and probable post-traumatic stress disorder (PTSD). Methods Using a sample of 950 women in rural Côte d’Ivoire, logistic generalized estimating equations assessed associations between IPV and crisis violence exposures with past-week probable PTSD. Results Over one in 5 (23.4%) women reported past-year IPV, and over one in 4 women (26.5%) reported experiencing IPV prior to the past year (i.e. remote IPV). Crisis violence was experienced by 72.6% of women. In adjusted models including demographics, crisis violence (overall and specific forms), and IPV (remote and past-year), women who reported past-year IPV had 3.1 times the odds of reporting probable past-week PTSD (95%CI: 1.8–5.3) and those who reported remote IPV had 1.6 times the odds (95%CI: 0.9–2.7). Violent exposures during the crisis were not significantly associated with probable PTSD (any crisis violence: aOR: 1.04 (0.7–1.5); displacement: aOR: 0.9 (95%CI: 0.5–1.7); family victimization during crisis: aOR: 1.1 (95%CI: 0.8–1.7); personal victimization during crisis: aOR: 1.7 (95%CI: 0.7–3.7)). Conclusion Past-year IPV was more strongly associated with past-week probable PTSD than remote IPV and violence directly related to the crisis. IPV must be considered within humanitarian mental health and psychosocial programming.

Gender norms, poverty and armed conflict in Côte D’Ivoire: engaging men in women’s social and economic empowerment programming

Engaging men is a critical component in efforts to reduce intimate partner violence (IPV). Little is known regarding mens perspectives of approaches that challenge inequitable gender norms, particularly in settings impacted by armed conflict. This article describes mens experiences with a womens empowerment program and highlights mens perceptions of gender norms, poverty and armed conflict, as they relate to achieving programmatic goals. Data are from 32 Ivorian men who participated in indepth interviews in 2012. Interviews were undertaken as part of an intervention that combined gender dialogue groups for both women and their male partners with womens only village savings and loans programs to reduce IPV against women. Findings suggested that in the context of armed conflict, traditional gender norms and economic stressors experienced by men challenged fulfillment of gender roles and threatened mens sense of masculinity. Men who participated in gender dialogue groups discussed their acceptance of programming and identified improvements in their relationships with their female partners. These men further discussed increased financial planning along with their partners, and attributed such increases to the intervention. Addressing mens perceptions of masculinity, poverty and armed conflict may be key components to reduce mens violence against women in conflict-affected settings.

Perceptions and Experiences of Intimate Partner Violence in Abidjan, Côte d'Ivoire

Background Men and women’s perceptions of intimate partner violence (IPV) within crisis-affected populations are not well understood. This mixed-methods study examined the frequency of IPV against women in urban Cote d’Ivoire, and qualitatively explored how men and women perceive the impact of various forms of IPV on health, everyday activities, and feelings of shame. Methods A survey was administered to Ivorian women (N = 80) to measure the frequency of IPV, and ten focus group discussions were conducted with women (n = 46) and men (n = 45) to explore perceptions of different forms of IPV, including its impacts on disruptions to health, everyday activities, and experiences of shame. Results Half of all surveyed women (53.6%) reported past year exposure to physical, sexual, or emotional IPV. Of the multiple types of violence, emotional IPV was most common (46.4%), followed by sexual IPV (21.7%) and physical IPV (17.4%). Focus group participants identified additional forms of violence including economic IPV and community discrimination. Lack of financial resources and unemployment were common problems among crisis-affected women and were described as an underlying source of IPV. Both women and men reported that shame and stigma play a large role in how women experience the repercussions of IPV, regardless of the form of violence, with public episodes of IPV almost always seen as more detrimental than private episodes of IPV. Conclusions These results underscore the need for increased social support mechanisms for women to reduce the shame, stigma, and isolation associated with their experiences. The creation of safe and supportive spaces for women to talk about and challenge social norms may be an important first step in reducing community shaming and the secrecy that often surrounds IPV. Safe spaces along with broader societal outreach, including challenging men’s social positions and creating opportunities for increasing economic resources can, in turn potentially decrease the frequency of IPV and its deleterious impacts on a woman’s well-being

Food insecurity associated with intimate partner violence among women in Abidjan, Cote d’Ivoire

Almost 60% of Ivorian women residing in rural, conflict-affected communities report experiencing intimate partner violence (IPV) during their lifetime; this can lead to increased risk of negative reproductive and maternal health outcomes [1]. IPV could also be associated with food insecurity [2], which could further increase vulnerability to poor reproductive health. The aim of the present study was to explore associations between food insecurity and IPV among urban Ivorian women. Language: en