Evaluation of the rural response system intervention to prevent violence against women: findings from a community-randomised controlled trial in the Central Region of Ghana

Background: Intimate partner violence (IPV) affects one in three women globally and undermines women’s human rights, social and economic development, and health, hence the need for integrated interventions involving communities in its prevention. Objective: This community-randomised controlled trial evaluated the Rural Response System (RRS) intervention, which uses Community Based Action Teams to prevent IPV by raising awareness and supporting survivors, compared to no intervention. Methods: Two districts of the Central Region of Ghana were randomly allocated to each arm. Data were collected by repeated, randomly sampled, household surveys, conducted at baseline (2000 women, 2126 men) and 24 months later (2198 women, 2328 men). The analysis used a difference in difference (DID) approach, adjusted for age and exposure to violence in childhood. Results: In intervention communities, women’s past year experience of sexual IPV reduced from 17.1% to 7.7% versus 9.3% to 8.0% in the control communities (DID = −9.3(95%CI; −17.5,−1.0), p = 0.030). The prevalence of past-year physical IPV among women in the intervention communities reduced from 16.5% to 8.3% versus 14.6% to 10.9% in the controls (DID = −4.2(−12,3.6), p = 0.289). The prevalence of severe IPV experienced by women reduced from 21.2% to 11.6% in intervention versus 17.3% to 11.4% in controls (DID = −3.7(−12.5,5.1), p = 0.408). The direction of impact of the intervention on violence perpetrated by men was more towards a reduction but changes were not statistically significant. Emotional IPV perpetration was significantly lower (DID = −15.0(−28.5, −1.7), p = 0.031). Women’s depression scores and reports of male partner controlling behaviour significantly also reduced in the intervention arm compared to those in the control arm (DID = −4.8(−8.0,−1.5), p = 0.005; DID = −2.7(−3.3,−1.0), p = 0.002, respectively). Conclusion: Our findings indicate that the RRS intervention reduced women’s experiences of IPV, depression, and partner controlling behaviour and some evidence of men’s reported reductions in the perpetration of IPV. The RRS intervention warrants careful scale-up in Ghana and further research

Prevalence and risk factors of physical or sexual intimate violence perpetration amongst men in four districts in the central region of Ghana: Baseline findings from a cluster randomised controlled trial

<div><p>Background</p><p>Evidence-based interventions are essential in the prevention of violence against women (VAW). An understanding of risk factors for male perpetration of VAW using population-based research is crucial for developing such interventions. This study is a baseline assessment of a two-arm unmatched cluster randomised controlled trial (C-RCT), set up to assess the impact of a Rural Response System (RRS) intervention for preventing violence against women and girls in Ghana. This study aims at assessing past year prevalence and risk factors for sexual or physical intimate partner violence (IPV) perpetration among men.</p><p>Methods</p><p>The population-based survey involved 2126 men aged 18 and above living in selected communities in 4 districts in the central region of Ghana. Logistic regression techniques were used to determine risk factors for sexual or physical IPV perpetration. All models adjusted for age of respondent and took into account the study design.</p><p>Results</p><p>Half of the men had perpetrated at least one form of violence against their intimate partners in their lifetime while 41% had perpetrated sexual or physical IPV. Majority (93%) of the men had been in relationships in the 12 months preceding the survey, and of these, 23% had perpetrated sexual or physical IPV. Childhood factors associated with sexual or physical IPV included witnessing abuse of mother (aOR:1.40(1.06–1.86)), and neglect (aOR:1.81(1.30–2.50)). Other major risk factors for IPV perpetration were: having multiple partners (aOR:1.76(1.36–2.26)), (involvement in transactional sex (aOR:1.76(1.36–2.26)), substance use (aOR:1.74(1.25–2.43)) and gender inequitable attitudes (aOR:0.94(0.91–0.97)).</p><p>Conclusion</p><p>Childhood violence experience and witnessing, risky behaviour (multiple partners, transactional sex, substance use) and gender inequitable attitudes are major risk factors for sexual or physical IPV perpetration. Perpetration of sexual or physical IPV tend to co-occur with non-partner violence and emotional IPV perpetration. Interventions targeting these factors are critical in reducing IPV.</p></div

Prevalence of violence perpetration by men.

<p>Prevalence of violence perpetration by men.</p

Social and demographic characteristics of the sample of men interviewed in the 4 districts.

<p>Social and demographic characteristics of the sample of men interviewed in the 4 districts.</p

Multivariate logistic regression analysis of the risk factors of past year sexual or physical IPV perpetration.

<p>Multivariate logistic regression analysis of the risk factors of past year sexual or physical IPV perpetration.</p

Bivariate analysis of factors associated with past year sexual or physical intimate partner violence perpetration.

<p>Bivariate analysis of factors associated with past year sexual or physical intimate partner violence perpetration.</p

List of items for measuring physical or sexual IPV.

<p>List of items for measuring physical or sexual IPV.</p

Determinants of domestic violence against women in Ghana

Abstract Background The prevalence of domestic violence remains unacceptably high with numerous consequences ranging from psychological to maternal and neonatal mortality and morbidity outcomes in pregnant women. The aim of this study was to identify factors that increased the likelihood of an event of domestic violence as reported by ever married Ghanaian women. Methods Data from the 2008 Ghana Demographic and Health Survey (GDHS) was analysed using a multivariate logistic model and risk factors were obtained using the forward selection procedure. Results Of the 1524 ever married women in this study, 33.6 % had ever experienced domestic violence. The risk of ever experiencing domestic violence was 35 % for women who reside in urban areas. Risk of domestic violence was 41 % higher for women whose husbands ever experienced their father beating their mother. Women whose mother ever beat their father were three times more likely to experience domestic violence as compared to women whose mother did not beat their father. The risk of ever experiencing domestic violence was 48 % less likely for women whose husbands had higher than secondary education as compared to women whose husbands never had any formal education. Women whose husbands drink alcohol were 2.5 times more likely to experience domestic violence as compared to women whose husbands do not drink alcohol. Conclusion Place of residence, alcohol use by husband and family history of violence do increase a woman’s risk of ever experiencing domestic violence. Higher than secondary education acted as a protective buffer against domestic violence. Domestic violence against women is still persistent and greater efforts should be channelled into curtailing it by using a multi-stakeholder approach and enforcing stricter punishments to perpetrators