Research, Evidence And Learning Digest - Humanitarian Library
GBV AoR HELPDESKGender-BasedViolence AoRResearch, Evidence and Learning DigestIntimate Partner Violence (IPV) in EmergenciesIPV is one of the most common forms of violence against women and girls (VAWG) and includes physical,sexual, and emotional abuse and controlling behaviours by an intimate partner. IPV can affect women of allages and results in short and long-term physical, sexual and reproductive, and mental health problems thatcan be severe and life-threatening. Global estimates indicate that about 1 in 3 (35%) women worldwide haveexperienced either physical and/or sexual intimate partner violence or non-partner sexual violence in theirlifetime and this rate can be much higher in emergencies. Humanitarian crises exacerbate pre-existing formsof VAWG, including IPV. Until recently, IPV in emergencies has been a relatively neglected issue and moreevidence and action is required to effectively address IPV in humanitarian settings. This evidence digestfocuses on emerging research in relation to IPV in emergencies, with a focus on 1) the prevalence and driversor predictors of IPV; 2) approaches to prevent IPV; and 3) interventions to respond to IPV. Notably, however,evidence of promising practices on multi-sectoral responses to IPV in humanitarian crisis is limited. Links torelevant IPV research, guidance and tools are provided at the end.Select evidence on the prevalence and drivers orpredictors of IPV in emergenciesWhile data is lacking, available evidence indicatesthat IPV is the most common form of gender-basedviolence (GBV) in humanitarian settings. Recentresearch suggests that IPV is more prevalent thannon-partner sexual violence during emergencies butreceives less attention. Conflict, displacement,accompanying shifts in gender roles andresponsibilities, breakdown in family andcommunity protection mechanisms and poverty aresome of the key contributing factors associated withincreased levels of IPV in emergencies.What works to prevent and respond to violenceagainst women and girls in conflict andhumanitarian settings? (Murphy, M., Arango, D.,Hill, A., Contreras, M., MacRae, M., and Ellsberg, M.,2016)This evidence review was part of initial research onthe What Works: Violence Against Women and Girlsin Conflict and Humanitarian Crises initiative.i Theobjective of the review was to provide a succinctoverview of existing evidence on the prevalence ofVAWG, including IPV, during emergencies and sharepromising and emerging practices to prevent andrespond to VAWG in humanitarian action. Theevidence review found that little is known about theprevalence of different forms of VAWG inhumanitarian settings and that the existing evidencebase is weak.Even so, the review highlighted that although sexualviolence prevalence is high during crisis, severalstudies have shown that women are at an evengreater risk of IPV during emergencies. The evidencereview included a desk review by Stark and Ager(2011) which analysed 14 studies and found thatreported rates of IPV were often higher than nonpartner sexual violence in humanitarian settings.The evidence review was careful to emphasize thatprevalence data is not necessary to take action toaddress different forms of VAWG in humanitarianresponse. While stressing the need for furtherevaluations of programming focused on respondingto and preventing IPV during crisis, the review foundthat some evidence of effective interventions isemerging – both from lessons learned inhumanitarian settings as well as from approaches innon-emergency settings that may be adapted, andthat the most effective programmes to reduce IPVtarget underlying gender unequal norms and power1
structures throughout the entire community,including engaging with men and boys.Private violence, public concern: Intimate partnerviolence in humanitarian settings (InternationalRescue Committee (IRC), 2015)This report is a follow up to IRC’s first researchreport on intimate partner violence in humanitariansettings, Let me not die before my time: Domesticviolence in West Africa (2012), which is one of thefirst reports of its kind to underscore IPV as asignificant problem in humanitarian settings.The 2015 report goes on to examine in greaterdepth the nature and drivers of IPV in humanitariansettings. It is based on research carried out by theIRC in 2014 in Domiz camp in Iraq, Dadaab camp inKenya, and Ajuong Thok settlement in South Sudan.The research focused on three key questions: 1)What are the drivers and nature of IPV inhumanitarian settings?; 2) How do displaced womenexperience intimate partner violence?; and 3) Whatdo women recommend to improve prevention andresponse to IPV?The research shows that IPV in humanitariansettings is fundamentally driven by pre-existinggender inequalities. Across the three settings, fouradditional contributing factors for IPV wereidentified as common: Rapidly changing gender norms triggered bydisplacement. Displacement resulted insignificant shifts in gender roles andresponsibilities that altered social dynamics.Women’s access to new opportunities cancreate tensions in the home, especially as men’sopportunities may diminish. Some men adapt,while others use violence to reassert power andcontrol. Women’s separation from their parents andfamilies. Displacement breaks down family andcommunity structures, dramatically reducingsafety options for women. Women reportedthat their partners were more likely to exertviolence with increased impunity becausefamily members were no longer present. Forced marriage and remarriage. Duringdisplacement, marriage is viewed as anopportunity to secure economic support andprotection. Child marriage puts adolescent girlsin positions of extreme dependence which mayincrease risks of IPV. Forced marriages,including re-marriages, are often conductedwith unequal economic and social s also increase risks of IPV. Poverty and substance abuse. Extreme povertyis correlated with increased stress and tensionbetween intimate partners. This, combinedwith the shifting power dynamics resulting fromwomen’snascentincome-earningopportunities, can become a contributingfactor to men’s justification of the use ofviolence. In addition, research found that menwho use substances like alcohol and khat weremore likely to use violence.Physical violence was the most common type ofviolence reported, and women consulted alsoexperienced psychological and sexual violence.Women are often prohibited from interacting withfamily and friends, which increases their isolation.Recommendations for humanitarian actors toimprove IPV prevention and response includedirectly engaging with women and girls to informthe design, implementation, and evaluation of IPVinterventions; establishing a coordinated responseacross health, psychosocial and protection services;providing safety options; considering family-levelinterventions that integrate IPV and childmaltreatment responses; providing economic andsocial programmes for survivors and those at risk;and influencing social norms.Preventing Household Violence: PromisingStrategies for Humanitarian Settings (Asghar, K.,Rubenstein, B., and Stark, L., 2017)This systematic literature review was conducted toidentify predictors of household violence inhumanitarian settings as part of the TransformingHouseholds: Reducing Incidence of Violence inEmergencies (THRIVE) project, co-led by the UNChildren’s Fund (UNICEF) and the CPC LearningNetwork at Columbia University. The THRIVE projectis aimed at identifying linkages between Violenceagainst Women (VAW) and Violence againstChildren (VAC) at the household level, with the goalof supporting GBV and Child Protection actors inhumanitarian settings to be better coordinated inefforts to address IPV.For the literature review, predictors of householdviolence were defined as any individual, household,or community-level exposure that increases ordecreases risks associated with physical, sexual, oremotional violence between two or more peopleliving together. This systematic review highlightedfive predictors common to both VAW and VAC:conflict exposure, alcohol and drug use, income andeconomic status, mental health/coping strategies,and limited social support. This finding confirmed2
the intersection of predictors of household violencein emergencies across VAW and VAC and thepotential for integrated interventions.The review also makes recommendations forpractitioners and researchers to improve violenceprevention and response programming and addressgaps in household violence interventions inemergencies. These include developing holisticinterventions that work with multiple actors in thefamily to prevent violence; looking at the waysprogramming affects different sub-groups withinhouseholds e.g. age, household dynamics,specialised needs in the household. Additionally, itrecommends that the negative unintendedconsequences of interventions should always beconsidered. For example, awareness-raising maylead to a decrease in some forms of violence, butother forms of violence may be used in their place.Finally, this review identified a clear need for betterknowledge generation, management and sharing oflearning and good practice among GBV and ChildProtection actors, alongside increased funding todocument and evaluate interventions.Select evidence of approaches to prevent IPV inemergenciesSuccessful interventions to reduce IPV need toaddress the root causes and underlying risk factorsto change harmful attitudes and behaviours thatperpetuate violence and should target both menand women to affect meaningful change, while alsoensuring that women participate and lead in thedesign of interventions. Increasingly, preventionprogramming focuses on supporting economic andsocial empowermentii, challenging social norms,implementing community-based programmesincluding awareness-raising campaigns and creatingmore protective environments. Evidence oneffective IPV prevention interventions forhumanitarian contexts has emerged in recent years.Community-Based Approaches to Intimate PartnerViolence (The Global Women’s Institute and WorldBank, 2016)This review presents evidence of interventionsdemonstrating effective community mobilisationapproaches successful in transforming harmfulgender norms to reduce IPV including SASA!, SomosDiferentes, Somos Iguales, Engaging Men in GBVPrevention, Stepping Stones, Program H, SHARE,and IMAGE. While not specifically focused onhumanitarian settings, it outlines the basiccomponents to adapt successful interventions todifferent contexts including emergencies. Thereview highlighted recent findings that programmesinvolving community mobilisation and/or economicempowerment paired with gender equality trainingsignificantly reduce rates of IPV. While theinterventions reviewed vary in methods, they arebased on common approaches that can be adaptedto different settings and cultures. Successfulcommunity-based interventions permeate multiplelevels of society, engage key stakeholders and fostercollective action to challenge gender norms withinentire communities.Community-based, multi-sectoral and culturallyadapted interventions increase ownership ofoutcomes. Longer term investment in programmesallows for more sustained capacity building and thecreation of networks that are critical for reducingIPV. Through educational and behaviour changeapproaches, these programmes foster collectiveaction and build community capacity to challengegender norms leading to reductions in IPV.The report also provides guidance andrecommendations on how to adapt successfulinterventions to different contexts. These includelocal stakeholder participation in developingadaptations, engaging a cross section on thecommunity, rigorous monitoring and evaluating,ensuring access to survivor-centered care andpromoting cooperation and exchange amongimplementers. It also recommends longer termresponses to address the root causes of violenceand capacity building to ensure sustainability.The guidance further details six essential steps tocontextualizing community-based interventions toprevent IPV in different contexts. These involveunderstanding violence in the setting and selectingthe methodology best suited to the context;identifying suitable, high-priority locations;considering community need and readiness;developing a network of local partners; formalisinga locally appropriate programme design; preparingprogramme materials; and finalising outreach anddissemination plans promptly.Working with men to prevent intimate partnerviolence in a conflict-affected setting: a pilot clusterrandomized controlled trial in rural Côte d’Ivoire(Hossain, M., Zimmerman, C., Kiss, L., Abramsky, T.,Kone, D., Bakayoko-Topolska, M., Annan, J.,Lehmann, H., Watts, C., 2014)This research conducted by the London School ofHygiene and Tropical Medicine measured theimpact of the IRC’s men’s discussion groups (MDGs)3
intervention in Cote d’Ivoire in 2014 as part of theIRC Men and Women in Partnership Initiative. iii TheMDGs were a four-month series of weekly sessionsdesigned to confront gender biases anddiscriminatory beliefs that influence men’s decisionto use violence, to educate men about theconsequences of GBV, and to provide them withconflict management skills to avoid violence.Researchers identified pairs of communities alreadyreceiving a comprehensive set of GBV services fromthe IRC, and randomly selected half of them toreceive the MDG intervention. All mmes.Intervention communities alsoreceived the 16-week IPV prevention MDGs.Overall, the MDGs contributed to a decline inphysical IPV and/or sexual IPV: women whosepartners had enrolled in the programme reported adecrease in both physical and sexual violence overthe 12- month period after the programme ended.Men’s attitudes about violence changed afterenrolling in the discussion groups with participatingmen reporting decreased intentions to use physicalIPV and improved attitudes toward sexual IPV.However, these findings did not reach statisticalsignificance.Significant differences were found between men inthe intervention and control arms’ reported abilityto manage conflict and their participation ingendered household tasks. Men in the discussiongroups learned to avoid violent behaviour.Participants were more likely to use newly learnedskills to control negative emotions and diffuse theirinclinations towards violence. The MDGs wereeffective in increasing men’s involvement in somehousehold chores normally performed by women,such as cooking, cleaning and caring for children.Key learning indicates that: interventions focused ontransforming beliefs and attitudes should targetboth men and women to effect meaningful change,and women should be advising and leading onapproaches, rather than taking a back to seat to thiswork; intervention groups should not be mixed maleand female; success in recruiting and sustainingmen’s participation in violence preventionprogrammes does not depend on financialincentives; and efforts to engage men in violenceprevention must emphasise that violence does notresult from anger--violence is a choice, and men canmake the decision to avoid violence.ivSelect evidence of interventions to respond to IPV inemergencies (and beyond)Women who experience IPV have complex needsand may require services from many differentsectors. Survivor-centred healthcare, psychosocialsupport, legal, community-based, and other multisectoral strategies are needed to respond to andmitigate the consequences of IPV. However, inhumanitarian contexts, evidence of effective multisectoral interventions to respond to IPV issignificantly lacking. More investment, research andlearning is required to inform IPV responses inemergencies.Promising practices from non-humanitariancontexts can be applied to emergency settings,especially in relation to health services for survivors.Evidence indicates that the best way to improveservices to survivors is to implement system-widereforms including policies and infrastructure;trainings and support; information, education,communication (IEC) materials; written protocolsand referral pathways; data collection systems;monitoring and evaluation to assess the quality ofservice provision.v At the same time, evidence (alsofrom non-humanitarian contexts) suggests thatinterventions such as mediation and screening forIPV should be avoided, if possible.Health responseThe health-systems response to violence againstwomen (García-Moreno, C., Hegarty, K., d'Oliveira,A., Koziol-McLain, J., Colombini, M., Feder, G., 2014)This paper is based on a detailed literature review ofevidence on health-care responses to VAWG in fivediverse countries (Lebanon, India, Spain, Brazil andSouth Africa), and on consultations with thoseinvolved in the planning or delivery of services inresource-poor settings.The review highlights the critical role of healthsystems in preventing, responding to and mitigatingthe effects of intimate partner and sexual violence.Health-care providers are often the first andsometimes only point of contact for survivors toseek help. The study notes that health systems needto strengthen the role of providers as part of amultisectoral response The appropriate responseby health-care providers will vary depending on asurvivor’s level of recognition or acknowledgment ofthe violence, the type of violence, and the entrypoint or level of care where the survivor is identified.Actions by health-care providers includeidentification, initial supportive response todisclosure or identification of IPV, and provision ofclinical care, follow-up, referral, and support forwomen experiencing IPV, in addition tocomprehensive post-rape care and support forsurvivors of sexual violence. The review then4
describes the components of a comprehensivehealth-system approach that helps health-careproviders to identify and support women subjectedto intimate partner or sexual violence. It provides anoverview of the core components (or buildingblocks) of a health system response: servicedelivery, health workforce, health information,infrastructure and access to essential medicines,financing, and leadership and governance.Challenges and lessons learned from differentcontexts to integrate effective care for womenexperiencing violence in policies and processes areoutlined. The review makes recommendations tobuild health system responses that can enableproviders to address IPV and sexual violence,including developing protocols, capacity building,effective coordination between agencies, andstrengthening referral networks. While not specificto emergency settings, the same components of aneffective health system response are applicable. Thereview concludes that additional research is neededto identify what works, assess promising practices,and develop new strategies for prevention andresponse with a focus on low-income and middleincome settings.Coordinated multi-sectoral responseMen and intimate partner violence: From researchto action in Bangladesh, Nepal and Pakistan(Samuels, F., Jones, N., Gupta, T., with Ghimire, A.,Karmaliani, Naved, K., Yount, K., 2017)This research used literature reviews, analysis ofexisting quantitative information and primaryqualitative data to explore the underlying drivers,triggers, risks and influencing factors for IPV inNepal, Bangladesh and Pakistan. It aimed tounderstand the multi-level drivers of maleperpetration of IPV; to determine which types ofpolicy and programming are tackling maleperpetration and the associated implications forpolicy and practice of IPV to strengthen responses;and to investigate how broader political economydynamics shape attitudes, behaviours and serviceprovision on IPV. This study presents some relevantcross-country findings that highlight multiplechallenges in the IPV response.In all three countries, under-reporting of IPV iswidespread due to stigma, fear, the fact that IPV isdeemed a ‘private’ family matter,
address different forms of VAWG in humanitarian response. While stressing the need for further . GV AoR HELPDESK Research, Evidence and Learning Digest Intimate Partner Violence (IPV) in Emergencies . This report is a follow up to IR ’s first research report on intimate partner violence in humanitarian settings, Let me not die before my .
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