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
Date
2020-01-14
Journal Title
Journal ISSN
Volume Title
Publisher
Global Health Action
Abstract
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.
Description
Research Article
Keywords
Intimate partner violence, violence against women, randomised control trial, community intervention, the rural response system, Ghana
Citation
Deda Ogum Alangea, Adolphina A. Addo-Lartey, Esnat D. Chirwa, Yandisa Sikweyiya, Dorcas Coker-Appiah, Rachel Jewkes & Richard M. K. Adanu (2020) Evaluation of the rural response system intervention to prevent violence against women: findings from a communityrandomised controlled trial in the Central Region of Ghana, Global Health Action, 13:1, 1711336, DOI: 10.1080/16549716.2019.1711336