This paper examines men’s lifetime physical intimate partner violence (IPV) perpetration across eight low- and middle-income countries to better understand key risk factors that interventions can target in order to promote gender equality and reduce IPV. We use data from men (n = 7806) that were collected as part of the International Men and Gender Equality Survey (IMAGES) in Bosnia and Herzegovina, Brazil, Chile, Croatia, Democratic Republic of Congo (DRC), India, Mexico, and Rwanda. Results show that there is wide variation across countries for lifetime self-reported physical violence perpetration (range: 17% in Mexico to 45% in DRC), men’s support for equal roles for men and women, and acceptability of violence against women. Across the sample, 31% of men report having perpetrated physical violence against a partner in their lifetime. In multivariate analyses examining risk factors for men ever perpetrating physical violence against a partner, witnessing parental violence was the strongest risk factor, reinforcing previous research suggesting the inter-generational transmission of violence. Additionally, having been involved in fights not specifically with an intimate partner, permissive attitudes towards violence against women, having inequitable gender attitudes, and older age were associated with a higher likelihood of ever perpetrating physical IPV. In separate analyses for each country, we found different patterns of risk factors in countries with high perpetration compared to countries with low perpetration. Findings are interpreted to identify key knowledge gaps and directions for future research, public policies, evaluation, and programming.

BackgroundRigorous evidence of the effectiveness of male engagement interventions, particularly on how these interventions impact relationship power dynamics and women’s decision-making, remains limited. This study assessed the impact of the Bandebereho gender-transformative couples’ intervention on impact on multiple behavioral and health-related outcomes influenced by gender norms and power relations.MethodsWe conducted a multi-site randomised controlled trial in four Rwandan districts with expectant/current fathers and their partners, who were randomised to the intervention (n = 575 couples) or control group (n = 624 couples). Primary outcomes include women’s experience of physical and sexual IPV, women’s attendance and men’s accompaniment at ANC, modern contraceptive use, and partner support during pregnancy. At 21-months post-baseline, 1123 men and 1162 partners were included in intention to treat analysis. Generalized estimating equations with robust standard errors were used to fit the models.FindingsThe Bandebereho intervention led to substantial improvements in multiple reported outcomes. Compared to the control group, women in the intervention group reported: less past-year physical (OR 0.37, p<0.001) and sexual IPV (OR 0.34, p<0.001); and greater attendance (IRR 1.09, p<0.001) and male accompaniment at antenatal care (IRR 1.50, p<0.001); and women and men in the intervention group reported: less child physical punishment (women: OR 0.56, p = 0.001; men: OR 0.66, p = 0.005); greater modern contraceptive use (women: OR 1.53, p = 0.004; men: OR 1.65, p = 0.001); higher levels of men’s participation in childcare and household tasks (women: beta 0.39, p<0.001; men: beta 0.33, p<0.001); and less dominance of men in decision-making.ConclusionsOur study strengthens the existing evidence on male engagement approaches; together with earlier studies our findings suggest that culturally adapted gender-transformative interventions with men and couples can be effective at changing deeply entrenched gender inequalities and a range of health-related behavioral outcomes.Trial registrationClinicalTrials.gov NCT02694627

Efforts to promote gender equality have recognized the importance of involving men and boys. Yet, in general, we have done little in terms of large-scale research in the Global South to understand how men are responding to the global gender equality agenda. This article presents findings from the International Men and Gender Equality Survey (IMAGES), one of the most comprehensive efforts of its kind to gather data on men's attitudes and practices related to gender equality in eight low-and middle-income countries: Brazil, Chile, Mexico, India, Bosnia and Herzegovina, Croatia, Democratic Republic of Congo, and Rwanda. It provides a current picture of men's attitudes about gender and gender equality, explores the determinants of equitable attitudes, and investigates the associations between equitable attitudes and relationship behaviors. We find that men report positive but ambivalent attitudes toward gender equality, and that education, income, and more equitable practices in men's childhood homes are associated with men's more equitable attitudes and Downloaded from practices. Finally, we show that in most countries, men's equitable attitudes are also associated with more equitable practices, including more participation in the home and reduced use of violence, as well as higher sexual satisfaction. The findings suggest both the need for program approaches that change attitudes, as well as policy and structural approaches that create lived experiences of gender equality for men. Given how much early childhood experiences influenced men's adult attitudes and practices, the findings also emphasize the need for programs and policies to promote equitable caregiving.

Background Prior cross-sectional research suggests that both men’s and women’s attitudes towards intimate partner violence (IPV) are predictive of women’s IPV experience, although this can vary greatly by context. In general, women who have experienced IPV are likely to report attitudes accepting of it. Men who perpetrate IPV may also report attitudes accepting of it, although some research has found that there is not always an association. Studies that investigate these dynamics often conflate attitudes with social norms, or use attitudes as a proxy for social norms, given that valid measures on social norms are usually lacking. Here we conduct a secondary data analysis to ask how are men’s and women’s IPV-related attitudes associated with women’s reports of IPV and how are men’s and women’s perceived social norms associated with women’s reports of IPV. Methods Dyadic data were collected from a representative sample of married adolescent girls and their husbands in 48 rural villages of the Dosso region of Niger (N = 1010). Assessments included logistic regression analyses of husbands’ and wives’ reports of individual attitudes towards IPV, and social norms based on husbands’ and wives’ perceptions of their communities’ beliefs related to gender roles and acceptability of IPV. Results Eight percent of women in this sample reported IPV. We found that, consistent with other research, wives who have reported IPV are more likely to report attitudes in support of IPV, while for husbands whose wives report IPV, that relationship is insignificant. On the other hand, husbands who report that people in their community believe there are times when a woman deserves to be beaten are more likely to have perpetrated IPV, while for wives there is no association between the community norm and IPV reporting. Finally, wives who report that people in their community hold inequitable gender norms in general are more likely to have experienced IPV, while for husbands, community gender norms are not predictive of whether their wives have reported IPV. Conclusions Our results are evidence that IPV prevention interventions focused solely on individual attitudes may be insufficient. Targeting and assessment of social norms are likely critical to advancing understanding and prevention of IPV.

Promoting men's participation in unpaid care work is part of the Programme of Action for the International Conference on Population and Development. However, men's involvement in care work does not mirror the advances women have made in paid work outside the home. This mixed method study explores which men are more involved in caregiving, and what childhood and adulthood factors influence their level of involvement. Quantitative research presents findings from 1169 men across six countries with children aged 0-4, and a qualitative study presents findings from in-depth interviews with 83 men engaged in atypical caregiving practices. Survey research finds that being taught to care for children, witnessing one's father take care of one's siblings, respondents' present attitudes about gender equality and having outside help (or none, in some cases) were all also associated with men's higher level of involvement. Qualitative research reveals that men's experiences of violence, the normalisation of domestic work as children and life circumstances rather than greater-than-average beliefs in gender equality all propelled them into care work. Findings suggest that engaging more men into care work implies changes to policies and structural realities in the workplace coupled with changing gender attitudes. These insights inform policy and practice aimed at promoting greater involvement in care work by men.

As newborn hearing-screening programs have expanded, more and more infants and young children need hearing services. Medicaid is one of the primary sources of funding for such services and, by law, must establish payment rates that are sufficient to enlist enough providers to provide services. In this study we compared 2005 Medicaid reimbursement rates for hearing services for infants and young children in 15 states with the payment rates for the same services by Medicare and commercially available health insurance. On average, Medicaid rates for the same services were only 67% as high as Medicare and only 38% as high as commercial fees. Furthermore, most Medicaid rates declined from 2000 to 2005, and many states did not have billing codes for a significant number of the hearing services needed by infants and young children. These factors likely contribute to infants and young children with hearing loss not being able to get the hearing services they need to benefit from early identification of hearing loss. These data also raise questions about the extent to which states are meeting the federal requirement that Medicaid payments be sufficient to enlist enough providers so that care and services are adequately available to the general population in the geographic area.

Intimate partner violence (IPV) and child maltreatment (CM) by a parent or caregiver are prevalent and overlapping issues with damaging consequences for those affected. This scoping review aimed to identify opportunities for greater coordination between IPV and CM programmes in low-and middle-income countries (LMIC). Nine bibliographic databases were searched and grey literature was identified through the scoping review team. Eligible studies were published in English; described primary prevention programmes in LMIC that addressed IPV and CM, or addressed one form of violence, but reported outcomes for the other; reported IPV and CM outcomes; and evaluated with any study design. Six studies were identified published between 2013 and 2016 (four randomised controlled trials, one pre-post non-randomised study and one qualitative study). Programmes were based in South Africa (2), Uganda, (2), Liberia (1) and Thailand (1). All except one were delivered within parenting programmes. The emphasis on gender norms varied between programmes. Some parenting programmes addressed gender inequity indirectly by promoting joint decision-making and open communication between caregivers. Conclusions are tentative due to the small evidence base and methodological weaknesses. More robust evaluations are needed. Improved coherence between IPV and CM programmes requires equal attention to the needs of women and children, and the involvement of fathers when it is safe to do so.KEYWORDS intimate partner violence; child maltreatment; low middle income countries; interventions; scoping review ARTICLE HISTORY

This study assesses the role of gender norms on the relationship between adverse childhood experiences (ACEs) and peer-violence perpetration among very young adolescents in three urban poor cities of Indonesia. Methods: A cross-sectional study was conducted in Bandar Lampung, Denpasar, and Semarang in Indonesia. A total of 2,974 participants (boys: 44.79%, girls: 55.21%) between 10 and 14 years were included in the analysis. Logistic regression, mediation, and moderation analyses were conducted stratified by sex. Results: Risk factors of peer-violence perpetration among boys and girls included three (boys: adjusted odds ratio [aOR] 2.51, 95% confidence interval [CI] 1.32e4.75; girls: aOR 1.82, 95% CI .95 e3.52) and four or more (boys: aOR 6.75, 95% CI 3.86e11.80; girls: aOR 5.37, 95% CI 3.07e9.37) history of ACE. Risk factors of peer-violence perpetration among boys included having inequitable sexual double standard (SDS) indices (aOR 1.46, 95% CI 1.09e1.95). SDS measures the perception boys are rewarded for romantic relationship engagement, whereas girls are stigmatized or disadvantaged for the experience. Other risk factors included lifetime tobacco use among boys and girls and lifetime alcohol use among boys. Protective factors included parental closeness among girls. Conclusions: Based on the research in three Indonesian communities, this study demonstrates that boys are disproportionately exposed to adversities including history of ACE, inequitable SDS, lifetime alcohol use and tobacco use in comparison to girls. Programs targeting ACE and gender norms which engage boys, girls, and families are more likely to be successful in reducing peer- IMPLICATIONS AND CONTRIBUTIONThis study provides increased evidence for the relationship between peer-violence perpetration and adverse childhood experiences among young adolescents in Indonesia. Although unequal gender norms increase peer-violence perpetration among boys, they do not mediate/ moderate the relationship between adversity and male aggression. Interventions reducing male aggression should be Conflicts of interest: The authors have no conflicts of interest to disclose.