A qualitative exploration of mechanisms of intimate partner violence reduction for Zambian couples receiving the Common Elements Treatment Approach (CETA) intervention

Murray, Sarah; Skavenski, Stephanie; Metz, Kristina; Mulemba, Saphira; Mwenge, Mwamba; Kane, Jeremy C.; Alto, Michelle E.; Venturo‐Conerly, Katherine E.; Wasil, Akash R.; Fine, Shoshanna L.; Murray, Laura

doi:10.1016/j.socscimed.2020.113458

Cited by 12 publications

(15 citation statements)

References 31 publications

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“…This is consistent with evidence from other Ethiopian studies, that women are often characterised as provoking abuse (victim blaming) [ 13 , 41 ]. Studies from Ethiopia and other sub-Saharan African countries also support our findings that IPV was reinforced by a lack of community sanctions [ 11 , 42 ], unequal gender norms [ 17 , 39 , 43 ], and treating women as property [ 38 , 39 ].…”

Section: Discussionsupporting

confidence: 83%

“…Community norms meant that women were expected to adjust their behaviour to accommodate IPV, which is consistent with findings from Ethiopia [ 13 ] and other sub-Saharan African countries [ 38 , 39 , 43 , 44 ]. Interviews highlighted the lack of substantial legal or community repercussions for perpetrators of IPV, as reported by other qualitative studies with women, health workers, and community stakeholders in Ethiopia [ 12 , 14 , 15 ].…”

Section: Discussionsupporting

confidence: 79%

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Pregnant women and health workers’ perspectives on perinatal mental health and intimate partner violence in rural Ethiopia: a qualitative interview study

Keynejad

Bitew

Mulushoa

et al. 2023

BMC Pregnancy Childbirth

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Background Mental health conditions are common during the perinatal period and associated with maternal, foetal, and neonatal morbidity and mortality. There is an established bidirectional relationship between mental health conditions and intimate partner violence (IPV), including during and after pregnancy. Mean lifetime prevalence of physical, sexual or emotional IPV exposure among women in rural Ethiopia is estimated to be 61% and may be even higher during the perinatal period. We aimed to explore the perspectives of women and antenatal care (ANC) health workers on the relationship between all types of IPV and perinatal mental health, to inform the adaptation of a psychological intervention for pregnant women experiencing IPV in rural Ethiopia. Methods We conducted in-depth qualitative interviews with 16 pregnant women and 12 health workers in the Gurage zone of the Southern Nations, Nationalities and People’s Region of Ethiopia, between December 2018 and December 2019. We conducted thematic analysis of English-translated transcripts of audio-recorded Amharic-language interviews. Results Participants contextualised IPV as the primary form of abusive treatment women experienced, connected by multiple pathways to emotional and bodily distress. Patriarchal norms explained how the actions of neighbours, family, community leaders, law enforcement, and government agents in response to IPV often reinforced women’s experiences of abuse. This created a sense of powerlessness, exacerbated by the tension between high cultural expectations of reciprocal generosity and severe deprivation. Women and health workers advocated a psychological intervention to address women’s powerlessness over the range of difficulties they faced in their daily lives. Conclusions Women and health workers in rural Ethiopia perceive multiple, interconnected pathways between IPV and perinatal emotional difficulties. Contrary to expectations of sensitivity, women and health workers were comfortable discussing the impact of IPV on perinatal mental health, and supported the need for brief mental health interventions integrated into ANC.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 79%

Pregnant women and health workers’ perspectives on perinatal mental health and intimate partner violence in rural Ethiopia: a qualitative interview study

Keynejad

Bitew

Mulushoa

et al. 2023

BMC Pregnancy Childbirth

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“…Follow-up at 24 months post-baseline showed no significant changes in AOD or IPV outcomes with authors suggesting that treatment gains were sustained for two years (Kane et al , 2021). A sub-set of couples reported that skills learnt in the programme included strategies to avoid conflict, anger management, reduce alcohol use and improved empathy for their partner (Murray et al , 2021). Similar findings occurred in the remaining two programmes in India and Nepal where development of mutually reinforcing skills improved inter-couple dynamics (Hartmann et al , 2020; Kalk et al , 2021).…”

Section: Resultsmentioning

confidence: 99%

“…Men’s voluntary participation in couple-based programmes reflects a desire to improve their relationship functioning. A RCT in Zambia compared counselling sessions separately for men and their spouses to no treatment (Kane et al , 2021; Murray et al , 2020; Murray et al , 2021). Couples ( n = 123) were randomised into the combined programme finding men’s alcohol use and IPV perpetration significantly reduced after treatment completion (Murray et al , 2021).…”

Section: Resultsmentioning

confidence: 99%

“…A RCT in Zambia compared counselling sessions separately for men and their spouses to no treatment (Kane et al , 2021; Murray et al , 2020; Murray et al , 2021). Couples ( n = 123) were randomised into the combined programme finding men’s alcohol use and IPV perpetration significantly reduced after treatment completion (Murray et al , 2021). Follow-up at 24 months post-baseline showed no significant changes in AOD or IPV outcomes with authors suggesting that treatment gains were sustained for two years (Kane et al , 2021).…”

Section: Resultsmentioning

confidence: 99%

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Programme responses for men who perpetrate intimate partner violence in the context of alcohol or other drugs: a scoping review

Nguyen

Kertesz

Davidson

et al. 2023

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Purpose Substance use plays a significant role in the perpetration of much intimate partner violence (IPV). However, responses to these two issues are rarely integrated. Single focus programme responses can lead to poor outcomes for men as well as their families experiencing these intersecting issues. This scoping paper aims to establish the current state of knowledge on contextual factors influencing the development and implementation of combined programmes. Design/methodology/approach Four electronic databases were systematically searched in May 2021 and December 2021. Twenty-one peer-reviewed studies reporting on ten programmes were included. Findings This scoping review revealed that combined programme responses are an underdeveloped area of research and evaluation. The limited evidence base indicated systemic barriers hindering services’ capacity to expand this field of work, affecting implementation and outcomes. Support is required from the wider service systems to intervene in men’s perpetration of IPV in the context of substance use. Practical implications Findings in this scoping review demonstrate the importance of fostering a coordinated and collective response to IPV in the context of substance use. Combined programmes have the potential to reduce siloed practices, enabling more holistic responses for men with intersecting issues. However, researchers and policymakers must also address contextual issues hindering or enabling combined programmes’ implementation and development. Originality/value Mapping the evidence based on combined programmes provides direction for further development and research to expand this field of inquiry.

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Improved Relationship Quality, Equitable Gender Attitudes, and Reduced Alcohol Abuse as Key Mechanisms to Reduce Intimate Partner Violence in the Bandebereho Couples’ Randomized Trial in Rwanda

Levtov¹,

Doyle²,

Bingenheimer

et al. 2022

Prev Sci

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A qualitative exploration of mechanisms of intimate partner violence reduction for Zambian couples receiving the Common Elements Treatment Approach (CETA) intervention

Cited by 12 publications

References 31 publications

Pregnant women and health workers’ perspectives on perinatal mental health and intimate partner violence in rural Ethiopia: a qualitative interview study

Pregnant women and health workers’ perspectives on perinatal mental health and intimate partner violence in rural Ethiopia: a qualitative interview study

Programme responses for men who perpetrate intimate partner violence in the context of alcohol or other drugs: a scoping review

Improved Relationship Quality, Equitable Gender Attitudes, and Reduced Alcohol Abuse as Key Mechanisms to Reduce Intimate Partner Violence in the Bandebereho Couples’ Randomized Trial in Rwanda

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