Applying upstream interventions for interpersonal violence prevention: An uphill struggle in low- to middle-income contexts

Abstract

a r t i c l e i n f o Keywords:Interpersonal violence prevention policy Risk factors Interventions Burden of disease Low-to middle-income contexts Western Cape South Africa a b s t r a c tIn South Africa's Western Cape province, interpersonal violence was identified among the key prevention priorities in the provincial government's Burden of Disease (BoD) Reduction project. To date, there are no adequate systematic reviews of the full range of potential intervention strategies. In response, available data and the literature on risk factors and prevention strategies for interpersonal violence were reviewed with a view to providing policy makers with an inventory of interventions for application. Given the predominance of upstream factors in driving the province's rates of interpersonal violence, efforts to address its burden require an intersectoral approach. Achievable short-term targets are also required to offset the long-term nature of the strategies most likely to affect fundamental shifts. Documentation and evaluation will be important to drive long-term investment, ensure effectiveness and enable replication of successful programmes and should be considered imperative by interpersonal violence prevention policymakers in other low-to middle-income contexts.

Evaluation of a Cape Town Safety Intervention as a Model for Good Practice: A Partnership between Researchers, Community and Implementing Agency

“…Interventions which directly target high-risk groups such as repeat offenders are relatively easy to evaluate through experimental study design (Rosenberg et al 2006). Hence, the effects of proximal, as opposed to distal, interventions may be more prominently represented in the literature because they are relatively easy to demonstrate (Limbos et al 2007;Matzopoulos et al 2010). Upstream interventions, instead, often address less clear-cut risk factors such as education, employment and living conditions, and are therefore more difficult to assess.…”

“…This second aspect informed a multi-sectoral violence prevention approach for the province. The review identified numerous examples of other upstream interventions which have been deemed promising and have relevance in the Western Cape, where new and innovative solutions to the high rate of interpersonal violence need to be found (Matzopoulos, Bowman, Mathews & Myers 2010).…”

Readiness to change is a predictor of reduced substance use involvement: Findings from a randomized controlled trial of patients attending South African emergency departments

“…Although many of these patients will have recurring substance-related injuries [10], most have never sought formal substance abuse treatment [11]. Screening patients in EDs for substance use-related problems, and providing brief interventions (BIs) to at-risk patients may reduce the likelihood of further substancerelated injuries [12].…”

“…Second, apart from a few studies [33][34][35][36], knowledge of how RTC informs response to BIs within the ED population is limited. Given the significant burden on the health care system posed by ED patients with substance-related problems [12], there is a need to better understand this population's response to BIs for substance use.…”

Gun control saves lives

“…As such, they can be difficult to sustain over relatively short political cycles. [9] Reducing firearm mortality by means of stricter gun control is one of the most important short-to medium-term measures to address the burden of violence in SA, while longer-term interventions and policy options take effect. When we have evidence that policies and interventions are working, we need to ensure that they are applied rigorously and consistently.…”