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

Long-term impacts of the Bandebereho programme on violence against women and children, maternal health-seeking, and couple relations in Rwanda: a six-year follow-up of a randomised controlled trial

“…Earlier analysis identified improved relationship quality (communication and emotional closeness), men's attitudes about gender and violence, and men's alcohol consumption as key mechanisms responsible for Bandebereho's effects on physical and sexual IPV. 17 Reductions in violent discipline likely operate through similar mechanisms, in addition to improved mental health, strengthened parent–child relationships, reduced stress, and increased parental awareness of violence and its consequences. 7 Although the programme had limited content on positive parenting, parents may have applied some of the couple relationship skills they learned in Bandebereho when interacting with their children.…”

“…These findings suggest more work is needed to change deeply entrenched norms—which position men as the decision-makers and women as the caregivers within the home—to transform household patterns of labour and decision-making. 17 , 38 …”

“…Below we present details of the six-year follow-up and a summary of the original study design, which is published in detail elsewhere. 15 , 17 …”

“…Additional programme details can be found in Supplemental File 1 and in previously published papers. 15 , 17 The control group received no intervention but had access to services as usual. Follow-up data were previously collected at 9 months and 21 months.…”

“…At 21 months, Bandebereho participants reported significantly lower rates of past-year IPV, including physical (OR 0.37, p < 0.001), sexual (OR 0.34, p < 0.001), emotional (OR 0.35, p < 0.001), and economic (OR 0.36, p < 0.001), and parents' physical punishment of children (women: OR 0.56, p = 0.001; men: OR 0.66, p = 0.005) compared to non-participants. 15 , 16 , 17 The trial also demonstrated effects on reproductive and maternal health outcomes (modern contraceptive use and women's antenatal care attendance), father engagement (accompaniment to antenatal care and participation in childcare and household tasks), and couple relations (sharing of household decision-making, childcare and household tasks). 15 …”