The Stepping Stones and Creating Futures intervention to prevent intimate partner violence and HIV-risk behaviours in Durban, South Africa: study protocol for a cluster randomized control trial, and baseline characteristics

Abstract

BackgroundPreventing intimate partner violence (IPV) remains a global public health challenge. Studies suggest urban informal settlements have particularly high levels of IPV and HIV-prevalence and these settlements are rapidly growing. The current evidence base of effective approaches to preventing IPV recognizes the potential of combining economic strengthening and gender transformative interventions. However, few of these interventions have been done in urban informal settlements, and almost none have included men as direct recipients of these interventions.MethodsStepping Stones and Creating Futures intervention is a participatory gender transformative and livelihoods strengthening intervention. It is being evaluated through a cluster randomized control trial amongst young women and men (18–30) living in urban informal settlements in eThekwini Municipality, South Africa. The evaluation includes a qualitative process evaluation and cost-effectiveness analysis. A comparison of baseline characteristics of participants is also included.DiscussionThis is one of the first large trials to prevent IPV and HIV-vulnerability amongst young women and men in urban informal settlements. Given the mixed methods evaluation, the results of this trial have the ability to develop a stronger understanding of what works to prevent violence against women and the processes of change in interventions.Trial registration NCT03022370. Registered 13 January 2017, retrospectively registered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4223-x) contains supplementary material, which is available to authorized users.

Effectiveness of a multi-level intervention to reduce men’s perpetration of intimate partner violence: a cluster randomised controlled trial

“…A different kind of intervention may be warranted in this setting, such as the Stepping Stones Creating Futures intervention, which was conducted in the per-urban setting in eThekwini. The intervention, conducted in small groups over a period of time, focused on livelihoods as well as participatory learning approaches, including critical reflection, role play and drama to build more gender-equitable relationships with better communication between partners [36,37].…”

Intimate partner violence: A key correlate of women’s physical and mental health in informal settlements in Nairobi, Kenya

“…When trying to account for the higher levels of VAW in informal settlements, scholars often employ socio-ecological frameworks to highlight the interplay of factors from multiple levels that shape its occurrence [38]. Some research links factors such as poverty in these settlements to high levels of VAW [33,39,40]. In addition, lack of durable housing, insecure tenancy, and lack of opportunity for education and employment may exacerbate incidence of 'stress-induced violence' in informal settlements [33].…”

Constructing, reproducing and challenging masculinities in a participatory intervention in urban informal settlements in South Africa

“…Data came from the Stepping Stones and Creating Futures randomised controlled trial (RCT), undertaken in urban informal settlements in eThekwini Municipality, South Africa between 2015 and 2018. The main trial evaluated the impact of Stepping Stones and Creating Futures on young (ages 18-30) men's perpetration and women's experience of intimate partner violence (IPV), alongside whether it changed HIV-risk behaviours, created more gender-equitable attitudes and reduced male controlling behaviours (Gibbs et al 2017). Embedded in the RCT was a qualitative process evaluation to understand intervention delivery by facilitators.…”

“…In this paper we describe how one gender-transformative programme -Stepping Stones and Creating Futures (Gibbs et al 2017), working with young (aged 18-30) Black African men in urban informal settlements in South Africaconstitutes a site in which different configurations of masculinity are displayed, used and in competition with one another in the daily practices of young male facilitators. We show how the programme's facilitators work to position themselves in the eyes of the male participants as 'successful men', both financially and with women, and then use this embodiment of attainable success to provoke male participants to change.…”