A community-based intervention to challenge attitudes toward intimate partner violence: results from a randomised community trial in rural southwest Nigeria

Early Abstract:

Background: Intimate partner violence is undoubtedly a major public health concern worldwide, with significant repercussions for women’s health. In some parts of the world, it is considered an acceptable practice within intimate partner relationships, especially in rural areas. Attitudes supportive of IPV have been reported as one of the foremost predictors of IPV and a shift in the attitudes that permit, promote, and perpetuate IPV is required to substantially reduce the occurrence of IPV. Community-based interventions a veritable strategy to engage community members in efforts to prevent IPV. This study tested a community mobilisation intervention to challenge attitudes toward IPV and prevent violence within intimate relationships.
Methods: This randomised community trial was conducted in selected rural communities in Oyo State, Nigeria, between January 2019 and April 2021. The study employed a convergent parallel mixed-methods design and a three-stage sampling technique in selecting two Local Government Areas (LGAs), eight communities and the study participants. The six-month community mobilisation intervention focused on creating awareness and challenging attitudes supportive of IPV was evaluated using two cross-sectional surveys (pre-and post-intervention), twelve in-depth interviews, and nine focus group discussions. The outcomes for this study, assessed using the WHO women’s health questionnaire, included attitudes supportive of IPV, women’s experience of IPV and men’s perpetration of IPV. Difference-in-difference regression models were estimated to compare changes in IPV levels in the intervention and control arms, while qualitative data were analysed using thematic approach.
Results: At baseline, 628 men and 667 women responded to the survey while at end-line, 640 men and 658 women responded to the survey. The median age of the respondents was 35 years at baseline and 40 years at end-line. In the intervention group, the proportion of women with attitudes supportive of IPV reduced between baseline and end line from 65.2% to 35.8% versus 45.2% to 32.7% in the control group (DID= -0.116, p=0.039). Women’s past year experience of IPV also reduced from 30.3% to 1.2% versus 48.3% to 33.2% in the control group (DID= -0.131, p=0.006). The changes in proportion of men who had attitudes supportive of IPV or perpetrated IPV did not follow this trend. The changes in proportion of men who had attitudes supportive of IPV or perpetrated IPV did not follow this trend. In the intervention group, the proportion of men with attitudes supportive of IPV increased between baseline and end line from 40.1% to 44.6% versus 43.7% to 45.8% in the control group (DID= 0.015, p=0.805). Men’s past year perpetration of IPV reduced from 29.9% to 19.9% versus 43.2% to 10.2% in the control group (DID= -0.050, p=0.155). However, respondents of the qualitative interviews highlighted the awareness of various forms of IPV, attitude to physical violence and alluded to a reduction in IPV at end line in the intervention group.
Conclusion: This trial demonstrates the effectiveness of a community mobilization intervention in reducing the proportion of women who had attitudes supportive of IPV and reported experience of past-year IPV.
Keywords: Attitudes towards intimate partner violence, rural community, intimate partner violence, Nigeria, perpetration.