Preventing intimate-partner violence: Impact Evaluation of Engaging Men through Accountable Practice in Eastern DRC

The Engaging Men through Accountable Practice (EMAP) approach aims to engage men as agents of change in ending violence against women and promoting gender equality through structured, weekly discussions with committed groups of men. This evidence-based approach founded on the IRC’s previous work in the DRC and West Africa, engages men as agents of change, working to address entrenched views of gender roles and identify positive models of masculinity. The approach follows a structured series of discussions designed to explore existing understandings of masculinity and create more positive models of what it means to be a ‘good’ man, promoting self-reflection and pushing men to analyze and change their own power and privilege, activities focused on anger management are also included. This methodology ensures the strong involvement of women in the process. It begins with a series of discussions with women (not necessarily partners of the male participants) to inform men’s dialogue groups, and includes continuous feedback loops with women throughout the process so that the work with men is grounded in, and accountable to, women’s views and objectives.

2016-04-16

2016-12-31

Women's experience of intimate partner violence (IPV) from a male partner in the past 12 months; Acceptability of intimate partner violence (among all women; all men); Acceptability that a woman can refuse to have sex (among all women; all men); Use of gender equitable behaviors in the home and in relationship (among all women, all men); Attitudes towards gender equitable/inequitable social norms (among all women, all men); Decision-making and communication around family planning (among all women, all men); Power sharing and decision-making around income generating activities and use of income (among all women, all men); Conflict and hostility management skills (among all men).

The study is a cluster randomized controlled trial. In 15 treatment communities, 50 self-selected men will participate in the EMAP intervention. In 15 control communities, 50 self-selected men will receive an alternative intervention focused on a non-gender topic. The 30 sites are matched into 15 pairs on a set of socio-demographic characteristic and within each pair, sites are randomly allocated to treatment or control status. Within each community, all adult men (20+ years old) are eligible to participate. In case of oversubscription, the 50 participants will be randomly drawn. At the time of recruitment, the participants do not know what the treatment status of their community will be, therefore, the selection process of participants is identical in treatment and control sites. Baseline and follow-up surveys are conducted with all participating men and their female partners. Differences in outcomes at endline will be imputable to having received the EMAP program only. At endline, 3 men within each EMAP participants’ close social network of friends and family will be interviewed to assess diffusion effects within the close network.

Randomization of sites done in office by a computer.

Community

Yes

30 communities

1500 men, 1500 women

750 men and 750 women in the treatment arm
750 men and 750 women in the control arm

Introduction
The study objective was to understand the effectiveness of Engaging Men through Accountable Practice (EMAP), a group-based discussion series which sought to transform gender relations in communities, on intimate partner violence (IPV), gender inequitable attitudes and related outcomes.
Methods
A two-armed, matched-pair, cluster randomised controlled trial was conducted between 2016 and 2018 in eastern Democratic Republic of Congo. Adult men (n=1387) and their female partners (n=1220) participated in the study. The primary outcomes of the study were female report of past year physical and/ or sexual IPV and men’s intention to commit violence. Secondary outcomes included men’s gender attitudes, women’s economic and emotional IPV, women’s perception of negative male behaviours and perceived quality of the relationship. Results
Men in EMAP reported significant reductions in intention to commit violence (β=−0.76; SE=0.23; p<0.01), decreased agreement with any reason that justifies wife beating (OR=0.59; SE=0.08; p<0.01) and increased agreement with the ability of a woman to refuse sex for all reasons (OR=1.47; SE=0.24; p<0.05), compared with men in the control group. We found no statistically significant differences in women’s experiences of IPV between treatment and control group at follow-up (physical or sexual IPV: adjusted OR=0.95; SE=0.14; p=0.71). However, female partners of men in EMAP reported significant improvements to the quality of relationship (β=0.28; p<0.05) and significant reductions in negative male behaviour (β=−0.32; p<0.01).
Conclusion
Interventions engaging men have the potential to change gender attitudes and behaviours in conflict-affected areas. However, while EMAP led to changes in gender attitudes and behaviours related to perpetration of IPV, the study showed no overall reduction of women’s experience of IPV. Further research is needed to understand how working with men may lead to longterm and meaningful changes in IPV and related gender equitable attitudes and behaviours in conflict areas.

Vaillant J, Koussoubé E, Roth D, et al. Engaging men to transform inequitable gender attitudes and prevent intimate partner violence: a cluster randomised controlled trial in North and South Kivu, Democratic Republic of Congo. BMJ Global Health 2020;5:e002223. doi:10.1136/ bmjgh-2019-002223

http://dx.doi.org/10.1136/bmjgh-2019-002223

Introduction: The Engaging Men through Accountable Practice (EMAP) program is a series of facilitated group discussions for men in the Democratic Republic of the Congo that sought to reduce intimate-partner violence and transform gender relations. While a previous analysis found null impacts on women’s experience of past-year intimate-partner violence (IPV), these average results obscure important heterogeneity. The study objective is to analyze the effects of EMAP on subgroups of couples based on their initial levels of IPV.
Methods: We use two rounds of data (baseline and endline) collected from adult men (n=1387) and their female partners (n=1220) as part of a two-armed, matched-pair, cluster randomized controlled trial conducted between 2016 and 2018 in eastern Democratic Republic of the Congo. Loss to follow up was low as 97% of male and 96% of female baseline respondents were retained at endline. We define subgroups of couples based on their baseline reports of physical and sexual IPV using two different methods: i) subgroups determined by binary indicators of violence at baseline, and ii) Latent Class Analysis (LCA).
Results: We find that the EMAP program led to a statistically significant decrease both in the probability and severity of physical IPV among women who experienced high physical and moderate sexual violence at baseline. We also find a decrease in the severity of physical IPV (significant at the 10% level) among women who experienced both high physical and high sexual IPV at baseline. Findings indicate that the EMAP program was more effective at reducing IPV perpetration among men who were the most physically violent at baseline.
Conclusion: These results suggest that men who perpetrate violence against their female partners with greater severity than average may be inspired to reduce their use of violence through participatory discussion with less violent men. In contexts of endemic violence, programs like EMAP can lead to a meaningful short-term reduction in harm to women, perhaps even without transforming prevailing norms about male superiority or the acceptability of IPV.

Gurbuz Cuneo A, Vaillant J, Koussoube ́ E, Pierotti RS, FalbK, Kabeya R(2023) Prevention, Cessation, or harm reduction: Heterogeneous effects of an intimate partner violence prevention program in eastern Democratic Republic of the Congo. PLoS ONE18(3): e0282339.

https://doi.org/10.1371/journal.pone.0282339