Evaluation of a violence prevention intervention and lessons for future research in conflict settings: Working with men to prevent violence against women - a community survey, cluster randomised controlled trial and nested cohort study in Cote d'Ivoire

Background Evidence from armed conflict settings points to high levels of intimate partner violence (IPV) against women. Current knowledge on how to prevent IPV is limited – especially within waraffected settings. This research aims to inform the prevention of IPV in conflict-affected settings, specifically identifying community exposures to violence and traumatic events and their consequences among men and women and the impact of an IPV prevention intervention in Côte d’Ivoire. Methods This thesis represents a coordinated programme of research comprised of four studies: (1) a systematic review of violence against women (VAW) prevention interventions in conflict settings; (2) a community survey to determine community levels of exposure and perpetration of IPV, non-partner violence and traumatic events before, during and after a period of conflict; (3) a cluster randomised controlled trial to determine the added value of an IPV prevention intervention working with men; and (4) a nested cohort study to assess the gendered and temporal impact of violence and the intervention on mental health. Results The systematic review uncovered an extensive VAW prevention programme but limited research on its effectiveness. The community survey found high levels of IPV, non-partner violence and traumatic events among women and men. Women experienced higher overall levels of violence compared with men. The cluster RCT found significant differences between men in the intervention and control groups with regard to their ability to manage conflict and their increased engagement in gender-equitable behaviours. Among women, the cohort study found that factors significantly associated with post-traumatic stress disorder (PTSD) included male partner alcohol use and experience of IPV in the past year. Men were strongly protected from PTSD if they cohabitated with their female partner. A research commentary further advocates for violence prevention programming in conflict settings with attention to all forms of violence against women, including IPV. Conclusion In conflict-affected settings, policy approaches and interventions that aim to improve the lives of survivors should work towards programming that promotes gender equality and protects women and girls from abuse.