264688 Does a Structural Intervention to Increase Food Security and Economic Opportunity Influence Gender-Based Violence in Rural Malawi?

Monday, October 29, 2012 : 10:45 AM - 11:00 AM

Jennifer Kibicho , Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI
Lance S. Weinhardt, PhD , Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Loren W. Galvao, MD, MPH , Center for Cultural Diversity and Global Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Patricia E. Stevens, RN, PhD, FAAN , College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI
Katarina Grande, MPH , Department of Population Health Sciences, University of Wisconsin-Madison Population Health Institute, Madison, WI
Naoyo Mori, PhD , College of Health and Sciences Center for Urban Population Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Thokozani Mwenyekonde , CARE, CARE International in Malawi, Lilongwe, Malawi
Andrew M. Muriuki, PhD , Center for Global Health, UW School of Medicine and Public Health, Madison, WI
Lucy Mkandawire-Valmu, PhD, RN , College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI
Background: Violence against women is linked to HIV transmission and impedes HIV testing and treatment. We evaluated CARE Malawi's SAFE food security program, which includes village-based savings and loan groups and sustainable agriculture training, at baseline and 18-months to determine if it reduced gender-based violence. Methods: We conducted logistic regression to identify predictors of violence and used Generalized Linear Models to examine SAFE effects on gender-based violence. Results: Data was collected from randomly selected 485 women (318 SAFE, 167 controls). Violence declined more significantly in the SAFE group compared to controls. Women reporting any violence declined from 83% at baseline to 70% at follow-up in the SAFE group, and from 72% to 66% in controls. Similar trends were observed for sexual violence: SAFE: (78% baseline to 67% follow-up) and controls: (68% to 65%). Partner violence decreased in the SAFE group: (56% to 30%), increased for controls: (30% to 34%). Women reporting sexual violence were four times more likely to report alcohol use, and 81% more likely to report STIs compared to women not reporting sexual violence. Conclusions: SAFE intervention decreased gender-based violence compared to the control condition. Nevertheless, given that more than two thirds of women reported experiencing violence post intervention, other elements beyond economic development and food security are needed to eliminate violence against women. Moreover, gender-based violence may have limited the effectiveness of the SAFE program on health and economic outcomes. Targeted combination structural and education interventions are necessary to increase protections for vulnerable women.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Public health or related public policy

Learning Objectives:
1. To evaluate the effectiveness of CARE Malawi's SAFE economic and food security intervention in reducing gender-based violence for rural Malawi women, by comparing SAFE and control groups at baseline and 18-months follow-up. 2. To identify predictors of gender-based violence for women in rural Malawi.

Keywords: Violence Prevention, Food Security

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the data analysis and have been involved in the project. I have a PhD in Economics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3149.1: Advocacy & Global Health