What is the potential for interventions designed to prevent violence against women to reduce children's exposure to violence? Findings from the SASA! study, Kampala, Uganda.
Intimate partner violence (IPV) and child maltreatment often co-occur in households and lead to negative outcomes for children. This article explores the extent to which SASA!, an intervention to prevent violence against women, impacted children's exposure to violence. Between 2007 and 2012 a cluster randomized controlled trial was conducted in Kampala, Uganda. An adjusted cluster-level intention to treat analysis, compares secondary outcomes in intervention and control communities at follow-up. Under the qualitative evaluation, 82 in-depth interviews were audio recorded at follow-up, transcribed verbatim, and analyzed using thematic analysis complemented by constant comparative methods. This mixed-methods article draws mainly on the qualitative data. The findings suggest that SASA! impacted on children's experience of violence in three main ways. First, quantitative data suggest that children's exposure to IPV was reduced. We estimate that reductions in IPV combined with reduced witnessing by children when IPV did occur, led to a 64% reduction in prevalence of children witnessing IPV in their home (aRR 0.36, 95% CI 0.06-2.20). Second, among couples who experienced reduced IPV, qualitative data suggests parenting and discipline practices sometimes also changed-improving parent-child relationships and for a few parents, resulting in the complete rejection of corporal punishment as a disciplinary method. Third, some participants reported intervening to prevent violence against children. The findings suggest that interventions to prevent IPV may also impact on children's exposure to violence, and improve parent-child relationships. They also point to potential synergies for violence prevention, an area meriting further exploration.
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Nambusi
N
Kyegombe
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Tanya
T
Abramsky
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Karen M
KM
Devries
Raising Voices, Kampala, Uganda.
Lori
L
Michau
Raising Voices, Kampala, Uganda.
Janet
J
Nakuti
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Elizabeth
E
Starmann
Centre for Domestic Violence Prevention, Kampala, Uganda.
Tina
T
Musuya
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Lori
L
Heise
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Charlotte
C
Watts
D000328:Adult; D002648:Child; D002649:Child Abuse / Q000517:prevention & control*; D000068216:Child Protective Services / Q000379:methods; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D000069581:Exposure to Violence / Q000517:prevention & control*; D005192:Family Health; D005260:Female; D006801:Humans; D010287:Parent-Child Relations; D011678:Punishment; D012944:Social Support; D013179:Spouse Abuse / Q000517:prevention & control*; D014454:Uganda
Corporal punishment; Parenting; Primary prevention of violence against women; SASA!; Uganda; Violence against children