What Works - Malawi SASA! Together
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-49
SponsorGeorge Washington University
About this trial
Violence against women is complex and must be addressed at multiple levels, with leadership from women themselves on how to bring about positive change to free women and girls from daily experiences of violence and to promote their rights. It is in this context that the Pamodzi Kuthetsa Nkhanza (PKN) consortium will implement a programme to facilitate the prevention of intimate partner violence (IPV) in Malawi as one of the most common forms of VAW experienced in Malawi. The programme takes a whole community approach and uses gender transformative approaches at different levels of society to address the root causes of IPV. It will draw primarily on two existing, evidence-based prevention models, namely SASA! Together (community mobilisation model) and Moyo Olemekeza (MO) (gender norms and behaviour change and economic empowerment approach).
A cluster randomised controlled trial (cRCT) will evaluate the effectiveness of the PKN programme, assessing the effectiveness of the SASA! Together programme at shifting individual behaviours and reducing violence in intimate relationships while also tackling community norms that drive these forms of violence against women. The cRCT will also assess the added value of combining SASA! Together and a women's social and economic empowerment programme (MO) for most at-risk households.
This protocol focuses on the evaluation of the SASA! Together programme.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Women and men aged 18-49 who have ever been in an intimate (romantic) relationship.
Living in selected Group Village Heads (GVHs) in Lilongwe or Balaka districts for at least a year. The specific Traditional Authorities (TAs) in Lilongwe are: Kalolo, Chimutu, Kabudula; The TAs in Balaka are: Msamala and Nyanyala.
Disqualifiers
Women and men younger than 18 years or older than 49 years old
Women who have never had an intimate relationship.
Not living in selected TAs and GVHs in Lilongwe or Balaka districts, or living in selected GVHs for less than one year
Paid employees of the PKN programme (any element), including SASA! Together community activists who deliver the programme activities.
Trial design
Design model
Parallel
Treatments tested in this trial
SASA! Together
BehavioralSASA! Together is a community mobilisation approach that engages communities to create positive and sustainable changes around norms and behaviors that perpetuate violence against women. Some new features in this revision of SASA! include a distinct focus on IPV, including sexual decision-making; three strategies aligned to the socio-ecological model that reach across the whole community (individuals, groups, and institutions); and more support to get organisations and communities started and to sustain change. The evidence- and theory-based SASA! approach is grounded in: (1) benefits-based activism, (2) a gender-power analysis, (3) four phases of change (start, awareness, support, action) according to the stages of behaviour change, (4) holistic community engagement, (5) local activism, (6) community leadership, and (7) institutional strengthening.
Treatment groups
4,800 Participants
are divided into 2 treatment groupsGroup A: ControlNo intervention 0 interventions
Group B: SASA! TogetherExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
Indicator for Past year experience of any violence (physical, sexual, or emotional) from a partner (among women who have had an intimate partner in the past year)
Defining past year experience of intimate partner violence using the World Health Organization's "Multi-country study measure for intimate partner violence" module.
Time frame
12 months2
Acceptability of violence (personal belief; among men and women separately)
Sum of indicators that the respondent agrees that a man/husband has a good reason to hit or beat his wife/partner if she (1) goes out without telling him; (2) she neglects the children; (3) she argues with him; (4) she refuses to have sex with him; (5) she burns the food; (6) he suspects that she has been unfaithful
Time frame
From time of implementation to endline assessment is 3 yearsSecondary outcomes
1
Indicator for Past year experience of physical violence from a partner (among women who have had an intimate partner in the past year)
An indicator equal to one if the respondent reports a partner perpetrated any of the following behaviors in the past 12 months: (i) Slapped you or thrown something at you (ii)Pushed or shoved you (iii) Hit you with his fist or with something else (iv) Kicked, dragged or beaten you (v) Choked or burnt you and (vi) Threatened you with, or actually used, a knife or other weapon against you
Time frame
12 months2
Indicator for Past year experience of sexual violence from a partner (among women who have had an intimate partner in the past year)
An indicator equal to one if the respondent reports a partner perpetrated any of the following behaviors in the past 12 months: (i) Physically forced you to have sexual intercourse (ii) Physically forced you to perform any other sexual acts (iii) Force you with threats to perform sexual acts
Time frame
12 months3
Indicator for Past year experience of emotional violence from a partner (among women who have had an intimate partner in the past year)
An indicator equal to one if the respondent reports a partner perpetrated any of the following behaviors in the past 12 months: (i) Insulted you or made you feel bad about yourself (ii) Destroyed things that are important to you (iii) Did things that made you feel scared or intimidated (iv) Threatened to harm you or someone you care about (v) Thrown you out of the house (vi) Taken away your phone or controlled how you use it
Time frame
12 months4
Indicator for Past year experience of economic violence from a partner (among women who have had an intimate partner in the past year)
An indicator equal to one if the respondent reports a partner perpetrated any of the following behaviors in the past 12 months: (i) Prohibits you from earning money (ii) Takes earnings from you against your will (iii) Refuses to give money for household expenses (iv) Keeps you from getting a loan (v) Not let you participate in deciding how the family finances are spend
Time frame
12 monthsSponsors and contacts
Click on the lead sponsor to view all of their trials.
George Washington University
Lead sponsor
Global Women's Institute
Collaborator
University of Cape Town
Collaborator
Source ClinicalTrials.gov