Using evidence to prevent gender-based violence and HIV in Uganda
Context
Globally, as many as 30 per cent of women experience physical or sexual intimate partner violence during their lifetimes. Women are often unable to protect themselves from HIV because they are not able to refuse sex or insist on condom use with their intimate partners. In Uganda, 59 per cent of women aged 15-49, who have ever been married, have been physically or sexually abused by their partners.
Recognition of this scale of violence has highlighted the urgent need for HIV programmes that address violence against women and the underlying causes of gender inequality. CEDOVIP, in partnership with Raising Voices, is implementing the SASA! programme in Uganda. This is a community-based approach that aims to change attitudes, norms and behaviours that perpetuate both a gendered power imbalance in male–female relationships and gender-based violence against women.
Researchers from the London School of Hygiene & Tropical Medicine worked with Raising Voices, a Ugandan NGO devoted to preventing violence against women and children, to design a randomised impact evaluation for the SASA! programme. Between 2008 and 2012, the team assessed the impact of the SASA! approach on gender norms and past-year levels of physical and sexual violence against women, HIV risk behaviours and community responses to violence.
The study team comprised Raising Voices, CEDOVIP staff and researchers. They collaborated to implement the evaluation and promote the use of its findings. The team understood the need for early buy-in and put in place systems for periodic review and feedback from key stakeholders. The team leveraged the strengths of the implementing partners to produce a robust engagement and communication plan. It also used the enabling policy environment to facilitate uptake of the study findings by the government.
Evidence
The study found that the SASA! approach positively influenced harmful gendered social norms. It increased community acceptance of women’s refusing sex in certain circumstances and increased disapproval of physical violence in heterosexual relationships. The women who participated in the 3ie-funded study reported that SASA! brought about a change in attitudes and beliefs that helped reduce physical violence. The intervention also had an impact on lowering the incidence of multiple or concurrent sexual partnerships, with fewer men reporting having had other sexual partners.
Evidence impacts
Type of impact: Improve the culture of evidence use
When decision makers or implementers demonstrate positive attitudinal changes towards evidence use or towards information the research team provides. Examples include strengthening monitoring and evaluation systems, increasing understanding of evidence and openness to using it, integrating these systems more firmly into programming or commissioning another evaluation or review.
This is one of 3ie’s seven types of evidence use. Impact types are based on what we find in the monitoring data for an evaluation or review. Due to the nature of evidence-informed decision-making and action, 3ie looks for verifiable contributions that our evidence makes, not attribution.
Read our complete evidence impact typology and verification approach here.
Close windowAt CEDOVIP, the evaluation was instrumental in institutionalising the value of data-driven decision-making. Participation helped CEDOVIP strengthen its monitoring and evaluation system and integrate it more firmly into programming. The impact evaluation necessitated close monitoring to ensure the study was implemented as planned.
Monitoring reports led to a better understanding of what was working and what was not, enabling adjustments to help achieve the desired outcomes. For example, CEDOVIP tweaked its communication approach to enhance community members’ receptivity to the intervention.
Type of impact: Inform discussions of policies and programmes
When subsequent phases of the evaluated programme or policy draw from the findings of the evaluation or review, and/or the study team participates in informing the design of a subsequent phase.
This is one of 3ie’s seven types of evidence use. Impact types are based on what we find in the monitoring data for an evaluation or review. Due to the nature of evidence-informed decision-making and action, 3ie looks for verifiable contributions that our evidence makes, not attribution.
Read our complete evidence impact typology and verification approach here.
Close windowCEDOVIP and Raising Voices used the findings to advocate for changes in governmental policies and programmes to reduce gender-based violence. In Uganda, where almost 60 per cent of women over 15 years of age have experienced violence, the findings resonated among policymakers.
The study provided legitimacy to promote the SASA! approach and inform the design of the national gender-based violence policy. To advance this dialogue and garner support from key stakeholders, CEDOVIP formed a partnership with the Ministry of Gender, Labour and Social Development and the Domestic Violence Coalition to further advocate for inclusion of key recommendations in the policy, such as the need to address the root causes of gender-based violence, including patriarchal attitudes, behaviours and practices.
Type of impact: Inform the design of other programmes
Where findings from the evaluation or review inform the design of a programme(s) other than the one(s) evaluated.
This is one of 3ie’s seven types of evidence use. Impact types are based on what we find in the monitoring data for an evaluation or review. Due to the nature of evidence-informed decision-making and action, 3ie looks for verifiable contributions that our evidence makes, not attribution.
Read our complete evidence impact typology and verification approach here.
Close windowDFID is using the study findings to inform the design and theory of change of new programmes in Uganda. In 2015, DFID launched the Support to Uganda's Response on Gender Equality project to promote equal access to opportunities, services and rights by women and men in Uganda. The project will support the piloting of the SASA! intervention to change gendered social norms and prevent gender-based violence. DFID has cited the positive findings about changing behaviour to reduce gender-based violence and HIV from the study to inform its support for the SASA! community mobilisation approach.
DFID has also developed a theory of change that cites the 3ie-funded study’s evidence to support its approach to promote gender equity through gender-based violence prevention and response. According to DFID’s programme document, SASA! is now one of the interventions in DFID’s suite of promising approaches of what works in tackling violence against women.
Suggested citation
International Initiative for Impact Evaluation (3ie), 2019. Using evidence to prevent violence against women in Uganda (online summary), Evidence Impact Summaries. New Delhi:3ie.
Evidence impact summaries aim to demonstrate and encourage the use of evidence to inform programming and policymaking. These reflect the information available to 3ie at the time of posting. Since several factors influence policymaking, the summaries highlight contributions of evidence rather than endorsing a policy or decision or claiming that it can be attributed solely to evidence. If you have any suggestions or updates to improve this summary, please write to influence@3ieimpact.org
Last updated on 30th October 2019