Abstract
Purpose
Intimate partner violence (IPV) is a significant public health issue in Nepal as 28% of ever partnered women aged 15–49 years have experienced physical, sexual, or psychological IPV. Change Starts at Home is a multi-faceted intervention strategy created to reduce the prevalence of IPV through 1) a 9-month couple’s curriculum; and 2) an 8-month anti-violence diffusion curriculum.
Methods
This study uses mixed methods data to longitudinally examine the contextual dimensions of the impact among intervention participants. We conducted in-depth interviews with 20 heterosexual, married couples at two time points, post-couple’s curriculum (n = 40 individuals) and post-diffusion-curriculum (n = 37 individuals). We used framework analysis to assess change in IPV and key risk factors (e.g., decision-making, quarrelling and conflict management, communication, and household task division) for intervention participants. We incorporated quantitative measures corresponding to key qualitative themes to triangulate findings.
Results
We observed qualitative changes in IPV risk factors, including task division, decision-making, quarrelling, and conflict resolution, with corroborating quantitative results across multiple themes. We found minimal change in the experience of IPV for those who qualitatively reported violence in the household, though, due to the indirect line of questioning to assess IPV, we believe IPV was underreported qualitatively. The intervention appeared particularly impactful among younger couples. Respondents also reported sharing their participation insights with members of their community, particularly those of the same gender.
Conclusions
This study highlights the positive impact of the Change Starts at Home intervention in Nepal, revealing improvements in relationship dynamics and a potential reduction in IPV.
