Impacts of an abbreviated personal agency training with refugee women and their male partners on economic empowerment, gender-based violence, and mental health: a randomized controlled trial in Rwanda.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Refugees*/psychology ; Refugees*/statistics & numerical data ; Mental Health*; Humans ; Rwanda ; Female ; Adult ; Male ; Young Adult ; Adolescent ; Middle Aged ; Empowerment ; Gender-Based Violence/psychology ; Gender-Based Violence/statistics & numerical data ; Intimate Partner Violence/psychology ; Intimate Partner Violence/statistics & numerical data ; Intimate Partner Violence/prevention & control

Introduction: We assessed the impact of a personal agency-based training for refugee women and their male partners on their economic and social empowerment, rates of intimate partner violence (IPV), and non-partner violence (NPV).
Methods: We conducted an individually randomized controlled trial with 1061 partnered women (aged 18-45) living in a refugee camp in Rwanda. Women received two days of training, and their partners received one day of training. The follow-up survey where all relevant outcomes were assessed was carried out at 6-9 months post-intervention.
Results: At follow up, women in the intervention arm were more likely to report partaking in income generating activities (aIRR 1.27 (1.04-1.54), p < 0.05) and skill learning (aIRR 1.59 (1.39-1.82), p < 0.001) and reported a reduction in experience of physical or sexual NPV in the past six months (aIRR 0.65 (0.39-1.07), p < 0.09). While improved, no statistically significant impacts were seen on physical or sexual IPV (aIRR 0.80 (0.58-1.09), p = 0.16), food insecurity (β 0.98 (0.93 to 1.03), p = 0.396), or clean cookstove uptake (aIRR 0.95 (0.88 to 1.01), p = 0.113) in the past six months. We found statistically significant reduction in physical and sexual IPV amongst those experiencing IPV at baseline (aIRR 0.72 (0.50 to 1.02), p < 0.07). Small improvements in self-efficacy scores and our indicator of adapting to stress were seen in the intervention arm. Some challenges were also seen, such as higher prevalence of probable depression and/or anxiety (aIRR 1.79 (1.00-3.22), p = 0.05) and PTSD (aIRR 2.07 (1.10-3.91), p < 0.05) in the intervention arm compared to the control arm.
Conclusion: Our findings echo previous research showing personal agency training can support economic well-being of women. We also find potentially promising impacts on gender-based violence. However, there is some evidence that integration of evidence-based mental health support is important when enhancing agency amongst conflict-affected populations.
Trial Registration Number: The trial was registered with ClinicalTrials.gov, Identifier: NCT04081441 on 09/09/2019.
(© 2024. The Author(s).)

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Keywords: Clean cookstoves; Economic empowerment; Evaluation; Gender-based violence; Intimate-partner violence; Mental health; Personal agency; Randomized controlled trial

ClinicalTrials.gov NCT04081441

Date Created: 20240514 Date Completed: 20240515 Latest Revision: 20240711

20240712

PMC11092213

10.1186/s12889-024-18780-8

38745312