RCT of the Effectiveness of the WfWI Intervention in Afghanistan

Study Overview
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Brief Summary
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This is an individually randomised control trial to assess the effectiveness of a livelihoods and social empowerment intervention, delivered by Women for Women International, on married women's experiences of intimate partner violence in Afghanistan. It has a 22 month follow up.

Official Title
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Individually Randomised Control Trial Evaluation of the Effectiveness of the Women for Women International (WfWI) Intervention in Afghanistan for Intimate Partner Violence Prevention Among Married Women

Conditions
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Livelihoods, Domestic Violence, Depressive Symptoms

Intervention / Treatment
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* Behavioral: Women for Women International Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women should be in the lowest economic level (earning less than US$1.25/day) Unemployed No in education/school Not involved in a similar programme Able to provide informed consent Exclusion Criteria: Not mentally incapacitated, so as unable to provide informed consent Already been part of the WfWI intervention previously

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Individual level randomised trial, with intervention and control group
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: WfWI Intervention<br>Women receive the WfWI intervention. This comprises of three main components. First, a social empowerment and health intervention. Second a livelihood strengthening intervention, including numeracy training, and vocational training. Third, a cash transfer conditional on attendance at the intervention to cover costs of attendance and provide start-up capital. The intervention is delivered over 12 months. | Behavioral: Women for Women International Intervention<br> <br> |
| No Intervention: Control<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Any past year physical intimate partner violence experienced amongst currently married women | Physical intimate partner violence is assessed using five items based on the WHO VAW scale. A positive response to any item leads to a person being classified as experiencing in the past year. | 22 months post baseline | 
| Past year severe physical intimate partner violence experience amongst currently married women | Severe physical intimate partner violence experience is assessed using 5 items. Past year severe physical IPV is assessed as positive if a person responds to two (or more) items as once, or one item as few (or more), essentially creating a more than once categorization. | 22 months post baseline | 
| Depressive symptomology | Past week depressive symptomology is assessed by the Centre for Epidemiological Studies Depression (CESD) scale, with the full twenty items. A mean score will be calculated. | 22 months post baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Household food insecurity in past four weeks | Three items ask about household level food insecurity in the past 4 weeks. A mean score is calculated. | 22 months post baseline | 
| Financial shock resilience | One item assesses ability to mobilise cash in an emergency. | 22 months post baseline | 
| Monthly earnings | A single item assesses women's past month earnings | 22 months post baseline | 
| Total savings | A single item assesses women's total savings | 22 months post baseline | 
| Life satisfaction | Life satisfaction is assessed using four-items derived from the Satisfaction With Life Scale. A mean score is produced. | 22 months post baseline | 
| Suicidal ideation in past 4 weeks | A single item assesses thoughts about suicide in past week. | 22 months post baseline | 
| Gender attitudes | 11 questions assess women's gender attitudes. A mean score is created. | 22 months post baseline | 
| Married women's participation in household decision-making | Five items are asked about women's ability to participate in household decisions. A mean score is created. | 22 months post baseline | 
| Any emotional abuse in the past year amongst currently married women | Seven items assess emotional abuse in the past year. A mean score is calculated. | 22 months post baseline | 
| Perceptions of husband cruelty amongst currently married women | Five items ask about married women's perceptions of her husband and his attitudes and relationship towards her. A mean score is created | 22 months post baseline | 
| Mother-in-law or abuse in the past 12 months amongst currently married women | A single item assesses whether mother-in-laws have hit the woman in the past 12 months and another item assesses whether siblings have hit the woman in the past 12 months, an affirmative response to either item would indicate abuse. | 22 months post baseline | 
| Perceptions of mother-in-law cruelty amongst currently married women | For married women, six items ask about their relationship and the mother-in-laws attitudes towards her | 22 months post baseline |