# **CHAPTER II: INITIATIVES TO PREVENT AND RESPOND TO GENDER-BASED VIOLENCE**

# **INTRODUCTION**

Over the past 20 years, many initiatives have sought to address violence against women at different levels and within different sectors. Unfortunately, relatively few have been rigorously evaluated. Evidence about effective approaches is particularly sparse in middle and low-income countries, but even in highincome countries, a review by Chalk and King (1998) found that among several hundred relevant intervention studies, only 34 were deemed methodologically sound. In general, evaluations have been characterized by a number of weaknesses such as:

- Exclusive reliance on “process” or “output indicators”

- Failure to measure (or even specify) the outcomes that the interventions were expected to achieve

- Lack of baseline data because evaluations did not begin until after programs were fully implemented

- Lack of control groups (or communities)

- Short follow-up periods or no follow-up at all

- Small sample sizes

Moreover, evaluating initiatives to prevent or respond to violence against women involves a host of methodological challenges. First, preventing violence often appears to require multiple organizations, strategies and sectors, making it difficult to determine which specific strategies can be credited with any changes measured (Chalk and King, 1998). Second, defining, measuring and interpreting levels of violence against women have not proven to be straightforward tasks (Campbell, 2000). Third, “successful” programs may appear to increase levels of reported violence. In some cases, this increase reflects a greater willingness to report experiences of violence without necessarily indicating that the underlying prevalence has changed (although such increases can have real consequences for police, service providers, and others). In other cases, programs that “successfully” empower women may increase conflict between men and women and thereby cause the incidence of violence to rise--at least in the short run (Sullivan and Bybee, 1999). Finally, few programs have measured outcomes over long periods of time. As a result, evaluations that measure only short-term effects cannot determine whether attitudinal or behavior changes are sustained in the long run.

## **_The structure of this chapter_**

The rest of this chapter reviews what is known about more and less effective ways to prevent and respond to gender-based violence. The review is divided into four different sections organized by sector, namely: Justice, Health, Education, and Multi-sectoral approaches (including social services, economic development, and infrastructure). In keeping with the ecological model, each sectoral chapter is subdivided into four sections, according to the level at which programs have operated, namely:

- Law and policies

- Institutional reforms

- Community level interventions

- Individual behavior change strategies

This review emphasizes efforts to prevent violence against women rather than initiatives aimed solely at assisting survivors with recovery. Unfortunately, even less is known about how to prevent violence than about how to care for survivors once it has occurred. This review will explore some initiatives that address the needs of survivors, but will not include a comprehensive discussion of survivor services. Finally, as mentioned earlier, this review will focus primarily on the two most common types of gender16