Promoting gender equality

to prevent violence
against women
Series of briefings on violence prevention
This briefing for advocates, programme designers and implementers and others is one
of a seven-part series on the evidence for interventions to prevent interpersonal and
self-directed violence. The other six briefings look at reducing access to lethal means;
increasing safe, stable and nurturing relationships between children and their parents
and caregivers; developing life skills in children and adolescents; reducing availability and misuse of alcohol; changing cultural norms that support violence; and victim
identification, care and support.
For a searchable evidence base on interventions to prevent violence, please go to: http://www.preventviolence.info
For a library of violence prevention publications, including the other briefings in this series, please go to:
http://www.who.int/violenceprevention/publications/en/index.html

WHO Library Cataloguing-in-Publication Data

Promoting gender equality to prevent violence against women.

(Series of briefings on violence prevention: the evidence)

1.Violence prevention and control. 2.Womens health. 3.Domestic violence prevention and control.
4.Women rights. 5.Gender identity. 6.Spouse abuse. 7.Social problems. I.World Health Organization.

ISBN 978 92 4 159788 3

(NLM classification: HV 6625)

World Health Organization 2009

All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20
Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for
permission to reproduce or translate WHO publications whether for sale or for noncommercial distribution should be addressed to
WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]).
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion
whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its
authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for
which there may not yet be full agreement.
The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by
the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the
names of proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication.
However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for
the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages
arising from its use.
Designed by minimum graphics
Printed in Malta

Overview
Promoting gender equality is a critical part of violence prevention.
The relationship between gender and violence is complex. Evidence suggests, however,
that gender inequalities increase the risk of violence by men against women and inhibit
the ability of those affected to seek protection. There are many forms of violence against
women; this briefing focuses on violence by intimate partners, the most common form.
Though further research is needed, evidence shows that school, community and media
interventions can promote gender equality and prevent violence against women by
challenging stereotypes that give men power over women.

School initiatives are well placed to prevent violence against women.

School-based programmes can address gender norms and attitudes before they become
deeply ingrained in children and youth. Such initiatives address gender norms, dating
violence and sexual abuse among teenagers and young adults. Positive results have been
reported for the Safe Dates programme in the United States of America and the Youth
Relationship Project in Canada.

Community interventions can empower women and engage with men.

Community interventions can address gender norms and attitudes through, for example,
the combination of microfinance schemes for women and methods that empower men
as partners against gender-based violence. The strongest evidence is for the IMAGE
microfinance and gender equity initiative in South Africa and the Stepping Stones
programme in Africa and Asia. Community programmes with male peer groups show
promise in changing attitudes towards traditional gender norms and violent behaviour, but
they require more rigorous evaluations. Well-trained facilitators and community ownership
appear to boost the effectiveness of these interventions.

Media interventions can alter gender norms and promote womens rights.
Public awareness campaigns and other interventions delivered via television, radio,
newspapers and other mass media can be effective for altering attitudes towards gender
norms. The most successful are those that seek to understand their target audience and
engage with its members to develop content. We do not yet know, however, whether they
actually reduce violence.

Programmes must engage males and females.

There is some evidence that microfinance schemes that empower women (without
engaging with men) may actually cause friction and conflict between partners, especially
in societies with rigid gender roles. Further research is needed to explore how such
possible negative effects might be overcome.

PROMOTING GENDER EQUALITY TO PREVENT VIOLENCE AGAINST WOMEN

1. Introduction

The relationship between gender and violence

is complex. The different roles and behaviours of
females and males, children as well as adults, are
shaped and reinforced by gender norms within
society. These are social expectations that define
appropriate behaviour for women and men (e.g. in
some societies, being male is associated with taking risks, being tough and aggressive and having
multiple sexual partners). Differences in gender
roles and behaviours often create inequalities,
whereby one gender becomes empowered to the
disadvantage of the other. Thus, in many societies,
women are viewed as subordinate to men and have
a lower social status, allowing men control over,
and greater decision-making power than, women.

Gender inequalities have a large and wide-ranging

impact on society. For example, they can contribute
to gender inequities in health and access to health
care, opportunities for employment and promotion,
levels of income, political participation and representation and education.
Often inequalities in gender increase the risk of
acts of violence by men against women (see definitions, Box 1). For instance, traditional beliefs that
men have a right to control women make women
and girls vulnerable to physical, emotional and
sexual violence by men (1,2). They also hinder the
ability of those affected to remove themselves from
abusive situations or seek support (3). Violence
against women is most often perpetrated by an in-

BOX 1

Definitions
GENDER EQUALITY: Equal treatment of women and men in laws and policies, and equal access to
resources and services within families, communities and society at large (11).
GENDER EQUITY: Fairness and justice in the distribution of benefits and responsibilities between women and
men. Programmes and policies that specifically empower women are often needed to achieve this (11).
GENDER-BASED VIOLENCE: Violence involving men and women, in which the female is usually the victim;
and which is derived from unequal power relationships between men and women. Violence is directed
specifically against a woman because she is a woman, or affects women disproportionately. It includes,
but is not limited to, physical, sexual and psychological harm (including intimidation, suffering, coercion,
and/or deprivation of liberty within the family, or within the general community). It includes that violence
which is perpetrated or condoned by the state (13). This widely accepted definition of gender-based
violence is now often expanded to include violence that results from unequal power relations between
men and between women (e.g. homophobic violence).
VIOLENCE AGAINST WOMEN: Any public or private act of gender-based violence that results in, or is likely
to result in physical, sexual or psychological harm or suffering to women, including threats of such acts,
coercion or arbitrary deprivation of liberty (14).
INTIMATE PARTNER VIOLENCE: Any behaviour by a man or a woman within an intimate relationship that
causes physical, sexual or psychological harm to those in the relationship. This is the most common form of
violence against women.

PROMOTING GENDER EQUALITY TO PREVENT VIOLENCE AGAINST WOMEN

BOX 2

Intimate partner violence

In a study of intimate partner violence across ten
countries, the percentage of women reporting
physical or sexual violence by their partners, or
both, in their lifetime varied from 15% (in one city
in Japan) to 71% (in a province of Ethiopia). The
percentage of women reporting physical or sexual
violence, or both, in the past year ranged from
4% (in cities in Japan, Montenegro and Serbia) to
54% (in a province of Ethiopia) (15).

timate partner, but it takes many other forms: violence by a family member, sexual harassment and
abuse by authority figures, trafficking for prostitution, child marriages, dowry-related violence, honour killings, sexual violence committed by soldiers
during wars and so on (4). Health consequences
of such violence range from physical injuries and
unwanted pregnancies to sexually transmitted infections (including HIV), emotional problems such
as anxiety and depression and (in extreme cases)
homicide or suicide (3,5,610).
For decades, therefore, promoting gender equality has been a critical part of violence prevention.
This has included interventions that confront the
entrenched beliefs and cultural norms from which
gender inequalities develop, and efforts to engage
all sectors of society in redressing these inequalities, both of which are thought to reduce genderbased violence. Despite the long history and high
visibility of such measures, however, few have been
subject to any kind of scientific evaluation.
This briefing reviews some of the most promis-

ing methods of promoting gender equality and their

effectiveness in reducing violence towards women.
There are many types of violence against women,
but this briefing focuses specifically on interventions to prevent violence by intimate partners and
during dating, as these have been evaluated more
than other interventions in this area. These include:
School-based interventions
These work with school children before gender attitudes and behaviours are deeply
ingrained. The most widely evaluated are
dating interventions that attempt to create
equal relationships and change attitudes and
norms towards dating.
Community interventions
These try to effect change in individuals and
whole communities, by addressing gender
norms and attitudes. They can include methods to empower women economically and to
enlist men as partners against gender-based
violence.
Media interventions
Public awareness campaigns use mass media
to challenge gender norms and attitudes and
try to raise awareness throughout society of
violent behaviour towards women and how to
prevent it.
Government interventions to promote gender
equality, such as laws and policies (see Box 3), can
also play an important role in the primary prevention of violence. These are not discussed at length
in this briefing, however, as there have been few
evaluations of such measures.

BOX 3

Laws and policies to promote gender equality

The development of international and national legal frameworks that promote gender equality can play
an important role in preventing violence against women. Internationally, a number of human rights
agreements require states to take measures to eliminate gender-based violence against women (15).
These include the Convention on the Elimination of All Forms of Discrimination Against Women; the
International Covenant on Civil and Political Rights; and the International Covenant on Economic, Social
and Cultural Rights. Significant changes are also underway worldwide to strengthen national laws and
policies. Among them are laws that criminalize violence against women (e.g. intimate-partner violence,
rape in marriage, trafficking for prostitution); laws and policies that support and protect those affected
(e.g. implementing protection orders, child and family protection units, specialized response teams,
womens shelters and family courts); improving the response of police and other criminal justice officials
towards cases of violence against women; and improving womens rights in marriage, divorce, property
ownership and inheritance and child support (3,16,17).

VIOLENCE PREVENTION: THE EVIDENCE

2. School-based interventions

School-based interventions attempt to address gender norms and equality early in life, before gender
stereotypes become deeply ingrained in children
and youth. A number of initiatives have been developed to address gender norms, dating violence and
sexual abuse among teenagers and young adults
(18). These target either male peer groups, or male
and female youth together, and aim to increase
knowledge of intimate partner violence, challenge
gender stereotypes and norms and reduce levels of
dating violence. Evaluations of these programmes
suggest they can increase knowledge about dating
violence and improve attitudes towards it; their effectiveness at reducing levels of actual abuse towards females appears promising, although it has
not been consistently demonstrated and evaluations have largely focused on short-term outcomes
(1821).
Positive results have been reported, however,
particularly for the Safe Dates programme in the
United States and the Youth Relationship Project
in Canada. Safe Dates is a school and community
initiative that targets eighth and ninth grade girls
and boys (1315-years-old). It includes a ten-session
educational curriculum, a theatre production, a
poster contest, training for providers of community services and support services for affected
adolescents. A randomized controlled trial of the
programme found that (compared to members of
a control group) participants reported less psychological abuse and sexual and physical violence
against their current dating partner one month after the programme ended (22) and four years later
(23).
Dating programmes are more effective if they
are delivered in multiple sessions over time (rather
than in a single session) and if they aim to change attitudes and norms rather than simply provide infor-

mation (30). Furthermore, there is some evidence

that for men, programmes presented to mixed male
and female groups are less effective in changing
attitudes than those presented to all-male groups
(31). Although the majority of evaluated school programmes for dating violence have been conducted
in the United States and other high-income countries, some initiatives are being implemented in
developing countries. For instance, in South Africa,
an adaptation of the Safe Dates programme for
students in eighth grade (1314-years-old) is now
being evaluated. Furthermore, the Men As Partners
programme (see Community interventions, below)
has established groups for students in grades 5 to
8 (1014-years-old). These encourage boys to stop
domestic and sexual violence towards women and
girls and to become responsible fathers (32). The
programme, however, has yet to be evaluated.
The Youth Relationship Project in Ontario, Canada, is a community-based intervention to help atrisk 1416-year-olds develop healthy, nonabusive
relationships with dating partners by providing
education about healthy and abusive relationships,
conflict resolution and communication skills and
social action activities. A randomized controlled
trial showed that the intervention was effective
in reducing incidents of physical and emotional
abuse and symptoms of emotional distress over a
16-month period after the intervention (24).
Other programmes targeting both males and females have changed attitudes towards violence. For
instance, in the United States, a five-session programme on dating violence for students in grades
9 to 12 (1418-years-old) addressed how gender
inequality fosters violence, challenged individual
and societal attitudes towards violence as a means
of conflict resolution, helped students develop
non-violent communication skills and identified re-

PROMOTING GENDER EQUALITY TO PREVENT VIOLENCE AGAINST WOMEN

sources to support victims of dating aggression. A

well-designed evaluation found that the programme
significantly lowered male and female participants
tolerance of dating violence (compared to members
of a control group) (25).
Another programme in the United States, Mentors in Violence Prevention, provides six or seven
two-hour educational sessions to male and female
high-school and college students, in mixed or
single-sex groups. Here the students learn about
different types of abuse, gender stereotypes and
societys acceptance of violence against women.
In addition, role-playing helps participants to confront sexist attitudes and to actively prevent violence (26). An evaluation of the programme in ten
schools examined the knowledge and attitudes of
participants before and two to five months after
the programme. This found that, compared to members of a control group, participants knowledge
of violence against women significantly increased
after the programme. The study also indicated
that the programme improved participants attitudes towards violence against women and gave
them greater confidence to intervene or speak out
against it (27).
Initiatives that work solely with male peer
groups have also been shown to change violencerelated attitudes in the short term particularly towards sexual violence and to promote new ideas
of masculinity based on non-violence and respect
for women. In the United States, for example, university undergraduates participated in a one-hour
programme led by four male peer educators. This

included a video that described a situation leading

to rape, and taught basic skills for helping a woman
recover from rape, communicating openly in sexual
encounters and challenging the societal normalization of rape. A randomized controlled evaluation
found that, immediately after the programme, levels of acceptance of rape-myths and the likelihood
of raping (measured by a behavioural question)
were significantly lower for participants than before the programme and no such changes were
reported in the control group. A follow-up study at
seven months indicated that the beneficial changes
were enduring; however, no changes were found in
levels of sexual coercion before and after the intervention (28).
In a related initiative, The Mens Program, a video was shown to male undergraduates describing a
homosexual, male-on-male, rape to teach the students how it might feel to be raped. The video also
made connections with male-on-female rape to encourage empathy for survivors. In addition, participants were taught how to support rape victims and
confront peers who joked or boasted about raping
women. An evaluation of this approach randomly
assigned participants to one of two additional
training modules that dealt with either bystander
intervention in situations involving alcohol where
there is a danger of rape, or defining consent in situations involving alcohol. A randomized controlled
trial found that in both treatment groups, participants were significantly less likely (than members
of the control group) to accept myths about rape or
commit sexual assault or rape (29).

VIOLENCE PREVENTION: THE EVIDENCE

3. Community interventions

Community interventions to reduce gender equality usually attempt to empower women, strengthen their economic position (through, for instance,
micro nance schemes) and change gender stereofi
types and norms (17,30,33,34). These programmes
have mainly been implemented in developing countries. Although most programmes involve women
(alone or with men), some community programmes
work solely with male peer groups focusing on masculinity, gender norms and violence. This reflects a
growing awareness of the importance of engaging
men and boys in interventions, not only to redefine
concepts of masculinity based on dominance and
control, but also to engage them in stopping violence against women. Community interventions aim
to change not just the way individuals think and behave, but also to mobilize entire villages or districts
in efforts to eradicate violence against women.

3.1 Microfinance
A number of initiatives involving micro-finance have
been established to increase womens economic
and social power. These provide small loans to mobilize resources for income-generating projects,
which can alleviate poverty. While microfinance
programmes can operate as discrete entities, successful ones tend to incorporate education sessions and skills-building workshops to help change
gender norms, improve communication in relationships and empower women in other ways (35).
One of the most rigorously evaluated and successful programmes is South Africas Intervention with Microfinance for AIDS and Gender Equity
(IMAGE). This targets women living in the poorest
households in rural areas, and combines financial
services with training and skills-building sessions
on HIV prevention, gender norms, cultural beliefs,
communication and intimate partner violence (36

38). The programme also encourages wider community participation to engage men and boys. It aims
to improve womens employment opportunities,
increase their influence in household decisions and
ability to resolve marital conflicts, strengthen their
social networks and reduce HIV transmission.
A randomized controlled trial found that, two
years after completing the programme, participants
reported 55% fewer acts of violence by their intimate partners in the previous 12 months than did
members of a control group (37). Compared with
controls, these women reported fewer experiences
of controlling behaviour by their partners (34%
of participants versus 42% of those in the control
group), despite having suffered higher levels of this
behaviour than members of the control group before entering the programme. In addition, participants were more likely to disagree with statements
that condone physical and sexual violence towards
an intimate partner (52% of participants versus
36% of the control group) (37). Furthermore, a
higher percentage of women in the programme
reported household communication about sexual
matters and attitudes that challenged gender roles.
The programme did not, however, have an effect on
either womens rate of unprotected sexual intercourse at last occurrence with a non-spousal partner or HIV incidence (37).
Other stand-alone credit programmes targeting
women appear to show promise in reducing intimate
partner violence. These include Grameen Bank and
Bangladesh Rural Advancement Committee (BRAC)
Rural Development programmes1 in Bangladesh.
1

The Grameen Bank and the BRAC Rural Development

Programme are the two largest non-governmental credit
programmes in Bangladesh. Participants are organized into
small solidarity groups which share responsibility for repayment.

PROMOTING GENDER EQUALITY TO PREVENT VIOLENCE AGAINST WOMEN

Here, women participants were interviewed retrospectively and asked if the programme had changed
their experience of intimate partner violence. Their
answers revealed that they were less than half as
likely to have been beaten by their partners in the
previous year as women living in villages with no
exposure to such programmes (39). Women were
protected from intimate partner violence through
their ability to bring home a resource that benefited
their partners, which improved their status in the
household. Since participation allowed the women greater contact with others outside the home,
their lives (and, therefore, experience of intimate
partner violence) also became more visible. These
programmes also showed benefits for the entire
community. Levels of intimate partner violence
among non-participating women living in villages
where credit programmes had been implemented
were about 30% lower than among non-participating women in villages with no credit programmes.
The promise of these programmes is tempered,
however, by reports of lenders exploiting disadvantaged borrowers with very high rates of interest
which can trap people in debt and contribute further
to poverty (40) and of increases in intimate partner violence (41). Disagreements over the control
of newly acquired assets and earnings, combined
with womens changing attitudes towards traditional gender roles, improved social support and
greater confidence to defend themselves against
male authority, sometimes led to marital conflicts
and violence against women perpetrated by their
partners (39). Increases in violence following participation in credit programmes have also been reported elsewhere (42), at least in the initial stages
of membership (43).
These negative outcomes may be explained by
differences between the Grameen and BRAC credit
programmes and South Africas IMAGE intervention, described above. IMAGE includes education
and skills-building sessions that address a variety of social issues and engage men and boys. The
Grameen and BRAC programmes do not, however,
include such educational and skills-building sessions (except for self-employment, often a year after
membership). Furthermore, these programmes are
solely for women. Pre-existing gender roles appear
to affect the violence-related outcomes of credit
programmes: in communities with rigid gender
roles, womens involvement can result in increased
levels of intimate partner violence, but not in those
with more flexible gender roles (44). Through education and skills-building, and engagement with
8

boys and men, IMAGE has the potential to change

the attitudes of whole communities, making them
more receptive to female empowerment, without a
backlash.

3.2 Challenging gender norms

and attitudes
Other community programmes challenge gender
norms and attitudes that justify intimate partner
violence. The most widely established and rigorously evaluated is the Stepping Stones programme,
a life-skills training intervention developed for HIV
prevention, which has been implemented in Africa
and Asia. Using a variety of methods, including reflection on ones attitudes and behaviour, role-play
and drama, it addresses issues such as genderbased violence, communication about HIV, relationship skills and assertiveness. Thirteen three-hour
sessions are run in parallel for single-sex groups
of women and men. These are complemented by
mixed peer group and community meetings. Stepping Stones is designed to improve sexual health
by developing stronger, more equal relationships
between those of different gender. Versions of the
programme have been evaluated in a variety of
countries (45); however, the most thorough study
is a randomized controlled trial in the Eastern Cape
province of South Africa, with participants aged 15
26 years-old. This indicated that a lower proportion
of the men who had participated in the programme
committed physical or sexual intimate partner
violence in the two years after the programme,
compared with the men in a control group (46). Furthermore, a qualitative evaluation in Gambia that
followed participating couples over one year found
that, compared to couples in a control group, they
communicated better and quarrelled less, and that
the men were more accepting of a wifes refusal to
have sex and less likely to beat her (47).
In Uganda, Raising Voices and the Centre for Domestic Violence Prevention run a community initiative for males and females, designed to challenge
gender norms and prevent violence against women and children (48). This includes raising awareness of domestic violence and building networks
of support and action within the community and
professional sectors; community activities such as
theatre, discussions and door-to-door visits; and
using radio, television and newspapers to promote
womens rights. A review of the programme after
two years suggested that all forms of intimate partner violence had decreased in the community (48).
However, 8% of women and 18 % of men reported
VIOLENCE PREVENTION: THE EVIDENCE

BOX 4

Nicaraguan backlash shows need to engage men, as well

During the last decade, Nicaragua has pioneered a number of initiatives to protect women against
domestic violence. These have included:
L A network of police stations for women (Comisaria de la Mujer), where women who have been abused
receive psychological, social and legal support;
L A ministry for family affairs (Mi Familia), which among other responsibilities, ensures that shelter is
available to women and children who suffer domestic violence;
L Reform of the national reproductive health programme to address gender and sexual abuse.
At the same time civil society groups have campaigned to promote the rights of women and to empower
them to oppose domestic abuse. Despite these efforts, the reported number of acts of domestic and
sexual violence against women has increased dramatically: e.g. reports of sexual abuse received by the
Comisaria de la Mujer rose from 4174 (JanuaryJune 2003) to 8376 (JanuaryJune 2004).
Researchers at the Universidad Centro Americana and the Institute for Gender Studies say two factors
explain this increase: better reporting of cases, as women are now encouraged to speak out; and the
growing awareness among women that cultural traditions that foster violence are no longer acceptable
under international law. In turn, as Nicaraguan women have more actively opposed male hegemony,
domestic conflicts have increased and more men have resorted to domestic violence.
These findings suggest responses to domestic violence must not focus exclusively on women, but must also
target men to prevent a backlash (49).

an increase in physical violence against women

following the introduction of the programme. This
backlash was attributed to men feeling threatened
by the empowerment of women (see Box 4).
A number of programmes work specifically with
male peer groups, addressing values and attitudes
associated with violence against women, redefining
concepts of masculinity and engaging men in violence prevention. In general, however, few rigorous
evaluations have assessed the impact of these programmes on violence. In Africa, Asia, Latin America
and the United States, Men As Partners provides
education and skills-building workshops for men to
explore their attitudes regarding sexuality and gender and promote gender equality in relationships
(50). The project provides enhanced health-care
facilities for men, leads local and national public
education campaigns and advocates for change
at national and international levels. A review of a
five-day workshop in South Africa reported some
positive results, although it was not an independent study, and it failed to include a control group
for comparison. Nonetheless, changes in gender
attitudes were reported among the men attending and completing a survey (67% of those attending completed a survey). For instance, 54% of men
disagreed with the statement that men must make
all the decisions in a relationship in a pre-training
interview, compared with 75% three months later.

Similarly, 61% of men disagreed that women who

dress sexy want to be raped before training, compared with 82% three months later (50).
Another intervention that uses male peer groups
is Brazils Program H. This fosters healthy relationships and aims to prevent HIV and other sexually
transmitted infections. Program H has two main
components: educational sessions (with video,
role-playing and discussions) lasting two hours per
week for six months to promote changes in attitude
and behaviour; and a social marketing campaign to
promote changes in norms of masculinity and lifestyles. An evaluation among 1425-year-old males
compared three communities: the first received the
Program H educational component, the second received the educational component plus the social
marketing campaign and the third (control group)
received no intervention. Compared to the control
community, at six months, participants in the two
communities that received one or both of the interventions were less likely to support traditional gender norms than before the intervention (51).
India has also tested a version of Program H,
with the same design and time frame as in Brazil.
An evaluation found that it encouraged male participants to question traditional gender norms.
Additionally, the proportion of men in the Indian
programme reporting violence against a partner in
the previous three months declined significantly in

PROMOTING GENDER EQUALITY TO PREVENT VIOLENCE AGAINST WOMEN

the intervention groups, compared to the control

group (52).
While evaluations of community interventions indicate that they may help in reducing violence and changing gender attitudes and norms
(17,30,33,34), more scientific evaluation studies
are needed, particularly for programmes focusing
on male peer groups. Community interventions are

10

more effective when facilitators are well-trained

and have won the trust of a community. Their success is also linked to communities taking ownership of interventions, the concurrent use of a
variety of methods and activities (30), adequate
and sustained funding and the support of highlevel political decision-makers.

VIOLENCE PREVENTION: THE EVIDENCE

4. Media interventions

Media interventions use television, radio, the Internet, newspapers, magazines and other printed
publications to reach a wide range of people and
effect change within society. They aim to increase
knowledge, challenge attitudes and modify behaviour. Media interventions can also alter social
norms and values (e.g. the belief that masculinity is
associated with aggression) through public discussion and social interaction. Media campaigns have
proven successful in increasing knowledge of intimate partner violence and influencing attitudes towards gender norms, but less is known about their
ability to reduce violent behaviour, as it is difficult
to measure potential changes in levels of violence
associated with media interventions (21,30,33,53).
Research shows, however, that the most successful media interventions are those that begin by
understanding the behaviour of their audience and
engaging its members in developing the intervention (30).
One of the best-known and most carefully evaluated media programmes is Soul City in South Africa (54). This uses a series of radio and television
episodes to highlight intimate partner violence,
date rape and sexual harassment, among other
social problems. The series is accompanied by information booklets that are distributed nationally.
An evaluation of the fourth series, which focused
on gender-based violence, used a random sample
of the national population and conducted two sets
of interviews, eight months apart: before and after
the intervention. The study reported an association between exposure to the Soul City series and
changes in knowledge and attitudes towards intimate partner violence (55). For instance, at followup, the percentage of people agreeing with the
statement no woman ever deserves to be beaten
had increased from 77% to 88%, while the percent-

age disagreeing with the assertion women who

are abused are expected to put up with it had
increased from 68% to 72%. However, there were
no significant changes reported in other attitudes
such as as head of household, a man has the right
to beat his wife (55) and the study design was not
able to establish if there was an impact on violent
behaviour.
In Nicaragua, a mass communication strategy named Somos Diferentes, Somos Iguales
(We are different, We are equal) has promoted
social change to improve sexual and reproductive
health. The strategy aimed to empower women and
young people to take control of their lives and to
promote womens rights and gender equality. Activities included a national television series (Sexto Sentido, or Sixth Sense), a radio talk show for
youth and community activities such as training
workshops for young people and youth leadership
camps. The television series was a weekly drama
with issue-based storylines that was broadcast in
Nicaragua, other Central American countries and
the United States. Using a sample of Nicaraguan
youth (1324-years-old), an evaluation found that
the strategy was associated with a positive change
in attitudes towards gender equity, among those
exposed to it. However, the study lacked a control
group for comparative purposes and did not measure changes in levels of violence towards women
(56).
A number of campaigns have targeted men specifically, aiming to challenge traditional concepts
of masculinity associated with violence. Evaluations of these have not, however, looked at their
effect on violence. For instance, a 2001 Australian
campaign known as Violence against WomenIts
Against All the Rules targeted 2129-year-old men.
Sports celebrities delivered the message that vio-

PROMOTING GENDER EQUALITY TO PREVENT VIOLENCE AGAINST WOMEN

11

lence towards women is unacceptable and that a

masculine man is not a violent man (57). Similarly, in the United States, Men Can Stop Rape runs
a public education campaign for men and boys
with the message My strength is not for hurting.
The campaign materials highlight how men can be
strong without overpowering others and aim to redefine masculinity (58). Internationally, the White
Ribbon campaign engages men and boys in work
to end violence against women. This educational
initiative raises awareness about violence against
women and challenges men to speak out against it.
Supporters wear a white ribbon, symbolizing their
promise never to commit, condone or remain silent
about violence towards women (59).
Many other public information campaigns promote gender equality and raise awareness about
intimate partner violence, though few have been
evaluated. These campaigns can be useful for advocating for the implementation of laws and policies that contribute to gender equality (see Box 3).
International campaigns include:
16 Days of Activism to End Gender Violence:
This annual campaign, established by the
Center for Womens Global Leadership in 1991,
has engaged organizations in more than 130
countries. Activities include raising aware-

12

ness about violence as a human rights issue,

strengthening local work around violence
against women and pressuring governments
to make the changes needed to eliminate violence (http://www.unfpa.org/16days/);
UNITE to End Violence Against Women:
Launched by the UN Secretary-General in
February 2008, this aims to raise public
awareness and increase political will and
resources for preventing and responding to
violence against women and girls (http://
endviolence.un.org);
Say NO to Violence Against Women: Run by
the United Nations Development Fund for
Women, this advocates for the right of every
woman to lead a life free of violence (http://
www.unifem.org/campaigns/vaw/); and
Stop Violence Against Women: Launched in
2004 by Amnesty International, this advocates for equal rights for women and children, urging governments to abolish laws and
practices that perpetuate violence against
women and adopt policies that protect women (http://www.amnesty.org/en/campaigns/
stop-violence-against-women).

VIOLENCE PREVENTION: THE EVIDENCE

5. Summary

The promotion of gender equality is an essential

part of violence prevention. A range of school, community and media interventions aim to promote
gender equality and non-violent relationships by
addressing gender stereotypes that allow men
more power and control over women. These include some well-evaluated interventions, but more
evaluations are needed that use measures of actual violent behaviour as an outcome rather than
improvements in attitude or knowledge, whose relation to violent behaviour may be unknown.
Some school-based programmes have demonstrated their effectiveness. With the exception
of the Safe Dates programme and the Youth Relationship Project, however, evaluations of these
have looked at short-term outcomes and more research is needed on their long-term effects. School
programmes are well placed to prevent violence
against women, since they have the potential to
address gender norms and attitudes before they
become deeply ingrained. They are also ideal environments to work with male peer groups, where
rigid ideas about masculinity can be questioned
and redefined. Among community interventions,
the IMAGE and Stepping Stones programmes are

supported by the strongest evidence. Community

programmes with male peer groups show promise
in changing attitudes towards traditional gender
norms, as well as violent behaviour, but they require more rigorous outcome evaluations. Finally,
media interventions, such as Soul City in South
Africa, appear to be effective at addressing attitudes towards gender norms and womens rights
that may influence violent behaviour. However, we
do not yet know whether they actually reduce violent behaviour.
There is evidence that the success of some microfinance programmes in empowering women
(without engaging with men) may actually cause
friction and conflict between partners, especially
in societies with rigid gender roles (44). Further
research is needed to explore how such possible
negative effects might be overcome. When gender roles become more flexible, most women enjoy
greater power, status and economic independence
and the threat of violence against them decreases
(60). It is important, therefore, to engage both men
and women and boys and girls in interventions
that promote gender equality and prevent violence
against women.

PROMOTING GENDER EQUALITY TO PREVENT VIOLENCE AGAINST WOMEN

13

References

1.

2.

3.

4.

5.

6.

7.

8.

9.
10.

11.

12.

13.

14

Ilika AL. Womens perception of partner violence in

a rural Igbo community. African Journal of Reproductive Health, 2005, 9:7788.
Mitra A, Singh P. Human capital attainment and
gender empowerment: the Kerala paradox. Social
Science Quarterly, 2007, 88:12271242.
Heise L, Garcia-Moreno C. Intimate partner violence. In Krug et al., eds. World report on violence
and health. Geneva, World Health Organization,
2002.
Heise L, Ellsberg M, Gottmoeller M. A global overview of gender-based violence. International Journal
of Gynecology and Obstetrics, 2002, 78:S5S14.
Violence against women. Fact sheet No. 239. Geneva, World Health Organization, 2008. (http://www.
who.int/mediacentre/factsheets/fs239/en/print.
html, accessed 5 February 2009).
Sarkar NN. The impact of intimate partner violence
on womens reproductive health and pregnancy
outcome. Journal of Obstetrics and Gynecology,
2008, 28:26671.
Coker AL. Does physical intimate partner violence
affect sexual health? A systematic review. Trauma
Violence and Abuse, 2007, 8:14977.
Plichta SB. Intimate partner violence and physical
health consequences: policy and practice implications. Journal of Interpersonal Violence, 2004,
19:1296323.
Campbell JC. Health consequences of intimate partner violence. Lancet, 2002, 359:133136.
Dutton MA et al. Intimate partner violence, PTSD
and adverse health outcomes. Journal of Interpersonal Violence, 2006, 21:955968.
Transforming health systems: gender and rights in
reproductive health. Geneva, World Health Organization, 2001.
UN Economic and Social Council (ECOSOC). Agreed
Conclusions 1997/2. 18 July 1997. (http://www. unhcr.
org/refworld/docid/4652c9fc2.html, accessed 5
February 2009).
United Nations Population Fund (UNFPA). Violence
against girls and women: a public health priority
(http://www.unfpa.org/intercenter/violence/, accessed 5 February 2009).

14. United Nations General Assembly A/RES/48/104

20th December 1993. (http://www.un.org/
documents/ga/res/48/a48r104.htm, accessed 5
February 2009).
15. Garcia-Moreno C et al. Prevalence of intimate partner violence: findings from the WHO multi-country
study on womens health and domestic violence.
Lancet, 2002, 368: 126069.
16. Commonwealth Secretariat. Integrated approaches to eliminating gender-based violence. London,
Commonwealth Secretariat, 2003.
17. Morrison A, Ellsberg M, Bott S. Addressing genderbased violence in the Latin American and Caribbean region: a critical review of interventions.
World Bank policy research working paper 3438.
(http://www-wds.worldbank.org/, accessed 5 February 2009).
18. Hickman LJ, Jaycox LH, Aronoff J. Dating violence
among adolescents: prevalence, gender distribution, and prevention programme effectiveness.
Trauma, Violence and Abuse, 2004, 5: 123142.
19. Avery-Leaf S, Cascardi, M. Dating violence education: prevention and early intervention strategies. In:
Schewe PA, ed. Preventing violence in relationships:
interventions across the life span. Washington, DC,
American Psychological Association, 2002.
20. Wekerle C, Wolfe DA. Dating violence in mid-adolescence: theory, significance and emerging prevention initiatives. Clinical Psychology Review, 1999,
19:435456.
21. Whittaker DJ, Baker CK, Arias I. Interventions to
prevent intimate partner violence. In: Doll LS et al.,
eds. Handbook of injury and violence prevention.
New York, Springer, 2007.
22. Foshee VA et al. An evaluation of safe dates an
adolescent dating violence prevention programme.
American Journal of Public Health, 1998, 88:4550.
23. Foshee VA et al. Assessing the effects of the dating
violence prevention program Safe Dates using
random coefficient regression modelling. Prevention Science, 2005, 6:245257.
24. Wolfe D et al. Dating violence prevention with atrisk youth: a controlled outcome evaluation. Journal of Consulting and Clinical Psychology, 71(2):
279291.

VIOLENCE PREVENTION: THE EVIDENCE

25. Avery Leaf S et al. Efficacy of a dating violence prevention program on attitudes justifying aggression.
Journal of Adolescent Health, 1997, 21:1117.
26. Ward, KJ. MVP Evaluation 19992000 (http://www.
sportinsociety.org/files/mvp-evaluation1.pdf, accessed 5 February 2009).
27. Campbell JC. Health consequences of intimate partner violence. Lancet, 2002, 359:133136 (http://
www.sportinsociety.org/files/completeformat.
doc, accessed 5 February 2009)
28. Foubert JD. The longitudinal effects of a rapeprevention program on fraternity mens attitudes,
behavioral intent, and behavior. Journal of American College Health, 2000, 48:158163.
29. Foubert JD, Newberry JT. Effects of two versions of
an empathy-based rape prevention program on fraternity mens survivor empathy, attitudes and behavioural intent to commit rape or sexual assault.
Journal of College Student Development, 2006,
47:133148.
30. Harvey A, Garcia-Moreno C, Butchart A. Primary
prevention of intimate partner violence and sexual
violence: background paper for WHO expert meeting May 23, 2007. (http://www.who.int/violence_
injury_prevention/publications/violence/IPV-SV.
pdf, accessed 5 February 2009).
31. Brecklin LR, Forde DR. A meta-analysis of rape
education programs. Violence and Victims, 2001,
16:303321.
32. Sonke Gender Justice Project. Men as partners: engaging men to reduce childrens vulnerabilities to
HIV/AIDS and gender-based violence in Nkandla,
KwaZulu-Natal and OR Tambo, Eastern Cape. (www.
genderjustice.org.za, accessed 5 February 2009).
33. Guedes A. Addressing gender-based violence from
the reproductive health/HIV sector: a literature review and analysis. Report commissioned by USAID
Interagency Gender Working Group (IGWG). Washington, DC, POPTECH project, 2004.
34. Engaging men and boys in changing gender-based
inequity in health: evidence from programme interventions. Geneva, World Health Organization,
2007.
35. Kim J et al. Assessing the incremental benefits of
combining health and economic interventions:
experience from the IMAGE Study in rural South
Africa. Bulletin of the World Health Organization,
2009, in press.
36. Rural AIDS and Development Action Research Programme (RADAR). Social interventions for HIV/
AIDS. Intervention with Micro-finance for AIDS and
gender equity (IMAGE) study. Evaluation Monograph No. 1. South Africa, RADAR, 2002.
37. Pronyk PM et al. Effect of a structural intervention
for the prevention of intimate-partner violence and
HIV in rural South Africa: a cluster randomised trial.
Lancet, 2006, 368:197383.
38. Kim JC, Watts CH, Hargreaves JR et al. Understanding the impact of a microfinance-based intervention
on womens empowerment and the reduction of intimate partner violence in South Africa. American
Journal of Public Health, 2007, 97:17941802.

39. Schuler SR et al. Credit programs, patriarchy and

mens violence against women in rural Bangladesh.
Social Science and Medicine, 1996, 43:17291742.
40. Rhyne E. Commercialization and crisis in Bolivian
microfinance. Bethesda USA, Microenterprise Best
Practices, 2001.
41. Kabeer N. Conflicts over credit: re-evaluating the
empowerment potential of loans to women in rural
Bangladesh. World Development, 2001, 1:6384.
42. Rahman A. Micro-credit initiatives for equitable and
sustainable development: who pays? World Development, 1999, 27:6782.
43. Ahmed SM. Intimate partner violence against women: experiences from a woman-focused development programme in Matlab, Bangladesh. Journal of
Health and Population Nutrition, 2005, 23:95101.
44. Koenig MA et al. Womens status and domestic violence in rural Bangladesh: Individual and Community level effects. Demography, 2003, 40:269288.
45. ActionAid International. Evaluating Stepping
Stones. A review of existing evaluations and ideas
for future M&E work. (http://alextechw10.co.uk/
steppingstones/downloads/AAI SS_review_finalMay_2006.pdf, accessed 5 February 2009)
46. Jewkes R et al. Impact of Stepping Stones on incidence of HIV and HSV-2 and sexual behaviour in
rural South Africa: cluster randomised controlled trial. British Medical Journal, 337: a506. doi:
10.1136/bmj.a506
47. Paine K et al. Before we were sleeping, now we
are awake: preliminary evaluation of the Stepping
Stones sexual health programme in The Gambia.
African Journal of AIDS Research, 2002, 1:4152.
48. Raising Voices and the Center for Domestic Violence
Prevention. Mobilising communities to prevent domestic violence, Kawempe Division, Uganda. Impact Assessment. (http://www.preventgbvafrica.
org/images/publications/evaluations/rv.cedovip.
impactassess.pdf, accessed 21 August 2008).
49. Schopper D, Lormand J-D, Waxweiler R, eds. Developing policies to prevent injuries: guidelines for
policy-makers and planners. Geneva, World Health
Organization, 2006.
50. Peacock D, Levack A. The men as partners in South
Africa: reaching men to end gender-based violence
and promote sexual and reproductive health. International Journal of Mens Health, 22 September
2004. (http://findarticles.com/p/articles/mi_m0PAU/
is_3_3/ai_n13733408?tag=artBody;col1, accessed
21 August 2008).
51. Pulerwitz J et al. Promoting gender-equity among
young Brazilian men as an HIV prevention strategy. Horizons Research Summary. Washington, DC,
Population Council, 2006.
52. Verma RK et al. From research to action addressing masculinity and gender norms to reduce HIV/
AIDS related risky sexual behavior among young
men in India. Washington, DC, Population Council,
2008.
53. Campbell JC, Manganello J. Changing public attitudes as a prevention strategy to reduce intimate
partner violence. Journal of Aggression, Maltreatment and Trauma, 2006, 13:1339.

PROMOTING GENDER EQUALITY TO PREVENT VIOLENCE AGAINST WOMEN

15

54. Soul City Institute. Johannesburg (http://www.

soulcity.org.za, accessed 21 August 2008).
55. Usdin S, Scheepers E, Goldstein S et al. Achieving
social change on gender-based violence: a report
on the impact evaluation on Soul Citys fourth series.
Social Science and Medicine, 2005, 61:24342445.
56. Solrzano I et al. Catalyzing personal and social
change around gender, sexuality, and HIV: impact
evaluation of Puntos de Encuentros communication strategy in Nicaragua. Washington, DC, Population Council, 2008.

16

57. Flood M. Engaging Men: Strategies and dilemmas in

violence prevention education among men. Women
Against Violence: A Feminist Journal, 20022003,
13:2532.
58. Men Can Stop Rape. Strength Campaign. (http://
www.mencanstoprape.org, accessed 5th February
2009).
59. White Ribbon Campaign (http://www.whiteribbon.
ca, accessed 5th February 2009).
60. Archer J. Cross-cultural differences in physical aggression between partners: a social-role analysis.
Personality and Social Psychology Review, 2006,
10(2):13353.

VIOLENCE PREVENTION: THE EVIDENCE