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IntroductionThe study objective was to understand the effectiveness of Engaging Men through Accountable Practice (EMAP), a group-based discussion series which sought to transform gender relations in communities, on intimate partner violence (IPV), gender inequitable attitudes and related outcomes.MethodsA two-armed, matched-pair, cluster randomised controlled trial was conducted between 2016 and 2018 in eastern Democratic Republic of Congo. Adult men (n=1387) and their female partners (n=1220) participated in the study. The primary outcomes of the study were female report of past year physical and/or sexual IPV and men’s intention to commit violence. Secondary outcomes included men’s gender attitudes, women’s economic and emotional IPV, women’s perception of negative male behaviours and perceived quality of the relationship.ResultsMen in EMAP reported significant reductions in intention to commit violence (β=−0.76; SE=0.23; pConclusionInterventions engaging men have the potential to change gender attitudes and behaviours in conflict-affected areas. However, while EMAP led to changes in gender attitudes and behaviours related to perpetration of IPV, the study showed no overall reduction of women’s experience of IPV. Further research is needed to understand how working with men may lead to long-term and meaningful changes in IPV and related gender equitable attitudes and behaviours in conflict areas.Trial registration numberNCT02765139.

IntroductionInterpersonal violence is a critical public health concern in humanitarian contexts, but evidence of effective violence prevention programmes targeting adolescent girls is lacking. We investigated the efficacy of a life skills and safe spaces programme to reduce adolescent girls’ experiences of interpersonal violence in a refugee setting.MethodsIn this two-arm, single-blinded, cluster randomised controlled trial, we recruited 919 Sudanese and South Sudanese girls ages 13–19 years residing in refugee camps in Ethiopia. Girls were divided into 31 clusters, with 457 and 462 participants assigned to the intervention and control arms, respectively. Intervention clusters received 30 life skills sessions delivered in safe spaces and 8 complementary sessions for caregivers. The primary outcome was exposure to sexual violence in the previous 12 months. Secondary outcomes included disaggregated forms of sexual violence, physical violence, emotional violence, transactional sex, child marriage, feelings of safety, attitudes around rites of passage and perceptions of social support. Intent-to-treat analysis was used.ResultsAt 12-month follow-up, the intervention was not significantly associated with reduction in exposure to sexual violence (adjusted OR =0.96, 95% CI 0.59 to 1.57), other forms of violence, transactional sex or feelings of safety. The intervention was associated with improvements in attitudes around rites of passage and identified social supports. Additionally, the intervention showed a decrease in reported child marriage among girls who were married at baseline.ConclusionWhile the intervention impacted key markers along the causal pathway to violence reduction, further research and programmatic adaptations are needed to prevent violence towards adolescents in humanitarian contexts.Trial registrationNCT02506543.

On 21 January 2017, millions of people across the globe stood up to demand that women's and girls' rights be respected and guaranteed. This call for global women's rights is especially critical at a time when the number of displaced persons totals 63.5 million—representing the highest global prevalence of displaced persons that the world has witnessed since World War II.1 Declining government stability and diminishing wealth are overwhelmingly viewed as the primary drivers of protracted and new conflicts that fuel such large-scale displacement. Yet, nearly a decade of research indicates that the status of women is also a critical predictor of a nation's security, and that women's rights must be safeguarded both in response to conflicts as well as an integral strategy towards preventing future humanitarian crises.2 This includes gender equity in educational attainment, political representation, economic empowerment, and safety in public and within the privacy of their homes. While equality and violence against women and girls has received high-level attention within global platforms, such as the 2030 Agenda for Sustainable Development,3 gaps remain regarding research on effective programmes that can reduce and prevent such violence from taking place. One in three women worldwide experience physical or sexual violence from a male partner (ie, intimate partner violence, hereafter IPV) at some point in their lifetime, and the health consequences have been extensively documented.4 In conflict-affected settings, IPV levels are higher, with lifetime prevalence estimates ranging from 20% to 59% within select conflict-affected countries in Sub-Saharan Africa.5 However, research and programmatic attention aiming to combat IPV in conflict settings are sparse. This is in part due to urgency in addressing basic health issues and physical infrastructure,6 donor and media prioritisation of sexual violence as a weapon of war without adequate attention to IPV, and logistical …