What Works - Malawi SASA! Together

According to the 2016 Malawi Demographic and Health Survey, 42% of ever-married women aged 15 - 49 have experienced spousal physical, sexual, or emotional violence by their current or most recent spouse, and a third (33%) of ever-married women experienced at least one of these forms of violence in the 12 months before the survey \[1\]. Overall, 41% of all women (whether they have ever been married or not) have experienced physical or sexual violence \[1\]. Despite these high levels of violence against women and girls (VAWG), there are a limited number of evidence-based interventions focused on preventing VAW in Malawi.

Violence against women must be addressed at multiple levels, with leadership from women themselves on how to bring about positive change to free women and girls from daily experiences of violence and to promote their rights. It is in this context that the Pamodzi Kuthetsa Nkhanza (PKN) consortium will implement a programme to facilitate the prevention of intimate partner violence (IPV) in Malawi. The programme takes a whole community approach and uses gender transformative approaches at different levels of society to address the root causes of IPV. It will draw primarily on two existing, evidence-based prevention models, namely SASA! Together and Moyo Olemekeza (MO).

This cRCT forms part of a broader mixed methods research design. Guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, the overall research design consists of five distinct components, all contributing to evidence on the efficacy of the programme and the contextual factors around the programme and its implementation that will guide the interpretation of the cRCT.

This protocol refers to the cRCT evaluation of SASA! Together only. Specifically, the cRCT aims to evaluate the community level impact of SASA! Together on experiences of IPV among women aged 18 - 49 in two districts in Malawi (Balaka and Lilongwe districts).

The specific aim for understanding the efficacy of the SASA! Together programme is:

1\) To estimate the community-level causal impact of SASA! Together (compared to a control) on the primary and secondary outcomes among women and men aged 18 - 49 in Lilongwe and Balaka districts, Malawi.

The overall goal of this study is to add to the evidence base on effective, comprehensive interventions to reduce violence against women in Malawi.

• Indicator for Past year experience of physical violence from a partner (among women who have had an intimate partner in the past year) [Time frame: 12 months]
• Indicator for Past year experience of sexual violence from a partner (among women who have had an intimate partner in the past year) [Time frame: 12 months]
• Indicator for Past year experience of emotional violence from a partner (among women who have had an intimate partner in the past year) [Time frame: 12 months]
• Indicator for Past year experience of economic violence from a partner (among women who have had an intimate partner in the past year) [Time frame: 12 months]
• Indicator for Past year experience of controlling behaviour from a partner (among women who have had an intimate partner in the past year) [Time frame: 12 months]
• Index for Acceptability of intimate partner violence (among all women and men separately) [Time frame: From time of implementation to endline assessment is 3 years]
• Index of Appropriate community response to women experiencing IPV in past year (among all women and men separately) [Time frame: From time of implementation to endline assessment is 3 years]