Impact of the Safe at Home Family Violence Prevention Trial in Eastern DRC

Background and purpose: In North Kivu, Democratic Republic of Congo, 56.1% of families report co-occurring child abuse and intimate partner violence (IPV) against women in the past three months. Given the shared drivers of these multiple forms of violence in the home, the Safe at Home program was developed to provide community-, family-, and single-sex sessions to transform power inequalities, including those rooted in gender and age hierarchies, improve relationship and parenting skills, and ultimately improve family functioning and prevent violence against women and children in the home. Safe at Home was built from previously trialed International Rescue Committee parenting and gender transformation programming.

Methods: A waitlisted, pilot, cluster-randomized controlled trial was completed between 2019-2021 across four communities. At baseline, 198 women and 196 men participated in the study with a 97% retention rate. The primary outcome, family functioning, was adapted for the context. Secondary outcomes, including past-three month IPV (only assessed amongst women) and child abuse (perpetrated by either caregiver), employed the WHO Multi-country Study and the MICS scales, respectively. Pathways assessed included attitudes related to acceptance of harsh discipline and gender inequity, couple power sharing, and parenting skills.

Results: Trial results demonstrated no significant change in a feminist-grounded measure of family functioning during the study period, which included the COVID-19 pandemic, a volcanic eruption, and vacillating insecurity in the study setting. However, women participating in Safe at Home reported significantly lower odds (OR=0.23, p 0.001) of experiencing recent IPV and using physical or psychological harsh discipline (OR=0.29, p 0.013) against their children as opposed to those in the waitlist arm at endline. Men reported non-significant reductions in child abuse (OR=0.56; p=0.19). Women in Safe at Home also reported significant improvements in non-acceptance of harsh discipline attitudes, gender equitable attitudes, couple power sharing, and mental health. Men in the treatment arm reported significant improvements in gender equitable attitudes, power sharing, and marginally significant increases in positive parenting skills and non-acceptance of harsh discipline.

Conclusions and implications: Trial results demonstrate that a feminist-grounded, asset-based, combined approach to address multiple forms of violence in the home is effective in improving family strengthening mechanisms and reducing violence. Further work is needed to unpack potential scaling and adaptation approaches across contexts.