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Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
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7


The Way Forward

There was much discussion throughout the workshop regarding next steps and proposed ways forward for the problem of IPV in East Africa. Many of those suggestions have been shared in previous chapters of this summary. This final chapter will recapitulate some of those suggestions as well as highlight some of the discussion points from the workshop’s closing panel.

RESEARCH

In her keynote address, Nduku Kilonzo, the Director of the Kenya National AIDS Control Council, explained that there needs to be a shift in research, one that moves away from international sources and studies toward more localized studies in terms of modeling, identifying surveillance points and surveillance data needs. She also highlighted the need for increased mentorship and long-term training of young scientists and researchers in the region to ensure the sustainability of research efforts in East Africa.

Cost Analyses

Many speakers also highlighted the need to include economic analyses as a common part of all intervention review and analysis in order to develop a case for policy makers and for the purpose of developing a plan for scaling up intervention practices.

Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
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Linking IPV to Other Public Health Issues and Research Activities

There were repeated calls from many speakers and participants alike to link research efforts across multiple factors related to IPV. This would mean bringing together researchers exploring issues of IPV and HIV as well as those who are studying the effects of chronic exposure to violence and the impact of IPV on children and families. Some participants noted that this could produce a broader pool of data, particularly related to subpopulations and it might also shed some light on the causal pathways of IPV both in terms of perpetrators and victims, which is another area that some participants raised as one needing further research.

Collecting and Analyzing Data on New Populations and Groups

Workshop moderator Ian Askew, the Director of Reproductive Health Services and Research at the Population Council, also pointed out that there was an apparent lack of evidence presented regarding perpetrators of IPV, particularly in relation to why they perpetrate these forms of violence. He suggested it might be worthwhile to invest some time and research into that question to develop subsequent primary prevention efforts for this population.

Many workshop participants also highlighted a need to expand research perimeters to include subpopulations across the lifespan, including aging populations and adolescents. These efforts appear to be under way, but some participants within this workshop indicated the studies were small and would likely require further efforts and resources to bring them to scale.

Collaboration Across Sectors

Keynote speaker Jessie Mbwambo of Muhimbili University also suggested that researchers should be willing collaborators with individuals from other sectors, including community workers, such as public health specialists, social workers, and policy makers, not only so these groups can help develop study designs and illuminate findings, but also so these same collaborative groups can work together to develop effective and innovative programming that would not have been possible otherwise. There were a few commenters within the closing panel’s discussion who shared their own experiences with multidisciplinary teams in the field of IPV prevention, each of whom lauded the approach and stated how much further it pushed the science and the programming efforts than had there been a team of like-minded individuals from only one discipline or sector. Mbwambo stated that she expected difficulties with this in practice given the siloed approach

Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×

to violence prevention and IPV; however, she urged her colleagues and the workshop’s participants to think creatively about the ways they can adopt this strategy in their own work to help break down those siloes.

Many participants also explained that researchers should be mindful of their dissemination and information sharing efforts. Some explained they had difficulty accessing data to inform intervention or programming efforts. They suggested that this issue could be resolved through collaborative efforts such as those just described, but there were also additional calls for broader dissemination and access to data and research in general within the region to facilitate future prevention and programming efforts.

COMMUNICATION EFFORTS

There was much discussion surrounding communication efforts within IPV prevention. Many of these points focused on the varying degrees of understanding of IPV across sectors and the unique language used within each sector. Many commenters felt that there needed to be increased communication across all sectors working on the issue of IPV generally, but also that there needs to be a system of standard operating procedures, languages, and best practices to better facilitate interactions and collaborations across disciplines.

Perhaps most prevalent in the workshop discussions on this subject were points related to communications with policy makers. Some participants and speakers suggested that researchers and programmers should become well versed in the language and drivers of policy in order better situate their needs, issues, and priorities within a policy context to garner the attention they deserve.

Keynote speaker Nduku Kilonzo explained that making a case to policy makers requires developing an articulate “ask” that is strongly rooted in the available evidence and delivered in a language that policy makers understand. This area, she explained, is a prime example of why economic and cost analyses are so important for moving forward in IPV-prevention efforts, because often the language of policy makers centers on the limited resources and funds available versus the costs of the proposed intervention efforts before them. By changing tactics to focus on this reality, she suggested, researchers and programmers could be in a better position to deliver effective arguments in the case for IPV funding and support.

TRANSNATIONAL COLLABORATION

The need to collaborate that was urged by many participants throughout the workshop extends beyond multidisciplinary approaches into transnational efforts to share research, data, and best practices. In fact, some

Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×

collaboration already exists, such as the East, Central, and South African Health Communities discussed in Chapter 4 of this summary. Many commenters suggested that these approaches increase the data pool and knowledge base, but also present opportunities to share in the costs of prevention efforts, thus somewhat alleviating the pressures of the resource constrained environment. Sharing of information includes the widespread dissemination of successful programming efforts and studies. Workshop speaker and professor at Johns Hopkins University, Jacquelyn Campbell, echoed this sentiment when discussing the upcoming release of many of the study results for interventions featured in this workshop—particularly for those related to the LVCT and SASA! interventions.

INVESTING IN COMMUNITY MOBILIZATION AND POPULATION-BASED PREVENTION

The impact of population-based interventions and efforts to mobilize communities to influence and change societal and cultural norms regarding violence against women was repeatedly raised throughout the 2-day program. The presentations from each of the speakers in Chapter 5 on this subject show that these efforts hold promise in the region for IPV prevention and reduction while simultaneously helping to develop a strong sense of ownership amongst East African communities as these programs are often implemented and driven by local community members and leaders. Many participants lauded these efforts, with some specifically citing the success of the SASA! program in reducing the prevalence of IPV and HIV within a matter of years, shattering the previously held notion that changes in social and cultural norms and their impact on violence against women would require substantial efforts across generations of community members.

Speaker Charlotte Watts also mentioned that the resource constrained environment precludes the opportunity to perform one-on-one interventions that are time consuming and expensive. Instead, she explained, larger-scale and more population-based methods are a more attractive and cost-effective method of increasing reach and impact despite limited capacities and resources.

Many participants and speakers suggested that primary prevention efforts be undertaken among young people to prevent IPV from developing within their relationships in the first place. Some participants suggested that community mobilization efforts could help in this respect by opening dialogues across communities. However, some other participants noted that it could be useful to develop more targeted interventions that focus on this population with the inclusion of their parents or caretakers as opposed to entire communities in order to preempt some of the concerns and barriers related to younger populations and IPV raised in Chapter 2 of this summary.

Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×

ADVOCACY

Finally, many speakers throughout the workshop discussed their desire and perceived obligation to contribute to the discourse on IPV and policy efforts through the use of advocacy. These efforts, many claimed, are instrumental in the process of creating the necessary public and political wills to influence the field of IPV work and the prevalence of this form of violence in the region. Many speakers and participants suggested that individuals working in this field should think critically about their communications efforts and develop tailored advocacy efforts for each of the sectors of society that they interact with in the fight to reduce the burden of IPV in East Africa.

Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×

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Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×
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Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×
Page 62
Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×
Page 63
Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×
Page 64
Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×
Page 65
Suggested Citation:"7 The Way Forward." Institute of Medicine and National Research Council. 2015. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania: Summary of a Joint Workshop by the Institute of Medicine, the National Research Council, and the Uganda National Academy of Sciences. Washington, DC: The National Academies Press. doi: 10.17226/21756.
×
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Next: Appendix A: Workshop Statement of Task »
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Globally, between 15-71 percent of women will experience physical and/or sexual abuse from an intimate partner at some point in their lifetime. Too often this preventable form of violence is repetitive in nature, occurring at multiple points across the lifespan. The prevalence of intimate partner violence is on the higher end of this spectrum in East Africa, with in-country demographic and health surveys indicating that approximately half of all women between the ages of 15-49 in Uganda, Kenya, and Tanzania having experienced physical or sexual abuse within a partnership.

It is now widely accepted that preventing intimate partner violence is possible and can be achieved through a greater understanding of the problem; its risk and protective factors; and effective evidence-informed primary, secondary, and tertiary prevention. To that end, on August 11-12, 2014, the Institute of Medicine's Forum on Global Violence Prevention, in a collaborative partnership with the Uganda National Academy of Sciences, convened a workshop focused on informing and creating synergies within a diverse community of researchers, health workers, and decision makers committed to promoting intimate partner violence-prevention efforts that are innovative, evidence-based, and crosscutting. This workshop brought together a variety of stakeholders and community workers from Uganda, Kenya, and Tanzania to engage in a meaningful, multidirectional dialogue regarding intimate partner violence in the region. Preventing Intimate Partner Violence in Uganda, Kenya, and Tanzania summarizes the presentations and discussion of the workshop.

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