In the world’s highest-prevalence settings, eight out of ten women will experience physical or sexual violence in their lifetime, yet there is almost no evidence on how to prevent it. This research programme works directly with indigenous communities in Samoa and Peru to build that evidence base from the ground up. The problem is that in settings where violence is widely seen as normal, standard prevention approaches fail—women face stigma, discrimination, and further violence when seeking help, and health systems have no proven responses. The researcher will first adapt tools for measuring violence and establish ethical guidelines for studying it sensitively. Then, working with community members and local leaders, she will co-create a theory of change and design an intervention to reduce violence. Finally, she will test the intervention using rigorous evaluation methods, so it can potentially be rolled out in other high-prevalence communities worldwide. If successful, this could give health systems and policymakers a practical, evidence-based strategy for tackling one of the most intractable global health and human rights issues.
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According to the World Health Organisation (WHO, 2013), violence against women (VAW) is a pandemic in many parts of the world with severe implications for women's physical and mental health. In the world's highest prevalence settings, eight out of ten women will experience physical or sexual violence from an intimate partner or stranger in their lifetime (WHO 2005, 2013). This is an enormous health and human rights issue, and yet we know very little about how it should be addressed. The proposed research programme draws on my specialisation in preventing violence against women for the highest prevalence settings, developed through over 30 peer-reviewed publications and increasingly large grants for projects in Afghanistan, Iraq, Rwanda, and the Amazon. High prevalence settings (where over 50% of women experience violence) present unique challenges for violence prevention: violence is widely accepted as normal by both men and women (Tran et al. 2016), those seeking help frequently experience stigma, discrimination, and further violence from family, community members, police and health professionals (Odero et al. 2014), and evidence of health system responses to VAW are largely non-existent (Garcia-Moreno et al., 2015). This research programme works in partnership with indigenous communities in Samoa and Peru to build an evidence base for how to prevent violence in high prevalence settings. Through well-established partnerships with local organisations, I will work with community members, leaders and local representatives in both settings to adapt innovative tools for measuring violence against women and establish ethical guidelines for how to research violence appropriately and sensitively. I will then create a theory of change for how to engage high-prevalence communities in reducing violence against women. These initial stages of the research culminate in the co-creation of an intervention to prevent violence against women in partnership with local communities that draws on the theory of change and ethical guidelines, followed by testing the effectiveness of the intervention using the highest standards of evaluation methodologies so that the intervention can potentially be rolled out in other high-prevalence communities around the world. This is a truly multidisciplinary project that requires an integration of skills and methods from across psychology, political science and global health epidemiology to be effective. To achieve this, I will draw on my unique background in the sociology of gender (PhD), community psychology (MSc, post-doc), and humanities (BA), and complement this with mentoring from the world's leading experts in process tracing methods from political science (Prof Jeremy Shiffman, JHU), VAW prevention interventions (Prof David Osrin, UCL), and the evaluation of community interventions in global health (Dr Andrew Copas, UCL) alongside training in epidemiology, statistics, and research leadership. Each stage of the research will include a knowledge-exchange activity between Peru and Samoa to build local research capacity and establish connections with scholars working on violence prevention in high-prevalence settings across Asia, South America and in the UK. Knowledge-exchange activities, an international advisory committee and public enagement will provide a means of linking local actors with global organisations I have worked with in the past including the Sexual Violence Research Initiative (SVRI), the South African MRC's Gender and Health Research Unit, UN Women, and the World Bank. In the short-term, the research has the potential to improve women's lives in Samoa and Peru by reducing the violence they experience. For the longer-term future, the development of new tools, theoretical frameworks and an intervention to prevent violence against women in high-prevalence settings has the potential to improve women's lives in similar settings all over the world.
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