“I got courage from knowing that even a daughter-in-law can earn her living”: Mixed methods evaluation of a family-centred intervention to prevent violence against women and girls in Nepal

BACKGROUND: We developed, and pilot tested a family focused intervention Sammanit Jeevan “Living with Dignity” to reduce gender-based violence by husbands, change harmful social and gender norms and improve the economic conditions of women through young married women-led income generating activities (IGAs). METHODS: We conducted a modified interrupted time series study and qualitative research to evaluate the intervention in two migrant communities in Baglung district, Nepal. We enrolled young married women, their husbands and in-laws from 100 families. 200 women and 157 men completed questionnaires before the programme, and 6, 12 and 18 months afterwards. 18 in-depth interviews were conducted before the programme and 6 and 12 months later. We analysed the data for trends. RESULTS: The intervention positively impacted young married women’s economic conditions, exposure to violence and changed inequitable gender attitudes. Some positive outcomes were observed among older women and men. Young women’s past month earnings (35.0% - 81.3%, β = 0.11, p-value<0.001) and savings (29.0% - 80.2%, β = 0.14, p-value<0.001) more than doubled over time. Young women experienced much less past year physical IPV over time (10% - 4.4%, β = -0.08, p-value = 0.077). They also perceived that their mothers-in-law were less cruel (mean 9.0–8.6, β = -0.03, p-value = 0.035). Improvements were observed in young women’s individual (mean 44.4–43.3, β = -0.04, p-value = 0.297) and perceived community gender attitudes (mean 54.4–51.4, β = -0.19, p-value<0.001) and they reported that their husbands were less controlling (mean 17.5–16.1, β = -007, p-value<0.001). These changes were supported by qualitative findings. CONCLUSIONS: Whilst caution is needed in attributing the effect due to lack of control arm, the results suggest that with adequate time and seed funding, Sammanit Jeevan enabled considerable income generation, a strengthened the position of young women in the households and it reduced their exposure to violence in this community. It warrants further research to optimise its impact.