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Nambusi Kyegombe

Biography

Nambusi is an interdisciplinary social scientist with a development studies background and a keen interest in the bi-directional relationship between health and poverty (and other social and structural drivers of morbidity) from a global health perspective.  She holds an MSc in Poverty Reduction and Development Management from the International Development Department of the University of Birmingham as well as an MSc in Demography and Health from the London School of Hygiene and Tropical Medicine (LSHTM).  Nambusi’s PhD research examined the socioeconomic impact of antiretroviral therapy on household livelihoods in Uganda.  Before joining LSHTM, Nambusi worked as a Research Officer at the Overseas Development Institute and currently, she works as a Research Fellow in the Department of Global Health and Development at LSHTM. 

Nambusi recently completed the qualitative evaluation of SASA!, a community-based intervention that seeks to prevent violence against women and reduce HIV-related risk behaviours in Kampala Uganda.  This was part of the SASA! Study, which also included a cluster randomised controlled trial, on-going operational research and an economic evaluation.  She is currently leading the qualitative evaluation of a school-based intervention in Uganda that is designed to reduce violence against children and improve learning outcomes and is currently being evaluated through a randomised controlled trial. 

More broadly, Nambusi’s research interests centre on HIV/AIDS, livelihoods and social and structural determinants of health.  She is also particularly interested in understanding HIV risk behaviours amongst vulnerable groups including adolescents and young people through their exposure to sexual exploitation and transactional sex.

 

Abstract

Findings from the SASA! Study on the Impact of a Community Mobilisation Intervention Designed to Prevent Violence Against Women and Reduce HIV-Related Risk in Kampala, Uganda 

Intimate partner violence (IPV) violates women’s human rights, and is a serious public health concern associated with increased HIV risk.  The SASA! study assessed the community-level impact of SASA!, a community mobilisation intervention designed to prevent IPV and reduce HIV-related risk behaviours.

From 2007-2012 a pair-matched cluster randomised controlled trial (CRT) was conducted in eight communities (4 intervention, 4 control) in Kampala, Uganda. Cross-sectional surveys of a random sample of community members, aged 18-49, were undertaken at baseline (n=1583) and 4 years post intervention implementation (n=2532).  Six violence and HIV-related primary outcomes were defined a priori.  An adjusted cluster-level intention-to-treat analysis compared outcomes in intervention and control communities at follow-up. Under a nested qualitative study, 40 in-depth interviews with community members (20 women, 20 men) were conducted at follow-up, audio recorded, transcribed verbatim, and analysed using thematic analysis.

The intervention was associated with significantly lower social acceptance of IPV among women (adjusted risk ratio 0.54, 95%CI 0.38-0.79), and lower acceptance among men (0.13, 0.01-1.15); significantly greater acceptance that a woman can refuse sex among women (1.28, 1.07-1.52) and men (1.31, 1.00-1.70); 52% lower past year experience of physical IPV among women (0.48, 0.161.39); and lower levels of past year experience of sexual IPV (0.76, 0.33-1.72).  Women experiencing violence in intervention communities were more likely to receive supportive community responses. Reported past year sexual concurrency by men was significantly lower in intervention compared to control communities (0.57, 0.36-0.91). Qualitative data show that SASA! influenced the dynamics of individual relationships and broader community norms enabling some couples to reduce their experience of violence.

SASA! achieved important community impacts, on the social acceptability of IPV, the past year prevalence of IPV, and levels of sexual concurrency and is now being delivered in control communities. 


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