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Transforming Gender Norms, Roles, and Power Dynamics: Evidence from Gender Integrated Health Programs on Gender Based Violence in Low and Middle Income Countries 

This systematic literature review examined the impact of gender-integrated programs on reproductive, maternal, neonatal, child and adolescent health, gender based violence (GBV), and HIV in low and middle-income countries (LMICs) with the aim to identify effective gender aware strategies to improve health. Findings presented here are specific to GBV.

Scientific and grey-literature published between January 2000 and June 2013 were searched. Relevant publications addressed any of the health areas mentioned above, and discussed a gender-aware intervention in LMICs, and its evaluation. These were abstracted and rated on the levels of gender integration and effectiveness. Abstracted data was analyzed thematically.

Thirty-eight gender-integrated GBV interventions were identified, a vast majority of which challenged and transformed inequitable gender norms, roles, and relationships at multiple levels: the individual, family, and community. These initiatives worked with adolescents of both sexes, adult men, mothers-in-law and health care providers to reduce tolerance for or acceptance of GBV, and encouraged actions and improved communication to reduce violence. Consequently, these programs, often implemented in community settings, decreased the perpetration of violence by men, reduced the reported incidents of violence, and to some extent, improved conflict resolution through negotiation as opposed to violent acts. GBV programs used gender transformative strategies to effect change: group education with critical reflection explored how gender norms and notions of masculinity support GBV, while social and behavior change communication activities with the community cultivated an environment less supportive of GBV. Some programs engendered equitable relationships and decision making among couples, and promoted women’s agency through empowerment, education, and employment. Few programs were institutionalized outside of NGO funding cycles or integrated into government services, questioning the sustainability of these interventions.

These findings provide evidence of the effectiveness of male involvement and community engagement in preventing GBV in LMICs. Community-based interventions and campaigns are pivotal to preventing GBV and addressing gender norms that fuel GBV. Future GBV programs should collaborate and coordinate with national governments and civil society to encourage local participation, and ensure effective interventions and strategies are sustained and scaled-up.