RCT of the Effectiveness of the WfWI Intervention in Afghanistan

• Women for Women International Intervention (Behavioral)

Primary outcomes

• Any past year physical intimate partner violence experienced amongst currently married women [22 months post baseline]: Physical intimate partner violence is assessed using five items based on the WHO VAW scale. A positive response to any item leads to a person being classified as experiencing in the past year.
• Past year severe physical intimate partner violence experience amongst currently married women [22 months post baseline]: Severe physical intimate partner violence experience is assessed using 5 items. Past year severe physical IPV is assessed as positive if a person responds to two (or more) items as once, or one item as few (or more), essentially creating a more than once categorization.
• Depressive symptomology [22 months post baseline]: Past week depressive symptomology is assessed by the Centre for Epidemiological Studies Depression (CESD) scale, with the full twenty items. A mean score will be calculated.

Secondary outcomes

• Household food insecurity in past four weeks [22 months post baseline]: Three items ask about household level food insecurity in the past 4 weeks. A mean score is calculated.
• Financial shock resilience [22 months post baseline]: One item assesses ability to mobilise cash in an emergency.
• Monthly earnings [22 months post baseline]: A single item assesses women's past month earnings
• Total savings [22 months post baseline]: A single item assesses women's total savings
• Life satisfaction [22 months post baseline]: Life satisfaction is assessed using four-items derived from the Satisfaction With Life Scale. A mean score is produced.
• Suicidal ideation in past 4 weeks [22 months post baseline]: A single item assesses thoughts about suicide in past week.
• Gender attitudes [22 months post baseline]: 11 questions assess women's gender attitudes. A mean score is created.
• Married women's participation in household decision-making [22 months post baseline]: Five items are asked about women's ability to participate in household decisions. A mean score is created.
• Any emotional abuse in the past year amongst currently married women [22 months post baseline]: Seven items assess emotional abuse in the past year. A mean score is calculated.
• Perceptions of husband cruelty amongst currently married women [22 months post baseline]: Five items ask about married women's perceptions of her husband and his attitudes and relationship towards her. A mean score is created
• Mother-in-law or abuse in the past 12 months amongst currently married women [22 months post baseline]: A single item assesses whether mother-in-laws have hit the woman in the past 12 months and another item assesses whether siblings have hit the woman in the past 12 months, an affirmative response to either item would indicate abuse.
• Perceptions of mother-in-law cruelty amongst currently married women [22 months post baseline]: For married women, six items ask about their relationship and the mother-in-laws attitudes towards her

Sex: Female, ages: 18 Years to 45 Years, accepts healthy volunteers

Inclusion Criteria:

* Women should be in the lowest economic level (earning less than US$1.25/day)
* Unemployed
* No in education/school
* Not involved in a similar programme
* Able to provide informed consent

Exclusion Criteria:

* Not mentally incapacitated, so as unable to provide informed consent
* Already been part of the WfWI intervention previously

• Results publication: Gibbs A, Corboz J, Chirwa E, Mann C, Karim F, Shafiq M, Mecagni A, Maxwell-Jones C, Noble E, Jewkes R. The impacts of combined social and economic empowerment training on intimate partner violence, depression, gender norms and livelihoods among women: an individually randomised controlled trial and qualitative study in Afghanistan. BMJ Glob Health. 2020 Mar 16;5(3):e001946. doi: 10.1136/bmjgh-2019-001946. eCollection 2020. PMID 32201622
• Results publication: Gibbs A, Said N, Corboz J, Jewkes R. Factors associated with 'honour killing' in Afghanistan and the occupied Palestinian Territories: Two cross-sectional studies. PLoS One. 2019 Aug 8;14(8):e0219125. doi: 10.1371/journal.pone.0219125. eCollection 2019. PMID 31393873
• Results publication: Gibbs A, Corboz J, Jewkes R. Factors associated with recent intimate partner violence experience amongst currently married women in Afghanistan and health impacts of IPV: a cross sectional study. BMC Public Health. 2018 May 3;18(1):593. doi: 10.1186/s12889-018-5507-5. PMID 29724222
• Results publication: Gibbs A, Corboz J, Shafiq M, Marofi F, Mecagni A, Mann C, Karim F, Chirwa E, Maxwell-Jones C, Jewkes R. An individually randomized controlled trial to determine the effectiveness of the Women for Women International Programme in reducing intimate partner violence and strengthening livelihoods amongst women in Afghanistan: trial design, methods and baseline findings. BMC Public Health. 2018 Jan 22;18(1):164. doi: 10.1186/s12889-018-5029-1. PMID 29357843

• Rachel Jewkes, PhD, Principal investigator, Director Gender and Health Research Unit