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Engaging men to transform inequitable gender attitudes and prevent intimate partner violence: a cluster randomised controlled trial in North and South Kivu, Democratic Republic of Congo
  1. Julia Vaillant1,
  2. Estelle Koussoubé1,
  3. Danielle Roth2,
  4. Rachael Pierotti1,
  5. Mazeda Hossain3,
  6. Kathryn L Falb4
  1. 1Africa Gender Innovation Lab, World Bank, Washington, DC, USA
  2. 2Violence Prevention and Response Unit, International Rescue Committee, Tunis, Tunisia
  3. 3Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
  4. 4Airbel Impact Lab, International Rescue Committee, Washington, DC, USA
  1. Correspondence to Dr Julia Vaillant; jvaillant{at}


Introduction The study objective was to understand the effectiveness of Engaging Men through Accountable Practice (EMAP), a group-based discussion series which sought to transform gender relations in communities, on intimate partner violence (IPV), gender inequitable attitudes and related outcomes.

Methods A two-armed, matched-pair, cluster randomised controlled trial was conducted between 2016 and 2018 in eastern Democratic Republic of Congo. Adult men (n=1387) and their female partners (n=1220) participated in the study. The primary outcomes of the study were female report of past year physical and/or sexual IPV and men’s intention to commit violence. Secondary outcomes included men’s gender attitudes, women’s economic and emotional IPV, women’s perception of negative male behaviours and perceived quality of the relationship.

Results Men in EMAP reported significant reductions in intention to commit violence (β=−0.76; SE=0.23; p<0.01), decreased agreement with any reason that justifies wife beating (OR=0.59; SE=0.08; p<0.01) and increased agreement with the ability of a woman to refuse sex for all reasons (OR=1.47; SE=0.24; p<0.05), compared with men in the control group. We found no statistically significant differences in women’s experiences of IPV between treatment and control group at follow-up (physical or sexual IPV: adjusted OR=0.95; SE=0.14; p=0.71). However, female partners of men in EMAP reported significant improvements to the quality of relationship (β=0.28; p<0.05) and significant reductions in negative male behaviour (β=−0.32; p<0.01).

Conclusion Interventions engaging men have the potential to change gender attitudes and behaviours in conflict-affected areas. However, while EMAP led to changes in gender attitudes and behaviours related to perpetration of IPV, the study showed no overall reduction of women’s experience of IPV. Further research is needed to understand how working with men may lead to long-term and meaningful changes in IPV and related gender equitable attitudes and behaviours in conflict areas.

Trial registration number NCT02765139.

  • cluster randomized trial
  • prevention strategies
  • public health
  • randomised

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  • Handling editor Seye Abimbola

  • Twitter @MazedaHossain

  • Contributors JV was the principal investigator of the study. EK, RP and KLF contributed to the design, analysis and interpretation of findings. DR contributed to the implementation of the programme and oversight in DRC. MH provided study design support. All authors have reviewed and contributed to the final manuscript.

  • Funding This research was made possible through the generous financial support of the State and Peacebuilding Fund and the Nordic Trust Fund at the World Bank, as well as the World Bank’s Umbrella Facility for Gender Equality.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was received from IRC’s Internal Review Board and the DRC Ministry of Women, Family, and Children.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request to the study team.