The adaptation of an IPV intervention

The adaptation process of a novel intervention to address intimate partner violence in a humanitarian setting: Lessons learned

Following the project baseline data collection and initial piloting in Dollo Ado, Ethiopia, project team members from Women and Health Alliance (WAHA) International, the Abdul Latiff Jameel Poverty Action Lab (JPAL) Europe, and Harvard Medical School came together for a three-day workshop.

The workshop took place in London, UK on August 20th to 22nd, 2018 and was attended by the two Principal Investigators, the Intervention Specialist for Emergency Operations, the WAHA International Research Manager, and external experts including a Medical Anthropologist and a Gender curriculum expert. Each individual contributed their own expertise, focusing especially on working with similar interventions to address intimate partner violence (IPV) and the project adaptation process.

The workshop aimed to identify key processes in the adaptation of an IPV prevention intervention for humanitarian settings and to identify lessons learned based on the process of adapting the initial Butajira project and curriculum “Unite for a Better Life” which was designed for a rural, Ethiopian population, to the Somali, refugee context.

On the first day of the workshop, we presented a project update followed by the preliminary findings from our baseline assessment in Dollo Ado. The data from female participants demonstrated that intimate-partner violence is common in the camps and that there is a need for interventions to address IPV. Upcoming analyses will assess the baseline data collected among men to see whether the male perspective captured corroborates or differs from the information reported by female participants and how this relates to existing research.

We also reviewed the existing literature on adaption of IPV and other public health interventions, as well as discussed current gaps in the literature and evidence base. While there are some published papers on this topic within global health programming, there is limited research and few guidelines for adapting interventions to address IPV. There were also few documented lessons learned relating to IPV program adaption and scaling up.

The second aim of the workshop was to compile the lessons learned from the adaptation of the curriculum and intervention designed for rural Ethiopian populations, for the Somali culture, and refugee population in order to fill some of the gaps identified above. Adaptation refers to “the systematic modification of an intervention to consider language, culture, and context in such a way that it is compatible with the client’s cultural patterns, meanings, and values” (Bernal G, Jimenez Chafey M, Domenech Rodriguez M, 2009). The discussion centered around steps for adaption of content and implementation or different cultures and populations, as well as adaption for humanitarian contexts, including the different phases of an emergency. The discussions also brought in examples from other projects such as the Maisha trial in Tanzania, as well lessons from other contexts.

The project team took considerable time to discuss the lessons learned in Dollo Ado and to begin drafting a summary that will be shared at the end of the project and that aims to help guide similar adaptation processes. Such a tool would be useful for future program planning and design by humanitarian actors delivering IPV and health education interventions in other contexts.

With diverse expertise in the room, the conversation often explored the potential for greater impact and future projects that will help build scope for IPV interventions in humanitarian settings and the use of an adaptation guide.

The drafting of the lessons learned was a collaborative process, in which all team members provided suggestions to refine the form and content of the product. The workshop was also an occasion to address administrative elements of the project and delegate the different tasks to ensure that the final months of the project run smoothly. As we are entering the final stage of the project, we are eager to see the impact and next steps planned for bringing innovation to traditional practices and reducing IPV.