Effectiveness of a Community-Based SGBV Prevention Model in Emergency Settings in Uganda: Testing the 'Zero Tolerance Village Alliance' Intervention

“The global refugee crisis is one of the most significant challenges of the 21st century. Sexual and gender-based violence (SGBV) exacerbates the already dire situation in refugee settings, and is both a prevalent concern and a complex phenomenon in these contexts. Although SGBV is recognized as a growing problem in emergency settings…evaluations of primary SGBV prevention models in these contexts have remained sparse.”

This Population Council study assessed the effectiveness of implementing a community-based sexual and gender-based violence (SGBV) prevention model in emergency settings. Referred to as the ‘Zero Tolerance Village Alliance’ (ZTVA) intervention, the model was developed and pioneered by the Thohoyandou Victim Empowerment Programme (TVEP), and implemented in Rwamwanja Refugee Settlement in Kamwenge District, Western Uganda. The study used a pre- and post-intervention design without a comparison group and was implemented between 2015 and 2016 by the Population Council in collaboration with the United Nations Refugee Agency (UNHCR), the Lutheran World Federation (LWF), the Thohoyandou Victim Empowerment Programme (the pioneers of the intervention model based in South Africa), the Child Health and Development Centre (Makerere University), and the Refugees Department (Office of the Prime Minister, Uganda).

The study area selected in the refugee settlement consisted of one zone that had particularly high rates of rape and defilement. Two out of five villages comprising this zone served as the study site. The report offers a description of the ZTVA methodology being assessed, which in short, consists of the following components:

• Community Mapping and Dialogues: A community mapping exercise helped to identify all structures and agencies that could be targeted for involvement in the intervention.
• Establishment of a Stakeholder Forum: A Stakeholder Forum, representative of structures and agencies in the settlement (i.e., community leadership, churches, education, and business) was appointed and tasked with ensuring that the intervention sites met a series of criteria in order to qualify for induction into the ZTVA.
• Signing a Memorandum of Agreement (MoA): Stakeholder Forum members signed a MoA to help formalise and guide the partnership between the Forum and the main implementing agency, the LWF.
• Training: LWF trained various key groups by sensitising them on SGBV-related issues, including domestic violence, sexual abuse, child abuse, family planning, and HIV.
• Pledge-Taking Ceremony: Once the expectations outlined in the MoA were achieved by the participating intervention sites, LWF sponsored a joint public ceremony for them. At the ceremony, the men of the intervention communities were invited to take a public pledge to proactively address the eradication of SGBV in their villages. All men taking the pledge were asked to sign a ‘Roll of Honor,’ which was later stored in a secure location available to the public in the villages. Such men were also given an LWF ‘Badge of Honor’ to identify them as pledge-takers. Female and male community members who had ‘broken the silence’ by taking some form of action against SGBV during the intervention implementation period were also recognised at the ceremony and were awarded ‘Badges of Courage.’ The ceremony was used as a platform to publicly announce that men who subsequently breached the pledge would have their names removed from the ‘Roll of Honor’ by the Stakeholder Forum.
• Alliance Identification: At the pledge-taking ceremony, the participating villages were given a large billboard, indicating the village names and declaring their ‘zero-tolerance’ status and induction into an alliance of 'zero-tolerance' villages.

The ZTVA intervention is underpinned by two theories, namely, achievement motivation theory and labeling theory. Achievement motivation theory contends that three dominant needs determine human motivation: the need for achievement, the need for power, and the need for affiliation. Labeling theory centres on how individuals’ self-identity and behaviour may be influenced by the terms used to describe or classify them. Labeling occurs when an identity (such as a ‘zero tolerance’ status) is imposed on an individual - usually by a more powerful person.

To give a brief overview of the findings, “The study demonstrated that the ‘Zero Tolerance Village Alliance’ model is an effective means of fostering SGBV prevention in emergency settings. The model proved to be particularly effective in: moderating negative gender attitudes and beliefs related to SGBV; positively changing perceptions of community SGBV norms; reducing the occurrence of physical IPV [intimate partner violence] (for men and women), sexual IPV (for men), non-partner physical violence (for men and women), and non-partner sexual violence (for women); engendering more comprehensive knowledge of rape; and increasing awareness of SGBV interventions. The ‘Zero Tolerance Village Alliance’ intervention was less effective in changing negative male attitudes toward women’s sexual autonomy in intimate partnerships, and in reducing the occurrence of sexual IPV for women. Study findings also suggest that a focus on care-seeking for sexual IPV could be strengthened within the intervention model.” However, given more time, it is likely that the intervention could positively affect these issues as well.

While findings from this evaluation confirmed the overall effectiveness of the ZTVA model in emergency contexts, they also highlighted important issues and concerns which have implications for SGBV programming in general in emergency settings in sub-Saharan Africa. These concerns include: the low literacy levels that characterise some emergency settings; the fact that women are often not aware of SGBV campaigns; unintended pregnancy due to rape; the vulnerability of female-headed households in emergency settings; and the fact that care-seeking for sexual IPV was low.

Based on these issues, the report makes the following recommendations:

• Ensure that SGBV interventions in emergency settings include a balance of non-literacy-based messaging in order to reach community members with no formal education.
• Develop and implement targeted approaches for reaching women with SGBV information and campaigns. Such approaches should not only consider women’s potentially lower literacy levels but should also take into account the most effective cultural strategies for reaching women within the culture concerned.
• Develop and disseminate appropriate Information, Education, and Communication (IEC) messages to de-stigmatise reporting of rape directly to SGBV clinics or to health facilities in general in the absence of specialised clinics. IEC messages should also emphasise the availability of services and the importance of timely reporting. To complement these exercises, post-rape care must be strengthened to ensure that pregnancy prevention services are readily available at health facilities. Psychological support services must also be strengthened to ensure providers are equipped to address the psychological and reproductive health needs of survivors presenting with rape-related pregnancy.
• Develop and disseminate appropriate IEC messages to publicise the availability of IPV care. The IEC messages concerned should incorporate issues such as the importance of IPV care (even when injuries do not seem to be severe), and should deal with issues of shame, as these barriers were reasons for low care-seeking behaviour among survivors. Building capacity to respond to IPV as a component of post-rape care would also be important.