Series
From work with men and boys to changes of social norms and reduction of inequities in gender relations: a conceptual shift in prevention of violence against women and girls
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Published Online: 20 November 2014
Article InfoSummary
Violence perpetrated by and against men and boys is a major public health problem. Although individual men's use of violence differs, engagement of all men and boys in action to prevent violence against women and girls is essential. We discuss why this engagement approach is theoretically important and how prevention interventions have developed from treating men simply as perpetrators of violence against women and girls or as allies of women in its prevention, to approaches that seek to transform the relations, social norms, and systems that sustain gender inequality and violence. We review evidence of intervention effectiveness in the reduction of violence or its risk factors, features commonly seen in more effective interventions, and how strong evidence-based interventions can be developed with more robust use of theory. Future interventions should emphasise work with both men and boys and women and girls to change social norms on gender relations, and need to appropriately accommodate the differences between men and women in the design of programmes.Introduction
The
need for work with men in the prevention of violence against women and
girls (VAWG) is well accepted among advocates, educators, and policy
makers. Over the past 10–15 years, interventions involving men and boys
have proliferated around the world. These interventions have been
motivated by a desire to address the role of men in violence
perpetration, and recognition that masculinity and gender-related social
norms are implicated in violence.1, 2, 3 Although not all men are violent, all men and boys have a positive part to play to help stop violence against women.4, 5
Furthermore, these men can benefit personally from more equitable
relations with women, although use of this argument to encourage men to
become involved is somewhat controversial.6
Violence
prevention practice has developed during the past few decades from
instrumental approaches that target only women to approaches that seek
to transform the relations, norms, and systems that sustain gender
inequality and violence.7, 8
Gender norms for men have become central. This change can be seen in
the language used by practitioners. Initially, men were rarely
mentioned, except possibly as (potential) perpetrators of violence.4
The language of men as partners emerged in the 1990s, with men
described as allies of women in the work to end men's violence, or the
promotion of gender equity. More recent interventions have sought to
change the way men see themselves as men (their gender identities) and
consequent gendered practices, including the use of violence, sexual
practices, and other behaviour towards women (figure 1).9
Figure 1
Changing perspectives on men in violence preventionShifts in influential views of men and violence prevention over time; however, these shifts are not linear and contemporary interventions can show signs of all four.
Prioritisation
of, and resource allocation for, work with men on violence prevention
has often been contested, not least by female gender activists concerned
about opportunity costs and future male domination of the field of
violence against women and girls.10
Although they engage men, some interventions have shied away from
naming men (eg, by explicit reference to the need to change men's
violence against women5)
and making their roles visible in the desired change objectives (ie, to
change men's behaviour). Interventions have been very varied, and some
have excluded women. The use of role models and stereotypical masculine
attributes in violence prevention work has been challenged by those who
fear that such interventions might reinforce that which we most seek to
change.9
Women's groups have voiced concerns that donors have diverted funding
from women's programmes and services to work with men, and this has
further marginalised women's voices and experiences.6
This Series paper seeks to situate these debates by addressing the
questions of why focus on men's violence, what part gender plays, what
works in work with men, and how evidence and gender theory can be used
to work more effectively to address social norms on gender relations
with men and boys in addition to women and girls.
Key messages
- •Men's use and experience of violence is a major public health problem, and men and boys are necessary participants, along with women and girls, in prevention interventions to reduce perpetration of violence against women and girls.
- •Men's perpetration of violence against women and girls is a constituent element of gender inequality, and men's use and experiences of violence are upheld by commonly held versions of manhood. Violence against women and girls is more common where men themselves encounter high levels of violence.
- •Interventions to address perpetration of violence against women and girls by men vary greatly in terms of target groups, change objectives, and methods. Evidence on interventions solely with boys and men is scarce, and most points to some measured attitudinal changes, but not necessarily change in violence perpetration or social norms.
- •Future work should promote more programmes with women and girls, in addition to boys and men, for effective and sustained gender transformation. This work should strive for several varied change objectives related to violence reduction and the factors most associated with perpetration, have enduring effects, and be based on robust theories of change.
- •Interventions need a coordinated focus on multiple risk factors and ecological levels (eg, individual, peer/family, and community levels). Approaches that centre on community norm change have the potential to change versions of masculinity that promote violence. In so doing, they address power and oppression, and seek to change the mechanisms in society that support them.
The multiplicity of men's use of violence
Perpetration
of violence against women and girls by men spans the lifecourse.
Children can perpetrate sexual violence, but in the teenage years rape
becomes more common such that between a half and three-quarters of men
who ever rape first do so as teenagers.11, 12, 13, 14
After marriage or dating, some men use emotional, financial, physical,
or sexual violence against a wife or girlfriend, and violence often
persists throughout the relationship, although it occurs most commonly
at younger ages.14, 15
Rape and intimate partner violence occur in all cultures, with varying
prevalence, and culturally specific forms of violence might be locally
common, such as honour killings or female genital mutilation (FGM).
Men
are also victims of violence. Interpersonal violence, mostly
perpetrated by men, is the seventh ranked cause of loss of
disability-adjusted life years of men aged 15–49 years worldwide, and is
the leading cause in much of Latin America.16
Rape of men (by men) is also appreciably common. The 2013 UN
multicountry study in Asia and the Pacific noted the population
prevalence of male rape of men to be 2–8%.11
Some of this abuse might have occurred in childhood, and credible
estimates of male experience of child sexual abuse are about 4–32%.17 Men can also face partner violence, and 6% of male homicides worldwide are estimated to be by intimate partners.18
Men's
use of violence against women and girls is closely related to their use
of violence against other men, and in some cases their own experiences
as victims.5, 11, 12, 14, 15
Men who have been victims are more likely to perpetrate intimate
partner violence or rape, although most male victims do not subsequently
perpetrate.11, 12, 15 Furthermore, men who are violent towards women and girls are much more likely to engage in violence against other men.11, 12, 15
Not surprisingly, where violence against women and girls is highly
prevalent, male experiences of violence as victims are especially
common, as is interpersonal violence between men.
Men, masculinity, and violence
So
how are these forms of violence connected? A simple explanation is that
a society with a culture related to the use of violence, and social
norms that are accepting of violence, in many respects permits a range
of forms of violence.19, 20
Although this can be empirically supported, it does not explain why
men, rather than women, are the most common perpetrators of moderate and
severe violence.21
Nor does it explain the links between ostensibly quite different types
of violence, such as sexual violence against girls and physical violence
between men.11, 15 A more complete answer requires an understanding of the association between violence and masculinity.
This
association is not simply Y-chromosome determined; prevalence and
patterns of violence differ greatly worldwide, and individual
differences exist between men in any one setting. The connection instead
lies in gender; that is, the social values, roles, behaviours, and
attributes thought to be appropriate and expected for men and women.22
These sets of ideas and behaviours that constitute gender are defined
and determined by societies and their subgroups. They vary across
societies and, to the extent that they reflect social norms, they are
propagated through the actions of people and institutions within a
society.23, 24, 25
Ideas and values related to gender affect how men view themselves as
men, their social and intimate relationships, and institutions and
policy frameworks.22, 26
Although differences between men and women are much less notable in
more equitable societies, all societies tend to confer a higher social
value on men than women, and a range of norms and powers derive from
this.27
Although
not all men are violent, and some actively oppose violence, the use of
violence over women is one source of power accorded to men in many
settings.8, 28, 29 Many different ways of being a man (multiple masculinities) exist within a society,30
but dominance and control over women are frequently part of the set of
male attributes and behaviours (masculinity) that is recognised as a
shared social ideal.31 The gender theorist Raewyn Connell22
refers to the most legitimate and acclaimed version of manhood as
hegemonic masculinity to show the particularities of how this position
is achieved within a society.31
Importantly, the dominance of this masculinity over others is not
imposed, but rather becomes accepted by women and men as normal. This
concept is taken in from childhood and aspired to by most men; even
those who, for various reasons, cannot fulfil all the associated roles
(eg, poverty preventing a man from being a provider). Mostly, both men
and women agree that this social ideal shows how men (and gender
relations) should be.32 Thus both men and women need to be engaged in any efforts to change it.
Violence
is not necessarily a part of masculinity, but the two are often linked.
If women are expected to fall under men's control, then physical or
sexual force and threat are ways to achieve this. This control also
includes punishment of acts of resistance to, or transgression of,
gender norms (eg, anti-lesbian violence). Physical strength and
toughness are very frequently associated manly attributes, and violent
competition between men is often used in demonstrations of this, such as
fights for honour and territory.24, 33, 34
Not all masculinities of men who use violence are hegemonic.26, 27, 31
In most settings, exaggerated masculinities that caricature the
masculine ideal exist, and emphasise power and force. These
masculinities are particularly common among men who have been victims of
violence and severe emotional adversity in childhood.35
Boys who are exposed to abuse in early childhood become prone to
aggression, impulsivity, and an absence of empathy and remorse, and are
more likely to perpetrate violence.11, 12, 15, 33, 35
They are over-represented in gangs, where aggressive young people
congregate, engage in antisocial behaviour, and adopt masculinities that
emphasise dominance over women and violent competition between men.36
Involvement of boys and men in violence prevention
The range of interventions implemented under the header of work with men and boys is very diverse.2, 9, 37
There have been different types of men or boys targeted, changes
desired, settings, scope, and durations of interventions. The category
has included, for example, both attendance at a brief lecture or drama,
and participation in a 50-h workshop-based intervention such as Stepping
Stones.1, 38
Interventions have also varied in the gender theory or politics
informing them, especially whether their focus was to stop violence or
build gender equity, raise awareness, or change gender norms. At times,
change objectives have stopped short of including reduction of violence
towards women. As reported by Ellsberg and colleagues,39
a substantial overall proportion of interventions to reduce violence
against women and girls involve boys and men. These either target men
together with women or men only.
Some interventions,
especially those implemented from a policing or justice perspective,
have not engaged with notions of gender in the course of intervening to
change violent men.40
Other interventions have engaged with gender and masculinity
explicitly, but in the course of which have courted controversy. For
example some campaigns have drawn on ideas commonly associated with
hegemonic masculinity such as strength, warrior, or leader, and spun
them in a direction that is non-violent, consensual, or gender
equitable.5, 41
Other campaigns use classic male role models such as sports stars.
Advocates argue that role models are influential, and ideas such as
leadership provide an easy frame of reference for engagement with other
men. However, the fear has been that these interventions might reinforce
the gender-inequitable masculine ideals that need to be changed to
prevent violence. These fears are greatest where little variation is
acknowledged between men, and thus concerns exist of further
marginalisation of men who are different.42
Interventions
have sought to change the way men see themselves as men (their gender
identities) and resultant gendered practices, including the use of
violence, sexual, and other behaviour towards women.9, 37 These interventions have used various strategies.2
Some have focused on involving those who are not themselves violent by
encouraging intervention with other men who are sexist and aggressive.5
The Mentors in Violence Prevention intervention in the USA is a good
example, and has been quite widely used. Face-to-face educational
programmes with boys and young men (and sometimes women and girls) that
promote critical reflection on gendered behaviours and norms have spread
across settings from clubs and schools, to sports teams, workplaces,
and other institutions. Examples include the Gender Equity Movement in
Schools adaptations in South Asia and Vietnam,43 the Men of Strength Clubs of Men Can Stop Rape in Washington, DC,41 and Sonke Gender Justice's work with the South African military.
As
a complement to group education, social marketing strategies have been
used in an effort to shift attitudes on men's use of violence, for
example as pioneered through Instituto Promundo's Programme H that
started in Brazil and has been adapted in several countries.44
There have been efforts to engage men through parenting and couples
programmes, such as the worldwide Men Care campaign that has a violence
prevention component in Indonesia. These efforts stem from a belief that
men involved in care practices might be less likely to use violence
towards women, although more empirical evidence of this is needed.45
Addressing the systemic and structural supports for male violence is
increasingly understood to be paramount, especially social norms on
gender such as barriers to women's participation in politics and the
economy. Community mobilisation approaches, such as Men's Action for
Stopping Violence against Women in Uttar Pradesh,46
foster men's participation in collective advocacy and social movements,
often in close collaboration with women and women's groups.
Lessons from prevention programmes
Evidence
of the effectiveness of interventions involving men and boys for the
reduction of use of violence, or its risk factors, is poor, since
rigorous evaluations are few, their geographical base narrow, and the
interventions evaluated have often been weak.1 A comprehensive review1
of interventions with men and boys to prevent sexual violence
identified 65 high-quality studies, and a handful have been reported
since.47
Of the 65 studies, 85% took place in high-income countries and 90% in
school settings. A third were only one session, typically of an hour's
duration, and few assessed change in the perpetration of violence as
opposed to participant satisfaction or attitudes. Only eight
interventions were classified as strong when evaluated with the Cochrane
Collaboration tool for bias assessment, and only seven of the moderate
or strong evaluations had an effect on violence perpetration. Of these,
four were focused on early teens, five included both sexes in the
intervention, and all involved more prolonged interventions that
addressed violence through promotion of respectful intimate
relationships. For example, the two strong interventions that had an
effect on male perpetration of violence were a 50 h programme with
school-attending young people in South Africa and a 26 h school
programme in Canada.38, 48
Despite
the small evidence base, these effective interventions with men and
boys address masculinity; that is they explicitly address the norms,
behaviours, and relationships associated with ideals of manhood.47
Such programmes have been termed gender-transformative, in that they
seek to transform gender norms and promote more gender-equitable
relations between men and women,49 and most worked with both women and men, which is essential for sustained gender transformation.1
Only
five of 12 moderate or strong evaluations of interventions that sought
to change gender roles had positive findings. Bystander
interventions—those that aimed to teach non-violent men or women to
challenge tacit acceptance of behaviour by others—did not fare well.1 Overall, two50, 51 of three52
moderate or strong evaluations have had any significant findings, but
there have been serious limitations in many of the evaluations and so
these cannot be considered to have shown the interventions worked. The
evaluations of bystander attitude interventions showed no more promise.53
Some prevention strategies have powerful rationales, but have been
implemented infrequently and rarely assessed, or have never had efforts
made to optimise them. These include interventions that focus on
changing social norms54 and initiatives specifically for male-dominated or masculine workplaces,
sports, and military contexts, where violence prevalence is high. The
focus of many prevention interventions has tended to be to raise
awareness and change gender attitudes, with an assumption that behaviour
change will follow; yet decades of behaviour change research shows the
association between attitudes and behaviour to be complex and
bidirectional.55, 56
Awareness might be more readily raised among those with least
propensity to ever be violent. Research from the USA with men in college
attending rape prevention programmes suggests that these have less
effect on men at a higher risk of committing rape.57
Violence prevention with men is very unlikely to be optimised with a
one size fits all intervention. Men who perpetrate the most severe
violence against women often do not see themselves as bound by social
norms.33, 35
Men who are most violent and controlling towards women often have
notable victimisation histories, or an exaggerated sense of entitlement.33
Interventions that seek to reduce the violence of men who are bound by
social norms might need to be different from those targeting men who are
positioned at society's margins, especially men who are highly violent,
otherwise antisocial, structurally marginalised through poverty, and in
environments where the social norms supporting violence are strongest.
Perpetrators'
programmes characteristically target more violent men, often identified
by courts or through restorative justice models. They can be mandated
by court order or voluntary, and often use cognitive behavioural therapy
approaches. As reported by Ellsberg and colleagues39 most of the programmes assessed have been in the USA, but the research has many limitations. Three systematic reviews58, 59, 60
have concluded that no evidence suggests that perpetrators' programmes
have any notable effect on reduction of recidivism, but this finding is
partly caused by the small evidence base, and researchers are calling
for more tests of such interventions using diverse strategies in
different settings. The interventions could be better and it has been
argued that those programmes that more explicitly aim to address
masculinities might be more promising.61
Change
in the use of violence by men is especially difficult in communities
that have experienced multiple traumatic events, particularly lengthy
conflict, and where normative support for the use of violence to show
dominance is especially strong. Here, the need exists to address
normative use of multiple forms of violence, change gender norms,
strengthen livelihoods, and recognise the pain of men's (and women's)
experiences as victims at a population level. Long-term work with
multiple participants is needed. However, in some post-conflict
settings, less complex masculinity interventions have shown promise.62
Several interventions have been developed to address deeply rooted
social norms in difficult settings. For example, the non-government
organisation Tostan's intervention on social norm change to prevent
female genital mutilation (FGM) in rural Senegal. Tostan works with
communities with sessions two to three times a week over 6–8 months and
combines broader life skills, such as literacy and numeracy, with
programming on gender, violence, and (in view of their specific goal)
FGM. Qualitative research suggests that there may be substantial
reductions in FGM in Tostan's villages.63
Interventions
with men have generally not developed links with substance misuse
programmes and other therapeutic programmes, and currently most of these
do not ask about, or deal with, intimate partner violence perpetration.
Although alcohol is not a main driver of violence against women in many
countries at a population level, it is an important risk factor in
some.11, 15
Population-level interventions on alcohol use, for example reduction of
outlet density, coupons to ration alcohol, or higher tax, have been
associated with reduced gender-based violence and child abuse rates.64, 65, 66 Interventions that reduce alcohol misuse can have positive effects at an individual level.67
In low-income and middle-income countries particularly, research is
needed into the benefits of the combination of intimate partner violence
prevention with alcohol abuse prevention interventions that are
currently being used, such as early detection and brief interventions
for problem drinking in primary health care; interventions to change
social norms related to men's alcohol and other drug consumption; and
couples interventions and self-help therapy (such as Alcoholics
Anonymous). More research should be done about the contribution of
therapeutic interventions with boys or men that address combinations of
these factors—healing from traumatic experiences, substance misuse,
mental ill-health, and use of violence—based on the assumption that they
are interrelated.
Masculinities and change
So
how do we build better interventions with men and boys? Present
discourse about evidence-based prevention programming emphasises the
need for interventions to have an explicit theory of change, grounded in
an empirical understanding of the problem. Interventions to prevent
male use of violence need to start by understanding the risk factors for
men's perpetration. More than 10 000 men participated in the recent UN
study in Asia and the Pacific,14
providing valuable insights into factors associated with men's
perpetration of violence against women and girls, and complementing work
from South Africa and work done through the International Men and
Gender Equality Survey (IMAGES).11, 12, 15, 68, 69 Figure 2 summarises the factors associated with perpetration of intimate partner violence and non-partner rape.
Figure 2
Risk factors for male perpetration of violence, connections to dimensions of hegemonic masculinity, and translation into foci for interventionsRisk factors are drawn from the UN Multicountry Study on men and violence (papers three and six on rape and intimate partner violence, respectively). Risk factors are listed in column one and the grey shading shows which are associated with the two types of violence against women and girls. Key factors strongly associated with perpetration of intimate partner violence and non-partner rape are shaded in pink. The purple shading shows the different risk factors that each intervention type might address.
When
grouped together, many of these behaviours are rooted in expected
practices or entitlements that flow from the hegemonic ideals that men
should be strong, tough, in control over women and their bodies,
heterosexual, and sexually dominant.11, 14, 15, 69
For example, key factors strongly associated with perpetration of
intimate partner violence and non-partner rape include controlling
behaviours towards women and inequitable gender attitudes, behaviours
which emphasise (hetero)sexual prowess (transactional sex and having
multiple sexual partners), and involvement in violence with men (figure 2).11, 15, 70, 71
Other associated factors suggest that men who are violent are more
likely to struggle to live up to a masculine ideal in other respects,
for example by having depression, or alcohol and drug misuse, no high
school education, and current food insecurity (the latter two being
proxies for social marginalisation and poverty).11, 14, 15
Furthermore, men's own history as victims of violence is visible in
associations between perpetration and men's experiences of childhood
victimisation, rape, and homophobic abuse.11, 14, 15, 72
These two groups of factors expose the other side of the coin: men
struggling to live up to the ideals of manhood that are hard to reach,
and men who have been traumatised through harsh childhoods and violence
in adulthood.
Figure 2
shows how the measured risk factors for intimate partner violence and
non-partner rape perpetration can be read from the perspective of
hegemonic masculinity and individual behaviours seen to represent
different underlying features. The importance of understanding this is
that interventions do not need to be developed to address each of the
individual risk factors, but to change the ideas and behaviours that men
adopt in the course of showing that they are men. Interventions that
have sought to do this, such as Stepping Stones, have shown the
possibility of this approach, and that, with a reduction in violence, a
change in other practices associated with hegemonic masculinity can be
seen.38 Interventions commonly have the potential to address multiple risk factors and this is illustrated by figure 2, which shows the different risk factors that each intervention type might address.
Theoretically
based interventions need to draw from gender theory in this broad way,
but they also need to draw from it in microlevel intervention planning.
The table
shows some of the considerations here. For example, discussion of
changing social norms can be opened up through acknowledgment that
multiple ways of being a man exist, and that men's positions and
experiences shift. Interventions that offer simplistic and homogenous
portrayals of ideal masculinity are not helpful in this respect. Over
time, men might both feel vulnerable and entitled. Interventions often
benefit from enabling men to acknowledge their fears and experiences of
victimisation. Social norms regarding masculinity often emphasise men's
difference from women, and differences between masculine norms and those
of gay men. Acknowledgment of similarities between men and women, and
addressing homophobia, are important for gender transformation. Even in
settings of poverty and adversity, men are typically better off than
similarly placed women, irrespective of their perceptions of hardship in
comparison to all men. Critical analysis of men's privilege, power, and
how they use their power is crucial to transform men. Finally, work
with both women and men is important, because women often take for
granted men's power and dominance over them. In some instances, within
the constraints of power relations within their social context, women
might benefit individually from men's power and therefore actively
support it; for example, if doing so enables them to achieve status and
power in their own right (eg, over younger women or daughters in law).73
A need exists to empower women not only economically, but also socially
and individually, and to raise their consciousness to enable critical
thought on women's own role in male gender socialisation and the
maintenance of gender power hierarchies so they demand more equitable
relationships. This need is suggested by research from South Africa that
shows women's acquiescence to the social order of male domination both
in their expectations of men and their dating preferences.74, 75
Effective women-focused initiatives have sought to strengthen
resilience against violence by combining economic empowerment
interventions with efforts to raise awareness of rights and build
women's relationship skills.76
Table
Use of Raewyn Connell's gender theory to build interventions
Intervention
developers also need to think about the question of what drives and
enables change. Ecological approaches (ie, those that address risk
factors operating at several of the levels shown in figure 3)
are particularly important to understand what supports social norms
within settings and, where relevant, institutions. In particular, the
necessity exists to understand the dynamic intersections between factors
pertaining to an individual, peer, household, or relationship, and
broader community levels (figure 3).
This necessity is suggested, for example, by work to change gender
norms in schools, which underscores the need to focus on interventions
within a classroom (eg, lesson and curriculum), institutional policy
(eg, on sexual harassment, corporal punishment), interactions (eg,
respect shown by teachers for learners, bullying), and the wider
environment (eg, the role of parents in support of schools' teaching).77, 78
Figure 3
Transformation of masculinities through combined changes across the social ecology
Intervention
developers need to select methods based on an empirical understanding
of what types of change can be achieved with different types of
intervention approaches. Interventions that have reduced violence
perpetration have tended to be many hours long, often involved women and
men with combined single-sex and mixed group delivery, and have
included critical reflection on social norms and building of
relationship skills.38, 48
Communication campaigns have an important role to provoke conversation
about an issue and can contribute to complex processes that have
long-term benefits, but generally do not change behaviour in the short
term.79, 80 The outputs and outcomes that are intended should be projected and stated explicitly.
Ways forward
Clear
ways forward to enhance violence prevention exist in the form of
approaches that involve boys and men in addition to efforts to
strengthen women's resilience to violence. As a starting point, this
Series paper discussed gender theory to explain that violence against
women and girls does not occur in a social vacuum, but arises out of a
context of gender inequity and social norms of gender relations that are
largely supported by both men and women.22, 75, 81
Thus women and men, and younger and older people, all need to be
actively involved in prevention efforts for sustainable gender
transformation to be achieved, since gender norms are reproduced through
generations and operate across the lifecourse and not only among those
most at risk of current perpetration.
Some variation in
the importance of different risk factors exists across settings, because
masculinities, men's histories, traumatic event exposure, and social
marginalisation all vary. Therefore, programme planning should be based
on local data, including sociological data that provide insight into
masculinities and any variations in the known risk factors for
perpetration.14
In many intervention sites, mapping of local versions of masculinities
and their influences can be a useful part of formative research for the
intervention design, and can also be part of the intervention.
Interventions that address masculinity seem to be more effective than
those that remain blind to the powerful influences of gender norms and
systems of inequality. Thus, understanding and application of theories
of masculinity are important for effective intervention design.
Furthermore, the theories suggest a movement away from interventions
with primary goals related to individual-level attitude changes, towards
a focus on transformation of hegemonic masculinities associated with
violence perpetration, with a goal of violence prevention.
Masculinities
are embodied and reproduced across the social ecology, and thus
interventions must seek changes at multiple levels. One intervention or
organisation cannot always do this and so strategic approaches to
programming, with collaborations between organisations, can be
particularly valuable. Further research is needed into the association
between changes among individuals, partnership dyads, and in
communities. This is not only a question of the scaling up of discrete
interventions, but coordination of separate interventions, which work at
different ecological levels and target different risk factors to
achieve a reduction in violence.
Some individual risk
factors for violence perpetration, particularly exposure to childhood
adversity, and subsequent traumatic experiences, substance misuse, and
mental ill-health, are also important factors that need specific
responses. Mental health services are often underprovided and not
focused on assisting trauma victims, but the importance of these
services for men and women needs to be recognised.
New
generations of interventions need to take the finding that more
successful violence prevention programmes have a relatively long
participant engagement time as a starting point. Further research is
needed to optimise this finding and understand how best to gain value
for money in violence prevention, but, at present, evidence suggests
that brief interventions on gender norms might simply not work. Overall,
the questions of whether and how diversity among men should be taken
into account in interventions, and what the implications of this are for
efforts to prevent the occurrence of violence are too little
understood.
One of the key controversies in work with men
has been the presentation of this approach as a superior alternative to
historical work with women on violence prevention and responses. This
controversy is increasingly clear as a false dichotomy. Experience shows
that violence prevention cannot be undertaken successfully without
provision of services for survivors, and indications that social
institutions care about violence against women and girls. Successful
prevention should involve empowerment of women as individuals, within
relationships and across society, and transformation of masculinities
should be framed as a complement to these. Furthermore, men need to both
change themselves and align themselves with women to deepen and sustain
the goals of women's rights and empowerment in economic, political, and
domestic terms. Deepening of men's understanding of the need for this
change is crucial, including how they can contribute directly, such as
by including their daughters in inheritance (or changing laws if this is
prohibited), supporting women's work, sharing domestic work, or at a
community level through supporting women's participation in political
processes.
Search strategy and selection criteria
Between
Jan 27, 2014, and March 31, 2014, we reviewed evaluations of
interventions that involved men and boys in the prevention of violence
against women and girls. The interventions included those targeting men
and boys and workshop interventions directed at individuals, those
directed at men in relationships, bystander interventions, school and
dating interventions, perpetrator programmes, social norm change
interventions including men, and multicomponent interventions including
men and group interventions. Many overlapped several of these
categories. We undertook a keyword search for interventions published in
English in PubMed, Google, and JSTOR, and manually searched the
websites of donors (DFID, USAID, World Bank, AusAID, CIDA, Danida, EU,
GIZ, NORAD, Sida, Irish Aid), UN agencies (UN Women, UNAIDS, UNDP,
UNFPA, UN Trust Fund on EVAW, UNICEF, WHO), international non-government
organisations and funders (ActionAid, Amnesty International, Comic
Relief, Human Rights Watch, International Rescue Committee, IPPF, Oak
Foundation, Oxfam, Plan International, Population Council, Sigrid
Rausing Trust, and Womankind), established violence intervention databases
(Partners for Prevention), and several universities and science
councils with an established track record on violence against women and
girls. Where possible we aimed to draw on systematic and comprehensive
reviews and meta-analyses in addition to interventions. We inventoried
the results and compiled 67 non-duplicate citations to putative
gender-based violence prevention interventions that sought to engage men
and boys.
Contributors
All authors contributed to the writing of the paper and approved the final draft.
Declaration of interests
We declare no competing interests.
Acknowledgments
RJ
was supported by the Medical Research Council of South Africa and
received funding from the Department for International Development
(DFID). JL was supported by the United Nations Development Plan. MF was
supported by the University of Wollongong for the work of writing the
manuscript. This document is an output from What Works to prevent
Violence: a Global Programme which is funded by the UK Aid from the UK
DFID for the benefit of developing countries. However, the views
expressed and information contained in it are not necessarily those of
or endorsed by DFID, which can accept no responsibility for such views
or information or for any reliance placed on them. RJ is grateful to the
South Africa/Sweden research links programme Hegemonic Masculinities
study group for inspiration in the development some of the ideas
presented here.
