Abstract:
BACKGROUND : Gender-based violence and HIV are highly prevalent in the harsh environment of informal
settlements and reducing violence here is very challenging. The group intervention Stepping Stones has been
shown to reduce men’s perpetration of violence in more rural areas, but violence experienced by women in the
study was not affected. Economic empowerment interventions with gender training can protect older women from
violence, but microloan interventions have proved challenging with young women. We investigated whether
combining a broad economic empowerment intervention and Stepping Stones could impact on violence among
young men and women. The intervention, Creating Futures, was developed as a new generation of economic
empowerment intervention, which enabled livelihood strengthening though helping participants find work or set
up a business, and did not give cash or make loans.
METHODS : We piloted Stepping Stones with Creating Futures in two informal settlements of Durban with 232 out
of school youth, mostly aged 18–30 and evaluated with a shortened interrupted time series of two baseline surveys
and at 28 and 58 weeks post-baseline. 94/110 men and 111/122 women completed the last assessment, 85.5% and
90.2% respectively of those enrolled. To determine trend, we built random effects regression models with each
individual as the cluster for each variable, and measured the slope of the line across the time points. RESULTS : Men’s mean earnings in the past month increased by 247% from R411 (~$40) to R1015 (~$102, and
women’s by 278% R 174 (~$17) to R 484 (about $48) (trend test, p < 0.0001). There was a significant reduction in
women’s experience of the combined measure of physical and/or sexual IPV in the prior three months from 30.3%
to 18.9% (p = 0.037). This was not seen for men. However both men and women scored significantly better on
gender attitudes and men significantly reduced their controlling practices in their relationship. The prevalence of
moderate or severe depression symptomatology among men and suicidal thoughts decreased significantly
(p < 0.0001 and p = 0.01).
CONCLUSIONS : These findings are very positive for an exploratory study and indicate that the Creating Futures/
Stepping Stones intervention has potential for impact in these difficult areas with young men and women. Further
evaluation is needed.