1. Prevalence and drivers of violence in informal settlements in eThekwini, South Africa
Andrew Gibbs, Laura Washington, Nolwazi Ntini, Thobani Khumalo, Samantha Willan, Yandisa Sikweyiya, Nwabisa Jama Shai, Esnat Chirwa, Rachel Jewkes

2. Urban informal settlements
61.7% of urban dwellers across the African continent, live in informal settlements. Set to increase from 400 million to 1.2 billion by (UN Habitat, 2015)
In South Africa, HIV-prevalence in urban informal settlements twice that of formal settlements (Rehle et al, 2007)
Kibera informal settlement in Kenya, 84.5% of women living there had experienced IPV, compared to 39% in the general population (Swart, 2011)

3. Gender inequalities and livelihood insecurity drive intimate partner violence: Women
Clear evidence that:
Their experience of poverty and gender inequalities drives their experience of IPV (Krishnan et al., 2008; Kim & Watts, 2005);
Transforming gender norm/empowerment and strengthening livelihoods reduces IPV (Pronyk et al., 2006; Gibbs et al., 2012; Ellsberg et al., 2015)

4. Gender inequalities and livelihood insecurity drive intimate partner violence: Men
Strong qualitative theoretical argument that men’s economic marginalization leads to increase in IPV perpetration (Bourgois, 1995; Silberschmidt, 2001; Gibbs et al., 2014)
Quantitative data rather more mixed:
Jewkes et al., 2011, cross sectional study of rape perpetration in South Africa – in descriptive analysis those earning >R500 in past month more likely to rape, but also those hungry due to lack of money more likely to. In regression, higher maternal education was associated with rape – suggested being better off linked to rape
Jewkes et al., 2016 SEM model of data, showed men with higher SES had less gender equitable behaviours increased rape perpetration, while men with lower SES had this pathway mediated by childhood trauma
From reviews know that strengthening men’s livelihoods – without transforming gender norms/relationships - can increase HIV-risk behaviours (Gibbs et al., unpublished) unsure impact on IPV perpetration
Major issue as large number of interventions working to increase young people’s access to work

5. Stepping Stones and Creating Futures
Cluster RCT with n=1320 participants (660 women; 660 men), in 34 clusters in urban informal settlements in Durban, South Africa
Stepping Stones and Creating Futures, participatory, group-based intervention to reduce IPV through strengthening livelihoods and transforming gender norms:
Pilot of intervention (n=232) showed strengthening livelihoods for women and men, more equitable gender attitudes, reduction in men’s controlling behaviours and reduction in women’s experience of sexual IPV (Jewkes et al., 2014)
Baseline findings from 28/34 clusters (final data collection ongoing)

6. Socio-demographics & IPV
Men (n=554)
Mean/%(95%CI)
Age
23.63( )
Education:
Primary
11.73( )
Secondary (not complete)
57.04( )
Secondary (complete)
31.23( )
Earnings past month
R404( )
Sexual/physical IPV past 12m
58.41( )
Sexual IPV past 12m
29.84( )
Physical IPV past 12m
51.17( )
Women (n=561)
Mean/%(95%CI)
Age
23.88( )
Education:
Primary
8.02( )
Secondary (not complete)
58.47( )
Secondary (complete)
33.51( )
Earnings past month
R176( )
Sexual/physical IPV past 12m
65.24( )
Sexual IPV past 12m
30.48( )
Physical IPV past 12m
59.36( )

7. Socio-demographic, livelihoods and IPV
Men - IPV
Women - IPV No
Yes
p value
%/mean (95%CI)
Age (mean)
23.65( )
23.59( )
0.8346
23.74( )
23.95( )
0.4929
Education: Primary
11.74( )
11.76( )
5.64( )
9.29( )
Secondary
52.17( )
60.34( )
50.26( )
62.84( )
Matric
36.09( )
27.86( )
0.106
44.10( )
27.87( )
<0.0001
Livelihoods
Earnings past 4 weeks (mean)
340( )
450( )
0.2012
198( )
164( )
0.3964
Earnt any money in past month (>=R1)
53.71( )
68.73( )
33.33( )
30.87( )
0.551
Food insecurity: None
20.52( )
16.41( )
27.18( )
13.93( )
Moderate
57.64( )
56.35( )
49.74( )
52.19( )
High
21.83( )
27.24( )
0.239
23.08( )
33.88( )
Stole in past 4 weeks as hungry: Yes
24.89( )
46.13( )
22.05( )
28.14( )
0.117
Borrowed past 4 weeks: >Weekly
30.13( )
41.80( )
0.005
26.67( )
35.25( )
0.038
Worked in past 12m:Most/each month
15.72( )
28.17( )
0.001
20.00( )
13.66( )
0.05
Stress work (>=more)
12.16( )
12.05( )
0.6807
12.03( )
11.92( )
0.6744
Feelings shame work (>=more)
10.82( )
10.93( )
0.6158
10.59( )
11.04( )
0.0498
Livelihood efforts (>=more)
16.28( )
17.21( )
0.0323
15.65( )
15.70( )
0.9092

8. Socio-demographic, livelihoods and IPV
Men - IPV
Women - IPV No
Yes
p value
%/mean (95%CI)
Age (mean)
23.65( )
23.59( )
0.8346
23.74( )
23.95( )
0.4929
Education: Primary
11.74( )
11.76( )
5.64( )
9.29( )
Secondary
52.17( )
60.34( )
50.26( )
62.84( )
Matric
36.09( )
27.86( )
0.106
44.10( )
27.87( )
<0.0001
Livelihoods
Earnings past 4 weeks (mean)
340( )
450( )
0.2012
198( )
164( )
0.3964
Earnt any money in past month (>=R1)
53.71( )
68.73( )
33.33( )
30.87( )
0.551
Food insecurity: None
20.52( )
16.41( )
27.18( )
13.93( )
Moderate
57.64( )
56.35( )
49.74( )
52.19( )
High
21.83( )
27.24( )
0.239
23.08( )
33.88( )
Stole in past 4 weeks as hungry: Yes
24.89( )
46.13( )
22.05( )
28.14( )
0.117
Borrowed past 4 weeks: >Weekly
30.13( )
41.80( )
0.005
26.67( )
35.25( )
0.038
Worked in past 12m:Most/each month
15.72( )
28.17( )
0.001
20.00( )
13.66( )
0.05
Stress work (>=more)
12.16( )
12.05( )
0.6807
12.03( )
11.92( )
0.6744
Feelings shame work (>=more)
10.82( )
10.93( )
0.6158
10.59( )
11.04( )
0.0498
Livelihood efforts (>=more)
16.28( )
17.21( )
0.0323
15.65( )
15.70( )
0.9092

9. Gender relationships Men - IPV Women - IPV No Yes p value
Men - IPV
Women - IPV No
Yes
p value
Gender attitudes/relationships
%/mean (95%CI)
Gender attitudes (>=less equitable)
26.72( )
29.07( )
<0.05
22.79( )
26.22( )
<0.0001
Controlling behaviours (>=more)
10.04( )
11.55( )
8.19( )
11.33( )
Alcohol use (>=more)
5.58( )
9.92( )
2.51( )
5.39( )
Drug use past 12m: Yes
41.41( )
60.25( )
20.51( )
36.89( )
Hope (>=more)
13.89( )
12.26( )
14.04( )
13.43( )
0.1149
Childhood trauma (>=more)
5.52( )
8.82( )
4.97( )
7.35( )
Views life (>=more positive)
9.97( )
10.49( )
0.0922
9.88( )
9.90( )
0.9442
Life success (>=more successful)
2.04( )
2.38( )
0.0045
2.44( )
2.53( )
0.534

10. Gender relationships Men - IPV Women - IPV No Yes p value
Men - IPV
Women - IPV No
Yes
p value
Gender attitudes/relationships
%/mean (95%CI)
Gender attitudes (>=less equitable)
26.72( )
29.07( )
<0.05
22.79( )
26.22( )
<0.0001
Controlling behaviours (>=more)
10.04( )
11.55( )
8.19( )
11.33( )
Alcohol use (>=more)
5.58( )
9.92( )
2.51( )
5.39( )
Drug use past 12m: Yes
41.41( )
60.25( )
20.51( )
36.89( )
Hope (>=more)
13.89( )
12.26( )
14.04( )
13.43( )
0.1149
Childhood trauma (>=more)
5.52( )
8.82( )
4.97( )
7.35( )
Views life (>=more positive)
9.97( )
10.49( )
0.0922
9.88( )
9.90( )
0.9442
Life success (>=more successful)
2.04( )
2.38( )
0.0045
2.44( )
2.53( )
0.534

11. Regression models Men aOR p-value Stealing because of hunger 1.83
0.004
Working in past 12m (every/most months)
1.92
0.008
Controlling behaviours (>=more)
1.09
0.003
Alcohol use (>=more)
1.06
<0.0001
Hope
0.93
0.002
Childhood traumas (>=more)
Life success (>=more successful)
1.21
0.01
No. observations: 547, Wald chi=80.31, p<
Controlling for education and age
Women
aOR
p-value
Hunger: Low
base
Moderate
1.56
0.084
High
2.13
0.01
Controlling behaviours (>=more)
1.16
<0.0001
Alcohol use (>=more)
1.09
Hope
0.95
0.033
No. observations: 561, Wald chi75.28, p<
Controlling for education and age

12. Regression models Men aOR p-value Stealing because of hunger 1.83
0.004
Working in past 12m (every/most months)
1.92
0.008
Controlling behaviours (>=more)
1.09
0.003
Alcohol use (>=more)
1.06
<0.0001
Hope
0.93
0.002
Childhood traumas (>=more)
Life success (>=more successful)
1.21
0.01
No. observations: 547, Wald chi=80.31, p<
Controlling for education and age
Women
aOR
p-value
Hunger: Low
base
Moderate
1.56
0.084
High
2.13
0.01
Controlling behaviours (>=more)
1.16
<0.0001
Alcohol use (>=more)
1.09
Hope
0.95
0.033
No. observations: 561, Wald chi75.28, p<
Controlling for education and age

13. SEM Men Depression Drug use Hope Alcohol use Sadness Substance use
Any IPV in past 12m
Childhood traumas
Working in past 12m
Stealing because of hunger
Arguing in relationship
Education
Controlling behaviours
Inequitable gender attitudes

14. SEM Women Arguing in relationship Drug use Childhood traumas
Alcohol use
Depression
Education
Any IPV in past 12m
Controlling behaviours
Inequitable gender attitudes
Poor
No food to eat in household
Go to sleep hungry as no food
Not eat for a whole day as no food
Borrowing as no food

15. Discussion: Men For men see a clustering of factors linked to IPV:
Being slightly better off (in context of poverty): working more in the past 12m, viewing self as successful as a man
Gender inequitable practices
Childhood traumas
Reflects argument that men who are slightly better off, associated with greater sense of sexual entitlement and control of women
Raises significant issues about just doing economic strengthening interventions with men, without focusing on gender transformative interventions at the same time

16. Discussion women
For women constellation of factors shape their risk of IPV driven by poverty:
Poverty drives poorer educational outcomes, poorer mental health outcomes
Poverty drives gender inequalities, primarily in the form of controlling behaviours
Reinforces need for comprehensive gender transformative and economic strengthening interventions

17. Acknowledgements:
Project Empower staff – facilitators and administrative team
HEARD – fieldworkers
Participants