Psychosocial interventions for intimate partner violence in low and middle income countries: A meta-analysis of randomised controlled trials.

ABSTRACT

BACKGROUND: Intimate partner violence (IPV) is prevalent worldwide and presents pernicious consequences for women in developing countries or humanitarian settings. We examined the efficacy of psychosocial interventions for IPV among women in low- and middle-income countries (LMICs). METHODS: Seven databases were systematically searched for randomised controlled trials (RCTs) examining psychosocial interventions for IPV in LMICs. Thirteen RCTs were included in random-effects meta-analyses. Risk ratios (RR) and risk difference were calculated as pooled effect sizes. Risk of bias was assessed using an adapted version of the Cochrane tool accounting for cluster RCTs. Sensitivity analyses were conducted for risk of bias and design characteristics. Publication bias and heterogeneity were assessed. RESULTS: Psychosocial interventions reduced any form of IPV by 27% at shortest (relative risk (RR) = 0.73) and 25% at longest (RR = 0.75) follow up. Physical IPV was reduced by 22% at shortest (RR = 0.78) and 27% at longest (RR = 0.73) follow up. Sexual IPV was reduced by 23% at longest follow up (RR = 0.77) but showed no significant effect at shortest follow-up. Sensitivity analyses for risk of bias led to an increase in magnitude of the effect for any form of IPV and physical IPV. The effect on sexual IPV was no longer significant. Heterogeneity was moderate to high in the majority of comparisons. CONCLUSIONS: Psychosocial interventions may reduce the impact of IPV in humanitarian or low and middle income settings. We acknowledge heterogeneity and limited availability of RCTs demonstrating minimal risk of bias as limitations.