Shifting social norms to prevent age-disparate transactional sex in Tanzania: what we can learn from intervention development research.

This paper reflects on the development process (2015-2020) of the Learning Initiative for Norms, Exploitation, and Abuse (LINEA) Intervention. The LINEA Intervention is a multi-component social norms intervention to prevent age-disparate transactional sex in Tanzania. This paper aims to: (1) critically reflect on the LINEA Intervention development process by retrospectively comparing it with a pragmatic, phased framework for intervention development in public health, the Six Essential Steps for Quality Intervention Development (6SQuID); and (2) discuss the usefulness and applicability of this framework to guide intervention development for gender-based violence prevention. This paper contributes to a growing field of intervention development research to improve the designs of interventions to prevent gender-based violence. Findings showed that the LINEA Intervention development approach mostly aligned with the steps in 6SQuID framework. However, the LINEA Intervention development process placed particular emphasis on two phases of the 6SQuID framework. First, the LINEA Intervention development process included significant investment in formative research, feasibility testing, and refinement; and second, the LINEA Intervention was informed by a clearly articulated behavior change theory-social norms theory. Beyond the 6SQuID framework the LINEA Intervention development process: (i) followed a non-linear, iterative process; (ii) applied ongoing feasibility testing to refine the intervention, and (iii) relied on co-development with local implementers and participants. This paper suggests future components for a robust intervention development process, highlighting beneficial additions to the 6SQuID approach, a well-recognized intervention development sequence. Particularly useful additions include incorporating sufficient time, flexibility, and resources to foster meaningful collaborations and iteration on the intervention design.

Lessons learned from implementing Indashyikirwa in Rwanda- an adaptation of the SASA! approach to prevent and respond to intimate partner violence.

This paper reviews adaptation processes of the Indashyikirwa program in Rwanda, a four-year program to prevent intimate partner violence, implemented by CARE Rwanda, Rwanda Men's Resource Center (RWAMREC) and Rwanda Women's Network (RWN). Indashyikirwa is a blended approach of evidence-based programming, primarily drawing on SASA! developed by Raising Voices in Uganda, as well as program innovations. Indashyikirwa consists of four major components; 1) a five-month curriculum with couples to support equitable, non-violent relationships, 2) supporting a sub-set of trained couples to engage in community activism for an additional two years, 3) establishment of women's safe spaces for dedicated support and referral of IPV survivors, 4) training and engaging opinion leaders to support an enabling environment for IPV prevention and response. This paper is based on implementation experience and qualitative evaluation research conducted at various time points with trained couples, women's safe space attendees and facilitators, opinion leaders and programme staff, as well as observations of program activities. The SASA! fidelity brief, which highlights key principles for adaptation of the program, guided the framing of the findings. Lessons learned around adaptation of such programs are offered.