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By Courtney J. McLarnon-Silk, Esther Spindler (IRH); Francesca Quirke (Tearfund)
Adapted from Institute for Reproductive Health 

In September 2017, Institute for Reproductive Health (IRH), Tearfund, and Equimundo co-led a satellite event titled, Exploring the Links between Intimate Partner Violence and Family Planning Use: Building Knowledge for Normative Change to Promote Adolescent and Youth Sexual and Reproductive Health, at the Sexual Violence Research Institute (SVRI) Forum in Rio de Janeiro, Brazil.

Why talk about family planning at SVRI?

Gender-based violence – particularly intimate partner violence (IPV) – is a key barrier to meeting the family planning (FP) needs of women and men worldwide. The links between IPV and family planning are documented, yet we know little of the underlying mechanisms and best practices for responding. Recognizing this gap, the Passages Project has been conducting a landscaping of existing evidence to explore these links, especially as related to social, cultural, and gender norms. The landscaping consists of a literature review, an online survey, and key informant interviews. Our goal is to consolidate the evidence on the IPV-FP relationship and to unpack promising interventions.

The satellite event was an opportunity to share initial findings from the landscaping effort, to exchange ideas, and to learn about new approaches in the field with other experts at SVRI.

What we shared: highlights from the landscaping

  • Intimate partner violence and family planning are linked. Three systematic reviews have examined the association of IPV with sexual health outcomes, including sexual risk taking, inconsistent condom use, unplanned pregnancy or induced abortion, sexually transmitted infections and sexual dysfunction. The evidence suggests multiple associations between IPV and FP, but the direction and causes of relationships are unclear. Overall, the literature suggests that IPV can have an impact on numerous outcomes, including FP use, reproductive coercion, and unintended pregnancy.
  • Social norms affect women’s autonomy and reproductive health. Few studies have documented how social norms affect the link between IPV and FP. We know that social norms – the unwritten rules of behavior shared by a group and held in place by social expectations, rewards and punishments – do in fact influence IPV and FP outcomes. For example, patriarchal ideas about male control over women influence FP use and the acceptability of IPV. Overall, norms influence women’s autonomy and control over their reproductive health, particularly when they experience IPV.
  • Few interventions address IPV and FP. Even fewer have been scaled up. Of the interventions identified, we included 14 approaches that varied from SBC to edutainment, economic empowerment, and service delivery. We found that multi-sectoral programs can be successful; however, few programs documented the pathways in which transforming norms relevant to both IPV and FP were clear. Lack of evidence on what works, for whom, and under what conditions is a challenge to scaling up of promising programs.

What we learned: feedback from experts in the room

During the panel presentations and interactive group work, over 40 experts shared insights about how to move IPV and FP research and practice forward. Suggestions included:

  1. Strengthen the conceptual story. A clear conceptual pathway is needed to link IPV and FP.
  2. Consider other life factors. Experts brought up the need to use a lifecycle approach and the ecological framework, and to consider structural barriers and the influence of other individuals on IPV and PF outcomes.
  3. Engage men responsibly. More evidence is needed to understand how best to engage men, while also ensuring women’s autonomy and lowering potential risk of further IPV (also known as “do no harm”).
  4. Analyze promising interventions to find key components and commonalties.
  5. Capitalize on expert opinions and sharing clear recommendations for policies and funding.

The expert opinions solicited at SVRI will be applied to the final landscaping assessment.

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