RCT evaluation of Skhokho: A holistic school intervention to prevent gender-based violence among South African Grade 8s


Autoři: Rachel Jewkes aff001;  Anik Gevers aff003;  Esnat Chirwa aff001;  Pinky Mahlangu aff001;  Simukai Shamu aff004;  Nwabisa Shai aff001;  Carl Lombard aff005
Působiště autorů: Gender & Health Research Unit, South African Medical Research Council, Pretoria, South Africa aff001;  School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa aff002;  Independent Consultant, Cape Town, South Africa aff003;  Foundation for Professional Development, Pretoria, South Africa aff004;  Biostatistics Research Unit, South African Medical Research Council, Cape Town, South Africa aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223562

Souhrn

We evaluated the effectiveness of the Skhokho interventions (enhanced teaching materials and a parenting programme) in reducing dating and sexual violence. This pragmatic, three-arm cluster randomised controlled trial was conducted in 24 State schools in Grade 8 classes, with all learners invited to participate. The interventions were: i) a schools’ package: A Life Orientation (LO) curriculum workbook for the Grade 8 national curriculum and teacher training; ii) a workshop for caregivers and teenagers, supported by clubs in the second year. Arms were: a no intervention control, the schools’ package, and the combined schools’ and families’ package. Learners were followed up for 18 months. The primary outcomes were the incidence of physical and/or sexual IPV, severe IPV and non-partner rape. At baseline, 3756 (61.8% of total) learners (aged 12–15) were interviewed and 3411 (90.8%) provided end line data. A third of caregivers and learners attended all four families’ intervention workshop sessions. At baseline, 47% of girls and 29% boys were dating and 18% of boys and 2% of girls had had sex. Differences in the primary outcomes between study arms were not statistically significant, however all effects were in the direction of protection from violence and several secondary outcomes were significantly changed. For girls, the incidence of any IPV experience was aIRR 0.84 (95%CI 0.66, 1.07 p = 0.159) for the school’s arm and the incidence of non-partner rape was aIRR 0.84 (95%CI 0.62, 1.14 p = 0.255) for the combined schools and families arm v. control arm. This under-powered pragmatic study’s findings suggest a generally beneficial impact of the Skhokho interventions on a number of outcome measures, when viewed by both adolescents, caregivers and their teachers. These include measures of adolescents’ exposure to violence, improved sexual health and reductions in several IPV risk factors. The intervention warrants further research.

Trial registration

ClinicalTrials.gov NCT02349321.

Klíčová slova:

Human learning – Child health – Intimate partner violence – Learning – Schools – Teachers – Workshops – Rape and sexual assault


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