Change Starts at Home — Couples' Curriculum and Community Diffusion Against Intimate Partner Violence, Nepal

Change Starts at Home is a social and behaviour-change communication strategy developed by Equal Access International with Interdisciplinary Analysts to reduce intimate partner violence (IPV) among married couples in Nepal's Terai region, which has the country's highest reported IPV prevalence. The model pairs a radio drama series with a 9-month couples' Listening and Discussion Group curriculum and an 8-month community diffusion curriculum designed to spread new norms beyond direct participants.
The intervention was evaluated through a pair-matched, single-blinded cluster-randomised trial (36 clusters/Village Development Committees across Nawalparasi, Kapilvastu and Chitwan districts, 1,440 individuals surveyed; NCT02942433), led by Emory University. At baseline, roughly a quarter of the 1,800 surveyed women reported past-year IPV. Reported IPV victimisation and perpetration declined significantly at midline, with the largest reductions among direct beneficiaries, and this reduction was sustained relative to control clusters at 18-month follow-up, alongside improved gender-equitable attitudes, reduced acceptance of violence, reduced alcohol use, and a higher likelihood of assisting a survivor.
A separate diffusion study in Nepal's Gandaki province found that community members exposed indirectly to the intervention (rather than as direct participants) also reported sustained decreases in IPV, though trends were non-linear across waves, illustrating that norm-diffusion effects — while real — are less uniform than direct-participant effects. Equal Access International has continued the approach under its ongoing "B.I.G Change" programme.

Read the full analysis: https://global.comminit.com/content/impact-change-starts-home-trial-womens-experience-intimate-partner-violence-nepal