Health equity
SASA! cut partner violence in Kampala
Open access · cc by · source: Europe PMC
A Kampala cluster RCT found community mobilization (SASA!) associated with roughly 50% lower past-year physical IPV and male partner concurrency.
Study at a glance
- Design
- RCT — Cluster RCT of SASA! community activism vs control in Kampala
- N
- N=2532 · Follow-up interviews: 600+768 intervention and 530+634 control (women+men)
- Population
- Adults in Kampala intervention and control communities in the SASA! CRT
- Outcome
- Past-year physical IPV and men’s sexual concurrency (community-level contrasts)
Structured fields used in claim comparison tables when every cited study has a complete layer.
Key findings
Past-year physical IPV and men’s concurrency were about 50% lower in intervention communities; attitudes supporting women’s right to refuse sex improved; first such CRT in sub-Saharan Africa for this structural approach.
Methodology
SASA! trained community activists across intervention clusters in Kampala to run thousands of activities challenging norms linking gender power, IPV, and HIV risk, compared with control communities.
Limitations
Precision was limited for some IPV estimates (wide CIs), and election-period suspension interrupted delivery.
How this study connects
Role on claims
Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.
SASA! trained community activists in Kampala intervention clusters to challenge norms linking gender power, IPV and HIV risk. Past-year physical IPV and men's concurrency were about 50% lower in intervention communities, and attitudes supporting women's right to refuse sex improved. Precision was limited for some IPV estimates (wide CIs), and election-period suspension interrupted delivery.
Evidence for the claim as stated.
Process success and health success are not the same cluster-trial result. TSC moved toilets (~19 percentage points) without moving child health; TB medication monitors moved adherence 40–50% without, in this report, proving cure; SASA! moved IPV and concurrency by about 50% as the intended social outcome. A student who treats 'the cluster intervention worked' as one sentence will misread at least one of these papers.
Evidence for the claim as stated.
Open-label clinical clusters and community structural trials ask different causal questions under the same design name. Digital medicines at 13 sites cut SBP by about 9 mm Hg without placebo control; Mashhad trained 35 physicians and followed 240 patients for literacy and BP; SASA! randomised Kampala communities to a norm-change programme. Blinding a village activist campaign is not the same problem as blinding a digital pill, and neither is an individually randomised ITT drug trial.
Evidence for the claim as stated.
SASA! used community surveys as outcome tools inside a cluster-randomised trial in Kampala, not as a stand-alone cross-section. Past-year physical IPV and men's concurrency were about 50% lower in intervention communities, with improved attitudes toward women's right to refuse sex. Wide CIs on some IPV estimates and election-period interruption still apply; the randomisation, not the questionnaire format, is what supports a causal reading.
Evidence for the claim as stated.
Hypothetical acceptance, reported coverage, administrative utilisation and CRT endline surveys are four different measurement jobs. Libya's 79.6% at ≥90% efficacy is a stated intention under a scenario. Seasonal flu coverage of ~21% and pandemic coverage of 11.1% are recalled past behaviour. Telemedicine's jump from 1.4% to 28.1% is billing data. SASA!'s ~50% IPV contrast is a randomised community comparison that used surveys. Averaging those percentages as 'survey findings on uptake' erases the disagreements.
Evidence for the claim as stated.
Open questions
Tensions this paper is part of
From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.
Process success and health success are not the same cluster-trial result. TSC moved toilets (~19 percentage points) without moving child health; TB medication monitors moved adherence 40–50% without, in this report, proving cure; SASA! moved IPV and concurrency by about 50% as the intended social outcome. A student who treats 'the cluster intervention worked' as one sentence will misread at least one of these papers.
- Supports · Did India’s toilet campaign improve child health?
- Supports · TB pillbox reminders beat SMS for doses
Open-label clinical clusters and community structural trials ask different causal questions under the same design name. Digital medicines at 13 sites cut SBP by about 9 mm Hg without placebo control; Mashhad trained 35 physicians and followed 240 patients for literacy and BP; SASA! randomised Kampala communities to a norm-change programme. Blinding a village activist campaign is not the same problem as blinding a digital pill, and neither is an individually randomised ITT drug trial.
Hypothetical acceptance, reported coverage, administrative utilisation and CRT endline surveys are four different measurement jobs. Libya's 79.6% at ≥90% efficacy is a stated intention under a scenario. Seasonal flu coverage of ~21% and pandemic coverage of 11.1% are recalled past behaviour. Telemedicine's jump from 1.4% to 28.1% is billing data. SASA!'s ~50% IPV contrast is a randomised community comparison that used surveys. Averaging those percentages as 'survey findings on uptake' erases the disagreements.
- Supports · COVID vaccine acceptance in Libya
- Supports · Seasonal vs pandemic flu vaccine coverage
- Supports · How did rural telemedicine change in COVID?
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