Key Social Norms Take-aways The Bandebereho intervention demonstrates that deeply entrenched gender norms—such as men’s dominance in decision-making, use of violence against women and children, and unequal household labor—can shift through a structured, gender-transformative approach. By promoting critical reflection, joint decision-making, and shared caregiving roles, the intervention disrupted patriarchal norms in a sustainable way. Male engagement was particularly effective when tied to life transitions like fatherhood, and delivered in a peer-based, participatory setting. Notably, the intervention reduced intimate partner violence and men’s dominance without undermining women’s autonomy, addressing concerns about potential backlash.
Objectives To assess the impact of the Bandebereho gender-transformative couples’ intervention on multiple behavioral and health-related outcomes influenced by gender norms and power relations, including intimate partner violence, reproductive and maternal health behaviors, and intra-household gender dynamics in Rwanda.
Methods A two-arm randomized controlled trial was conducted across four districts in Rwanda with 1,199 expectant or current fathers and their partners. Couples were randomly assigned to either the intervention or control group. Data were collected at baseline (men only), and at 9- and 21-months post-baseline (men and women). Primary outcomes included physical and sexual violence, antenatal care attendance and male accompaniment, contraceptive use, partner support, division of household labor, and household decision-making. Generalized estimating equations were used to analyze intention-to-treat effects.
Intervention Details The Bandebereho intervention consisted of 15 participatory sessions with men (and 8 with their partners) covering topics such as gender and power, caregiving, reproductive health, intimate partner violence, and household decision-making. Sessions were led by trained local male facilitators, with support from nurses and police for certain modules. The program was adapted from Program P and implemented by Rwanda Men’s Resource Center as part of the MenCare+ initiative.
Results At 21 months, women in the intervention group were significantly less likely to report experiencing physical (OR 0.37) or sexual intimate partner violence (OR 0.34). Couples in the intervention group reported more antenatal care attendance and male accompaniment, greater partner support during pregnancy, higher modern contraceptive use, reduced use of physical punishment of children, increased male participation in caregiving and household tasks, and lower male dominance in decision-making.
Conclusions The Bandebereho intervention had substantial, sustained positive effects on gender equity and health-related behaviors. It demonstrates the feasibility and effectiveness of gender-transformative approaches in shifting harmful norms and improving outcomes when interventions are culturally adapted and implemented through trusted community structures.