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Abstract
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Over the past five decades, housing interventions have been a cornerstone of support globally for women experiencing intimate partner violence (IPV). These interventions are crucial given that IPV is one of the most important causes of homelessness among women worldwide. Some women who have experienced IPV stay in shelters for months or years and use them to heal and move forward with their lives, whereas others stay for much shorter periods (ie, from days to weeks) to seek temporary respite and immediate safety. All shelters aim to provide a safe space and many provide other programmes, including advocacy and counselling, with good effects, and income-generating opportunities. This variability enables housing interventions to potentially meet a range of women's needs; however, the intervention delivered differs considerably between settings, so evidence on their overall impact and what makes them more effective is unevenly understood.
Alexa Yakubovich and colleagues systematically review the impact of housing interventions on women's health and experience of IPV in the first synthesis of quantitative global evidence. The authors found only 34 (mostly small) studies and just nine were from outside the USA. Although housing interventions are provided in diverse settings, no quantitative evaluation has been conducted in any low-income and middle-income country, and none from rural settings in high-income countries. Most studies (76%) evaluated shelters and assessed outcomes related to mental health, with fewer (65%) asking about perceived safety, readiness or decision to leave partner, and reoccurrence of IPV. Women who had experienced IPV generally reported improved mental health outcomes, as well as empowerment. Even though assessments were mostly positive, perhaps surprisingly, there was less evidence on the impact of interventions on IPV experiences, intention to leave, and perceived safety.
Given the heterogeneity of interventions, settings, and patterns of use by women experiencing IPV, further research on housing outcomes would greatly benefit from the use of mixed methods and building a community of practice, among which there may be comparability of outcomes and a wider range of outcomes explored over an extended follow-up period. Given that women experiencing IPV have various needs at the point of accessing housing interventions, length of stay, and programmes provided, much larger samples are needed across different settings. Attention should be given to measuring health and violence outcomes, alongside measures of success identified as key by female service users, which might differ considerably, especially for short-term users. Although some women choose to stay for short periods, others choose to do so because of shelter factors, including restrictive policies and rules. This reality needs to be captured in research and considered in evaluation design, with clear value to be gained from intention-to-treat approaches. ...
Language: en |