BANDEBEREHO
ENGAGING FATHERS AND COUPLES TO BREAK CYCLES OF VIOLENCE IN RWANDA
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WHERE
Musanze, Burera and Gakenke Districts, Rwanda
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PARTICIPANTS
Couples aged 21-35 and children under 5
MODULE
Journey of Transformation of 17 weekly sessions
The Bandebereho program is a gender-transformative intervention targeting expectant couples or parents with young children under five years. It promotes men’s engagement in reproductive, maternal, and child health, caregiving, violence prevention and healthier couple relations. Fatherhood is used as an entry point to engage men to participate in 17 weekly sessions, ten for couples. The sessions are facilitated with small groups of up to 12 couples. The sessions foster positive changes in gender attitudes, couple relations, caregiving, violence prevention, and overall family health.
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AN EVIDENCE-BASED AND GENDER TRANSFORMATIVE INTERVENTION
BANDEBEREHO is an evidence-based program that transforms traditional norms of masculinity in Rwanda by using fatherhood as an entry point to promote men’s participation as caring, non-violent and supportive fathers and partners.
UNIQUE POSITIVE OUTCOMES
AFTER 6 YEARS
Unique positive impacts on health and gender-related outcomes were assessed through two Randomized Control Trials (RCT) conducted 21 months (in 2015) and 6 years (2021) after the pilot program.
ADAPTED FROM PROGRAM P FOR RWANDA
The program was inspired by Equimundo's Program P and adapted for Rwanda in collaboration with the Rwanda Biomedical Centre (RBC), a governmental agency working closely with the Ministry of Health.
BANDEBEREHO ROAD MAP
THE DEVELOPMENT
CHALLENGE
The intervention draws on sociological theories of gender and masculinities that highlight how gender inequalities are reproduced–or transformed–through everyday interactions in the home.
The intervention creates a structured space for men and women to:
question and critically reflect on gender norms and how these shape their lives;
rehearse equitable and non-violent attitudes and behaviors in a comfortable space with supportive peers; and internalize these new gender attitudes and behaviors, and apply them in their own lives and relationships.
BANDEBEREHO INNOVATIVE APPROACH
Bandebereho is an evidence-based innovation aimed at transforming norms around masculinity by using fatherhood as an entry point to engage men and their female partners on maternal and newborn health, violence prevention, and unpaid care work via participatory, structured sessions led by community role models. Bandebereho is a contextually responsive programme whose adaptation and operationalisation from a different programme run in Latin America by Equimundo, global leaders in engaging men and boys, was carried out by the Rwanda Men’s Resource Center (RWAMREC). RWAMREC have extensive expertise in male engagement and gender norm-shifting programme implementation in Rwanda. The adaptation and implementation process also involved oversight and co-creation with the Rwanda Biomedical Center (RBC), who formally approved the curriculum in 2014, and has carried out subsequent rigorous testing through a randomised controlled trial, in collaboration with Equimundo.
ONE INTERVENTION : MULTIPLE IMPACTS
ENGAGED CAREGIVING
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Greater time spent by men on childcare and household tasks
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Greater sharing of tasks between partners
MATERNAL HEALTH
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Greater antenatal care attendance by women
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accompaniment by men and provision of support during pregnancy
EQUITABLE RELATIONS
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Less dominance of men in household decision-making
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Greater couple communication
VIOLENCE PREVENTION
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Less physical, sexual, emotional, and economic partner violence
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Less physical punishment of children by both parents
THEORY OF CHANGE
Bandebereho's Theory of Change is anchored in sociological theories of gender and masculinity that highlight how gender inequalities are reproduced, sustained, and transformed through everyday interactions in the home. The hypothesis is that if men and their partners become more aware of inequalities, reflect on the costs of rigid norms, and learn and practise new skills (e.g. partner communication and joint decision-making) in a safe, non-judgemental peer environment, this could lead to positive changes across a wide range of health and relationship behaviours. External evidence demonstrates that effective couples intervention to prevent IPV typically include components that involve critical reflection on gender and power dynamics, as well as building relationship skills like communication and conflict resolution
SIX YEARS LATER
At 76-month follow-up, compared to the control group Bandebereho participants report (all statistically significant unless otherwise noted):
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Lower rates of physical, sexual, emotional, and financial intimate partner violence
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Greater antenatal care by women and accompaniment by men 1
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Greater use of modern contraceptives
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Lower rates of depression for both parents
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Lower rates of child physical punishment by both parents
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Lower rates of harsh discipline by both parents
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Higher rates of using positive discipline techniques by both parents
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Greater participation in learning and responsive care of children by both parents
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Better emotional and behavioural outcomes for young children
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Higher levels of men’s participation in childcare and household tasks
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Less dominance of men in household financial decision-making
ACHIEVEMENTS
As a result of the initial positive findings from RCT of the pilot, in 2018, RWAMREC and Equimundo, in collaboration with the Rwanda Biomedical Center, sought to scale-up Bandebereho to reach more families and communities by integrating the program into the health system and specifically community health workers as the strongest and most sustainable option for scaling-up across Rwanda. From February, 2023 RWAMREC and RBC with technical support from Equimundo are scaling up the Bandebereho program in two additional districts of Burera and Gakenke with a Memorandum of understanding (MOU) signed between RWAMREC and RBC to integrated the program into the existing health structures of community health workers (CHWs).
Recently, RWAMREC, MOH and RBC concluded on the integration of Bandebereho indicators related to the male involvement in antenatal care (ANC), in the delivery system, in family planning and immunization into the national reported indicators.
Over the five-year period, two additional districts in the Northern province – Gakenke and Burera, a total of 1,568 CHWs will be trained and receive supportive supervision to recruit and facilitate Bandebereho group educations activities of couples of under five years children in their communities up to reach an estimated of 104,000 parents and more 45,000 under five years children over five years.
SCALE UP
As a result of the initial positive findings from Randomized Controlled Trial(RCT) of the pilot, in 2018, RWAMREC and Equimundo, in collaboration with the Rwanda Biomedical Center, sought to scale-up Bandebereho to reach more families and communities by integrating the program into the health system and specifically community health workers as the strongest and most sustainable option for scaling-up across Rwanda.
NATIONAL INDICATORS
Recently, RWAMREC, the Rwanda Ministry of Health (MOH) and the Rwanda Biomedical Center(RBC) concluded on the integration of Bandebereho indicators related to the male involvement in antenatal care (ANC), in the delivery system, in family planning and immunization into the national reported indicators through the Health Management Information System (HMIS).