SAMRC research team publishes promising evidence on sexual violence risk reduction interventions in South African universities

Globally and in South Africa, female students in higher education are part of a vulnerable group in sexual violence victimisation and associated negative outcomes on health and academics, yet limited research within this context is available to understand the drivers and interventions to address it. In recognition of the significant problem of violence against female students in tertiary education, policy frameworks, including the South African National Strategic Plan on Gender-based Violence and Femicide (NSP GBVF) and the Policy Framework to address Gender-Based Violence for Post-School Education and Training (GBV-PSET), these policies emphasise the need to prioritise research and evaluation of evidence-based, and innovative violence prevention interventions.

Against this background, the South African Medical Research Council (SAMRC) Gender and Health Research Unit’s research team led by Dr Mercilene Machisa and Pinky Mahlangu have conducted formative research in campuses within five provinces in South Africa. The formative research informed the development of the ‘Ntombi Vimbela!’ (translated young women resist, prevent or restore) sexual violence risk reduction intervention. A survey, which was published in a PLoS One article (2021), reported that about 20% of female students in selected public universities and technical college campuses experienced sexual victimisation in the preceding year. Combined qualitative and quantitative research identified individual-level factors that increased female students’ vulnerability to sexual violence. These included being a first-year female student, from poor socio-economic family background, lacking food and material resources, having less power within inequitable sexual relationships with men, engaging in risky sexual behaviours, and poorer assertive communication skills or resisting unwanted sexual advances. Female students who were most vulnerable, existed at the time around or consumed high levels of alcohol or other substances. These females reported mental ill health, harmful alcohol use, and there was a concentration of those with limited understanding and ability to assess sexual assault risks in their social contexts.

The team developed and piloted Ntombi Vimbela!, a 35-hour intervention consisting of ten workshop sessions that are co-delivered by two trained peer facilitators per group of at most 20 first-year female students. Ntombi Vimbela! Aimed to reduce the risks of experiencing sexual violence by raising awareness about sexual rights, violence against women and girls and its drivers, sensitising about gender inequality and sexual assault. Shifting inequitable gender beliefs, and equipping participants with skills to assess and act in situations where there is a high risk of sexual assault. It also focused on empowerment and enhancing resilience and skills to withstand social and material pressures in college or university, promoting mental health, coping and utilisation of health, psycho-social services and access to justice for survivors, as well as enhancing communication skills and building healthy sexual relationships, and fostering empathy towards survivors.

In their newly published article in BioMed Central (BMC) Public Health (2023), the team reported findings from a one year post-intervention follow-up, the mixed methods study involving 98 first-year female students enrolled at historically disadvantaged universities and technical vocational, education and training colleges participating in the Ntombi Vimbela! pilot workshops. The BMC Public Health article reported positive outcomes, including improved awareness of sexual rights, assertive communication, shifts in gender equitable beliefs, reductions in rape myth acceptance, improved expressed sexual relationship power sexual decision-making, and improved negotiation within their intimate relationships one year after attending Ntombi Vimbela! workshops. Participants’ depressive symptoms significantly decreased, and they reported improved awareness of sexual assault risk and vigilance, including using self-protection strategies such as removing themselves from environments where alcohol intoxication posed sexual assault risks. Some participants used assertive communication to withstand peer pressure to engage in risky sexual behaviours. Most participants scored highly on the self-defence efficacy scale, and some participants who were exposed to sexual assault risky situations reported successes in applying the verbal and physical resistance strategies they acquired through Ntombi Vimbela! workshops.

The promising benefits of Ntombi Vimbela! reported in BMC Public Health (2023) add to the preliminary evidence previously published in Global Public Health in 2022.  The previous article focused on reporting the acceptability of the content and feasibility of delivery methods among eight groups of participants at the end of the Ntombi Vimbela! intervention workshops.  Participants reported on their experiences of participating in Ntombi Vimbela! workshops and its immediate benefits. Participants found the content of Ntombi Vimbela! to be relevant and applicable to their lives. They experienced the intervention workshops as a safe space in which they could disclose their violence experiences and get support.

Building on the incremental findings of published articles, Drs Machisa and Mahlangu are currently collaborating with Dr Carrie Brooke Sumner from the Mental Health, Alcohol, Substance Use and Tobacco Research Unit (MASTRU) to lead research aimed at strengthening Ntombi Vimbela!’s mental health focus and to adapt the intervention to cater to the same-sex relationships of lesbian, queer and bisexual women, who are also highly vulnerable to violence in university settings, in preparation for a more rigorous randomised evaluation to establish the intervention’s effectiveness.

Article citations

1. Machisa, M.T., Mahlangu, P; Sikweyiya, Y; Nunze, N; Pillay, M; Chirwa, E; Dartnall, L; and Jewkes R. (2023).  Ntombi Vimbela! Sexual violence risk reduction intervention: pre- and one-year post assessments from a single arm pilot feasibility study among female students in South Africa. BMC Public Health 23, 1242. https://doi.org/10.1186/s12889-023-16149-x
2. Mahlangu, P; Machisa, M.T; Sikweyiya, Y; Nunze, N; Pillay, M; Chirwa, E; Dartnall, L; and Jewkes R. (2022) Preliminary evidence of efficacy of a sexual violence risk reduction intervention for female students in South African tertiary Institutions. Global Public Health. https://doi.org/10.1080/17441692.2021.1998574
3. Sikweyiya, Y., Machisa, M.T, Mahlangu, P., Nunze, N., Dartnall, E., Pillay, M. and Jewkes, R. (2023). “I Don’t Want to Be Known as a Weak Man”: Insights and Rationalizations by Male Students on Men’s Sexual Violence Perpetration against Female Students on Campus. International Journal of Environmental Research and Public Health, 20(5), p.4550.

For more enquiries:

• Dr Mercilene Machisa
  Specialist Scientist: Gender and Health Research Unit
  E-mail: Mercilene.Machisa@mrc.ac.za
• Ms Yolanda Phakela
  Public Relations Manager
  E-mail: Yolanda.Phakela@mrc.ac.za
  Mobile: +27 73 801 3691