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Community health promotion. For years health projects have used community outreach and peer education techniques to promote family planning, oral rehydration therapy, and other healthy behavior. Such techniques also can address the problem of violence—for example, by challenging harmful traditional gender norms and promoting new norms.

For example, the Mexican Family Planning Association (MEXFAM) has begun integrating antiviolence work into all of its programming. With funding from the MacArthur Foundation, MEXFAM has produced posters and workshop materials that encourage rural and indigenous men and women, including young people, to reflect upon domestic violence and its negative impacts. The goal is to help men and women begin to recognize the costs of abusive behavior and thereby become more motivated to change it (299).

In Honduras the Programa Feminina Hondureña de Salud Comunitaria (PROFEHSAC) has added drama, discussion, and role-playing on domestic violence to its training program for health promoters. As a result, PROFESHSAC health promoters have become major agents of change in their community, offering support to victims and holding discussion sessions with men, women, and youth (284).

The new popular education manual, Where Women Have No Doctor, should greatly facilitate such work because it features entire chapters on sexuality, domestic violence, mental health, and rape (54). Designed for low-literacy populations, this resource manual includes basic information on the dynamics of abuse and suggests how community health workers can assist victims and work to change cultural norms.

Programs also can include gender and violence themes in small-group sessions designed for other purposes. An example is Stepping Stones, a curriculum for sexual health and HIV prevention. Building on the pioneering work of two Brazilians—educator Paolo Freire and theater director and social activist Augusto Boal—the curriculum uses a problem posing approach to encourage reflection on complex issues such as trust, risk, the meaning of love, and learning to say “no” (468). A recent South African adaptation of the Stepping Stones curriculum adds a module specifically to address abuse and coercion in relationships (216).

Communication campaigns. Reproductive health programs also can use the mass media to address violence against women. During the 1990s, for example, a network of over 100 women's organizations in Nicaragua mounted an annual mass-media campaign to raise awareness of the impact of violence on women (128). Using slogans such as “Quiero vivir sin violencia” (I want to live without violence), the campaign mobilized communities against abuse. According to the 1998 DHS, more than half of the Nicaraguan population had heard at least one of the campaign's messages, and one-half of all women who had heard the messages were able to repeat at least one of the slogans (386).

Another Nicaraguan organization, Puntos de Encuentro, recently mounted a campaign specifically to reach men (307) (see photo). The campaign built on the results of an in-depth qualitative study designed to explore what benefits, if any, nonviolent men perceived from their nonviolence.

Puntos de Encuentro

Unlike the recent disastrous Hurricaine Mitch, violence against women is "a disaster that men can prevent," this Nicaraguan poster points out. It urges men on the verge of violence to control their anger, talk about their feelings, and respect their wives.

Reproductive health programs also can ensure that communication campaigns do not inadvertently reinforce negative gender roles or deliver negative messages about gender-based abuse. The imagery used in campaigns helps shape how people think and behave (16, 358). Campaigns that seek to promote contraceptives or condoms specifically by appealing to macho imagery, for example, run the risk of reinforcing negative male stereotypes that undermine women's power within sexual relationships. The Jamaican marketing campaign for Slam condoms, for example, used explicit references to rough sex and pictures of scantily clad dance hall girls to promote condom use to men (395).

Similarly, evaluation of Hum Log (We the People), India's first television soap opera designed to promote social themes, found that its plot inadvertently reinforced domestic violence. Characters intended to be positive role models did not consistently benefit from treating women better, while the negative role models were not consistently punished for treating women poorly (46). Many viewers of the program praised the long-suffering woman who accepted abuse from her husband and noted that she kept peace in her family, thus benefiting from her self-effacing behavior (416).

In contrast, the South African television drama “Soul City” successfully used entertainment media to challenge attitudes and norms that perpetuate abuse. This prime-time television drama weaves social responsibility themes concerning sexual coercion, harassment, and domestic violence into its stories. In addition, the program collaborates with the National Network on Violence Against Women to provide a toll-free hotline and free counseling services for victims of violence. “Once people can witness their own situations on television, and watch the characters they relate to solve their problems, they are empowered to take action in their own lives,” said Soul City researcher Thuli Shongwe (34).