Problem: The 2022 Demographic and Health Survey in Kenya found, 2 in 5 women report lifetime experience of intimate partner violence (IPV) and 1 in 10 report prior experience of pregnancy coercion. Other ARCHES studies have found rates of reproductive coercion (RC) to be even higher among women seeking family planning, up to 42% in our latest study. Approximately 1 in 3 women have reported a mistimed or unwanted pregnancy. Additionally, women in Kenya, like those worldwide, also struggle with issues of economic violence.

Overview: ARCHES has been adapted in Kenya in several projects. The first project, beginning in 2016, included adapting ARCHES within family planning counseling delivered in private clinics in Nairobi with the International Planned Parenthood Federation (IPPF) and Family Health  Options of Kenya (FHOK). Based on positive findings, in 2020 the Kenya Ministry of Health expressed interest in scaling the program, leading to the next project adapting ARCHES within family planning counseling delivered in public facilities in one county, Uasin Gishu. Most recently, ARCHES content is also currently being adapted and tested in women’s economic empowerment groups in Uasin Gishu. 

Learn more about ARCHES in Kenya

Problem: An estimated 50–60% of women in Bangladesh have experienced physical and/or sexual IPV in their lifetimes and 30% having experienced such violence in the past year. IPV experience is associated with a 50–60% increase in unwanted pregnancy and over two times higher odds of abortion (AOR = 2.60) in Bangladesh.

Studies assessing IPV among refugee and host country women and girls have documented that refugee women are at significantly higher risk than other women. Women in refugee camps report that men’s perpetration of violence is directly related to the violence men experience through displacement, and experiences of political violence, in general, are associated with increased likelihood of men’s perpetration of spousal violence. In the uncertain and often dangerous environment of refugee camps, a woman’s ability to manage her reproductive life is crucial to protecting her health and autonomy. There are currently 994,124 Rohingya refugees residing in Cox’s Bazar district, Bangladesh (source: Joint GoB- UNHCR Population Factsheet Bangladesh, 31st August 2024), most of whom have arrived since 2017, after fleeing religious persecution, ethnic cleansing, and violence in their home country, Myanmar. A qualitative study assessing violence among Rohingya refugees found that intimate partner violence was an accepted social norm, and that violence increased after arriving in refugee camps due to lack of male employment and financial pressures. Women were unlikely to report instances IPV due to stigma, and only sought help in the form of medical treatment in severe cases. Lack of information on available violence support services and inability to access services were also identified as barriers to receiving help.

Overview: Ipas Bangladesh and the Center on Gender Equity and Health at UC San Diego have undertaken three ARCHES adaptations in Bangladesh.

Learn more about ARCHES in Bangladesh

Problem: In 2016, the Mexican National Statistics Office (INEGI) conducted a survey which found that 44% of women in relationships had experienced IPV, with 2 in 5 reporting experiencing sexual IPV. In 2021, the National Institute of Statistics and Geography of Mexico (INEGI), through its National Survey on the Dynamics of Household Relationships (ENDIREH) reported that, in the Mexican Republic 40% of women have experienced IPV. Also, 7% have experienced sexual IPV. Studies in Mexico, as elsewhere, have shown that RC is particularly associated with experience of physical and sexual IPV. 

Overview: ARCHES has been adapted in two separate capacities in Mexico – first for adolescents and youth in public clinics along the border in Tijuana and separately for IPPF member affiliate MexFam in Mexico City.

Learn more about ARCHES in Mexico

Problem: In Nigeria, similar to global estimates, one in three (36%) ever-married women reported that they have ever experienced physical, sexual, or emotional violence by their husband/partner (Nigeria Demographic and Health Surveys or NDHS 2018). From 2008-2018, in some states, rates of IPV increased from 21% to 47%. Performance Monitoring for Action (PMA2020) found a prevalence of RC among reproductive-aged women in need of contraception in Kano and Lagos, Nigeria in the past year to be at 5% and 2.9%, respectively.

Overview: Under the USAID MOMENTUM Country and Global Leadership project in Nigeria, Jhpiego adapted and integrated ARCHES into family planning and antenatal care services along with the Nigerian guidelines on healthcare for those who have experienced gender-based violence, which was itself adapted from the World Health Organization (WHO) LIVES (Listen, inquire, validate, enhance safety and support) approach.

Learn more about ARCHES in Nigeria

Problem: The most recent National Family Health Survey (NFHS) in India reveals that around 29% of women have experienced IPV. Many also face RC, driven by social norms that prioritize early and frequent childbearing and a preference for sons. Nearly half of all pregnancies are unintended, and contraceptive discontinuation rates are high: 1 in 2 women using modern contraceptives discontinue within 12 months. Research indicates that women experiencing IPV or RC face a significantly higher risk of unintended pregnancy and contraceptive discontinuation due to compromised reproductive autonomy and restricted access to contraceptive methods.

Overview: Under the USAID funded project, Agency for All, the Center on Gender Equity and Health at UC San Diego is supporting the adaptation of ARCHES for public and private family planning health systems in India.

Learn more about ARCHES in India

Problem: The 2008 Bolivia DHS found that 24% of ever married women had experienced physical or sexual IPV and 38% had ever experienced emotional IPV. Though RC has not been measured in Bolivia, it is thought to be a reason for low modern contraceptive use (38% in 2008 DHS).

Overview: Based on Ipas’s successful adaptation of ARCHES in Bangladesh and Ipas Bolivia’s success supporting the Ministry of Health in addressing sexual violence in public sector facilities, Ipas Bolivia will adapt ARCHES for use in public sector facilities in Bolivia.

Learn more about ARCHES in Bolivia

Problem: Almost 5% of ever partnered women and girls in Indonesia have experienced physical or sexual IPV (https://www.unfpa.org/GBV-dashboard/countries/ID). The government of Indonesia seeks to support women experiencing violence and improve quality of contraceptive care, including addressing provider coercion.

Overview: Based on Ipas’s successful adaptation of ARCHES in Bangladesh, Ipas Indonesia is adapting ARCHES for use in public sector facilities in Indonesia.

Learn more about ARCHES in Indonesia

Problem: The DRC DHS 2013-14 reported that among ever-married women, 57% have ever experienced IPV. The DRC also ranks 179th in the world (out of 191 countries) in the gender equality index, affecting every aspect of a woman’s life and livelihood, including her reproductive decision-making. 

Overview: Based on Ipas’s successful adaptation of ARCHES in Bangladesh, Ipas and Ipas DRC integrated information on RC and IPV (aligned with ARCHES content) into simple learning scenarios for users in the Nurse Nisa chatbot. Nurse Nisa is a WhatsApp-based chatbot designed to simulate a chat between a trained health provider and person seeking information. Nurse Nisa is programmed to address frequently asked questions about contraception and self-management of abortion with pills. Integrating ARCHES content into Nurse Nisa will bring information on RC and IPV to women who need it.

Learn more about ARCHES in the DRC