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Greetings from the Stepping Stones team in London! We are pleased to bring you the fourth edition of our Stepping Stones Newsletter. By clicking on the underlined web links you will be able to access all relevant documents. In this issue we are focusing on gender violence.

1. Gender violence: A silent epidemic

  • Gender violence affects women of all social strata and in all countries around the world. 
  • A global study by WHO states that between 15% and 71% of women have experience physical and/or sexual violence by a partner
But violence does not just mean cuts and bruises. Violence comes in many different disguises. It can be mental, sexual, verbal or economic. Often people who experience these types of violence will not tell anyone else about it. A WHO report published in 2005, claims that, in some cases, up to two-thirds of women interviewed for a multi country study on domestic violence and women’s health had never told anyone about their partner’s violence prior to the interview (García-Moreno et al. WHO Multi-country Study on Women’s Health and Domestic Violence against Women).

a. What is gender violence?

Gender violence is often described as: "any act of violence that results in physical, sexual or psychological harm or suffering to women. This includes threats of such acts, coercion and deprivation of liberty in both public or in private life" (United Nations General Assembly, 1999 p.53).

But this definition does not go far enough: A recent report by Salamander Trust associates, Fiona Hale and Marijo Vasquez have highlighted how many problems currently referred to, as ‘stigma and discrimination’ would be better understood in the context of gender based violence. This includes a diverse array of concerns from sexual harassment at the work place - to the institutionalised violence of coerced sterilisation of women - to laws that prevent women from inheriting land. Such actions contravene the rights of all those involved.

 An illustration by Petra Röhr-Rouendaal. Taken from the Stepping Stones session "Chasing Away."

    “No one asked me [about sterilisation]. They got me ready and told me afterwards.”
 Woman living with HIV in the Dominican Republic. Quote taken from "Piecing it together for women and girls: The gender dimensions of HIV related stigma", 2011. 

b. Cultural Norms

"Beat your wife, if you don’t know why you’re beating her, she does!” (This is a well known, bad taste joke told about domestic violence)

In many countries, men are regarded as the bread winner, which brings them ‘ownership’ rights over all the women in the household. As a result violence is accepted and justified as being a fair and necessary way to ‘put things right’. It is therefore common to see a man beating his wife up in their home, parents physically disciplining their child and children beating each other up. Perceptions of violence vary from a culture to another.

Social violence against women can be observed in child marriage often leading to early and dangerous pregnancies; female circumcision, men’s harassment; predatory behaviours by ‘sugar daddies’; cultural female sexual submission to men (eg. in Malawi women are encouraged to say yes to any man who wants to have sex with them); sexual abuse of children; rape and social exclusion of women from education and from all sorts of activities leading to their own development.

Depending on the culture, these forms of violence are more or less socially accepted. In Central America for example, a major issue is men’s Machismo and the affirmation of one’s manhood through the ability to exert power over women in various ways. Machismo starts from a young age and leads many girls to being coerced into sexual intercourse and being abandoned when pregnant. Physical violence and lack of verbal communication are also common in the homes and encourage the expression of oneself through violence.

c. Why is violence directed at women?

"What do you tell a woman who has two black eyes? – Nothing, she’s already been told twice!”
(This is a common joke in the UK and France. It reflects the attitudes that still surround violence toward women.)

The main reason that women are the principally affected by violence is due to gender inequality rooted in cultural and social norms. Gender inequality means that women lack the power to negotiate with men on an equal footing. Gender inequality is both a cause and a consequence of violence.

However, gender violence doesn't only affect a man and woman, but also children. If children see gender violence taking place they can often grow up to assume that this is the way that men and women should behave. Also, if women are being treated badly by others, they can sometimes take out their understandable anger on their children. Thus there are frequently cycles of violence which spread across generations where gender violence is present.

---> The Centre for Reproductive Health has produced a report investigating the global abuse of women's reproductive rights. Click here to read it (2010).

Click here to read an article from The Guardian Newspaper about coerced sterilisation in Namibia (22/09/09)

d. What is the connection between HIV and gender violence?

The relationship between HIV and violence against women is complex. The two epidemics affect each other, directly and indirectly, as part of an intricate network of causes and consequences. However, the importance of these connections is often overlooked. This means that more research still needs to be done to understand how they correlate. As a basic starting point, it is useful to state that gender inequality pervades both problems.

Gender-based violence has been identified as a significant driver of HIV infection. Research by London School of Hygiene and Tropical Medicine and WHO has shown that women who experience gender based violence have a significantly increased vulnerability to HIV (2005).

Another report which addresses the violence experienced by women once they have learned that they have HIV is entitled “Violence Against Women Living with HIV/AIDS:A Background Paper.” This was written by Fiona Hale and Marijo Vasquez, with input from Stepping Stones’ founder Alice Welbourn. Together they have proposed the following definition to define Violence Against Women Living With HIV
“Violence against positive women is any act, structure or process in which power is exerted in such a way as to cause physical, sexual, psychological, financial or legal harm to women living with HIV.”
Lets look at some examples of ways in which the two problems overlap around the central issue of gender inequality:
  •        Gender inequality means that women lack the power to negotiate with men on an equal footing.
Example: This is especially relevant when negotiating sexual relations and the use of condoms. This might mean that women may be unable to protect themselves from engaging in unprotected sex. Also they might feel unable ask their partner about his extra-marital sexual activities even if they suspect something.
  • Cultural norms may accept violence against a woman as acceptable (e.g. as legitimate means for a man to punish his wife/daughter/sister)
Example: Women often suffer mental and physical violence from a partner or from the community as a result of disclosing her HIV status.
  • Institutional failures of health and judicial systems to address the specific needs of women.
Example: Violation of confidentiality regulations during HIV treatment. Some women may suffer aggressive/discriminatory treatment if their HIV status is known. 
  • Women suffer disproportionately from HIV-related stigma.       
Example:This stigma can be present in all areas of life. In social settings for example, this stigma can impact on a woman and girl’s ability to participate in family and community life. Women may be afraid to seek medical help or to talk about their HIV status because of repercussions such as verbal and physical violence.

According to research carried out in Ethiopia, more women than men had been physically assaulted in relation to their HIV    status.Among them, about a quarter had been assaulted by their husbands/partners

("Piecing it together for women and girls: The gender dimensions of HIV related stigma",2011, p.25).

Criminalisation of HIV is harmful to women!                                        
Read 10 Reasons why criminalisation of HIV exposure or transmission harms women to understand why criminalisation is targeting the wrong people & increasing the stigma attached HIV.          

e. An Integrated approach to gender violence and HIV/AIDS
Some programmes, including Stepping Stones, have attempted to work with initiatives that can tackle both the various forms of violence and the sensitive issues surrounding HIV.

Click on this link to read a report done by the World Health Organisation (WHO) and United Nations Programme on HIV/AIDS (UNAIDS) called "Addressing violence against women and HIV/AIDS: What works?" Stepping Stones is featured as a case study. 

"[Stepping Stones] is the only intervention with men outside of North America to show a decrease of reported male perpetration of violence."
(Addressing violence against women and HIV/AIDS: What works?, WHO, page. 15)


An image from the Stepping Stones manual called "men supporting sexual partners"  Illustrated by Petra Röhr-Rouendaal

Stepping Stones is designed to be flexible in order to be adapted to the specific cultural contexts at hand at any time. In order to achieve this, Stepping Stones training "must properly rooted in local understandings of sex, sexual behaviour, gender and family relationships, age hierarchies, and cultural beliefs and practices" ("Evaluating Stepping Stones", ActionAid International, 2006, p.6).

If your organisation is interested in developing an integrated strategy then you could look at these papers to help understand what changes you could make to help combat gender based violence and HIV:

Development Connections: A Manual for Integrating the Programmes and Services of HIV and Violence Against Women

By Dinys Luciano Ferdinand. Click here to read online

Violence against Women Living with HIV/AIDS: A background paper
By Fiona Hale and Marijo Vazquez. Click here to read online.

Fiona Hale and Marijo Vazquez list traits that they believe are important to a successful integrated approach to addressing violence against women and HIV.

  • They promote community dialogue to foster common reflection and deeper understandings of the root causes of violence, based on people’s own experiences.
  • They encourage communities to find their own best response to address the specific situation in each context.
  • They value the development of links with other organisations and projects, which are working for social change, to share approaches and learn from each other.
  • They are adaptable to different realities, because they are led by community- defined priorities and needs.
  • They have confidence in the capacity of communities.
  • They focus on highlighting strengths before addressing problems and needs.
  • They involve the whole community, or as much of it as possible.
  • The methodology is participatory in the broadest possible way, not just at specific points in the project.

2. Using Stepping Stones to help combat Gender based violence!

a. WHY? 

Although the original manual does not have explicit sessions on gender violence, the whole methodology is directed at exposing and working with the intricate and underlying issues that can lead to gender violence.
Stepping Stones seeks to overcome the issues that perpetuate gender violence by opening a dialogue between community members. This is because the Stepping Stones programme is based on the principle that change needs to happen at a social level, rather than just an individual level. Click here to find more information about how the Stepping Stones methodology works.

Stepping Stones addresses:
  • Gender Inequality
  • Conflict Resolution through improved communication
  • Engagement of the whole community, and particularly of men, into the various discussions and issues that affect them and the women around them
  • Inclusion of people living with HIV
In India and South Asia, Stepping Stones is being used to address issues around the dowry system, alcohol consumption, the lower priority given to educating women in rural communities and entrenched gender roles which result in women being extremely controlled. Stepping Stones is also used in Russia and Eastern Europe to combat the wide use of  drugs and the stigma attached to it, poverty and the lack of job opportunities that lead many women into sex work. The extreme isolation that many women endure because of stigma relating to these issues also represents another form of violence against women. 

*** We know many of you have your own experiences of using Stepping Stones to address issues of gender violence. We would love to hear about your experiences to help us to understand how Stepping Stones is being used around the world. Please get in contact at ***


"After being found HIV-positive, my husband left me. But after attending the Stepping Stones training, my husband decided to go for HIV testing and counselling, a thing that he vehemently refused to do in the past. His results revealed that he was HIV-positive. The training helped him to rediscover himself and he apologized for leaving me. My husband and I are now back together and happily married again with no incidents of violence because we are able to communicate better as a couple and respect each other’s rights.”

This is a quote by Enita Jailosi. Now Enita and her husband help other couples who are going through similar experiences.This quote is taken from a recent UNAIDS and ATHENA publication called, "Community innovations: Achieving sexual and reproductive health and rights for women and girls through the HIV response". This quote demonstrates how Stepping Stones can improve communication to help change attitudes between sexes.

Health interventions that are designed to reduce gender violence are notoriously difficult to evaluate but it is still necessary to carry out monitoring on these shemes to ensure they are working. There have been several recent attempts to evaluate the progress of Stepping Stones in this area. Stepping Stones is listed by WHO and by USAID as one of a few select community based programmes which has been reduced gender based violence. Here are three reports which all mention the work of Stepping Stones' work in relation to gender violence;
  1. Addressing violence against women and HIV/AIDS: What Works?, World Health Organisation, 2010
  2. Preventing intimate partner and sexual violence against women, World Health Organisation, 2010
  3. Gender based violence and HIV: Technical Brief, UNAIDS ,2010
Here Olive Edwards highlights how violence against women can be seen as normal aspect of life until a new awareness takes place through increased communication, understanding and education.

"For many when we first talked about gender based violence I thought it was just that women were not comfortable with talking because it would entail admitting to abuse. However when we introduced the research  on gender based violence and the paper by Fiona and Marijo at the start of the e-consults ... women admitted that they had not thought about it.They have had to learn survive like this or face having other women label them as man haters for not accepting the norm."

Stepping Stones helps us to investigate why we behave in the ways we do, how gender, generation and other issues can influence us, and empowers us to change our behaviour, if we want to. 

Another evaluation, this time conducted by ActionAid International, is named "Evaluation Stepping Stones: A review of existing evaluations and ideas for future monitoring & evaluation work." This report concluded that the main impact that Stepping Stones has on gender relations is an increased respect for women, including self-respect and reductions in gender violence. However, the also report noted that more traditional patterns of female subordination in relation to decision making and control over resources remained virtually unchanged.

Although Stepping Stones has been very successful facilitating communication, it is important to remember that Stepping Stones alone may not change attitudes towards gender, especially if they are deeply embedded in people cultural and religious beliefs. One Coalition which has been pro-active in overcoming the shortfalls in Stepping Stones' approach is the coalition of women living with HIV/AIDS in Malawi (COWLHA).

The integration of community leaders with Stepping Stones methodology in Malawi.

The coalition of women living with HIV/AIDS (COWLHA) in Malawi adopted Stepping Stones methodology "to challenge gender inequality through effective communication." However, in addition to this, they enlisted the support of traditional leaders within their community. By fostering a dialogue between support groups and community leaders, the women were able to strengthen their leadership roles and decision making. They organised collective meetings with the community and searched together for solutions to the discrimination, stigma and violence faced by women living with HIV. This joint approach issues has been very successful.

"Community leaders’ involvement has led to a reduction in HIV-related stigma and discrimination as evidenced by the increase in the number of people disclosing their HIV status publicly & the swelling of support group numbers. Finally, community dialogue meetings have emerged as a forum for challenging previously accepted gender norms."

Quote taken from "Women living with HIV building community engagement in Malawi: challenging gender norms to address violence against women" (2011) Community Innovation: Achieving sexual and reproductive health and rights for women and girls through the HIV response, page. 24-26.


Albert Ceralala, a Stepping Stones trainer from the Pacific, tells us how Stepping Stones is being used there to tackle Violence against Women.

Out with Violence in the Pacific: One Step at a time

Beneath the images of a turquoise, picturesque Pacific lays a reality that is unseen to many. Often promoted as a region that is unmatched for its beauty, friendliness and peaceful characteristics, a stark reality exists in many homes and communities. It is believed that anywhere between 17 – 66 percent of women and children across Pacific countries experience some form of serious physical, sexual and emotional abuse and violence, annually. Over 90 percent of perpetrators are men, often a relative. Thus, intervention programs that target men and boys in reducing gender based violence (GBV) and Violence Against Women and Girls (VAWG) have become increasingly important in this struggle in the Pacific.
The Stepping Stones program is an innovative communication package introduced into the Pacific that takes on such a challenge. Initially piloted in Fiji and the Solomon Islands by the Pacific Region HIV/AIDS Program (PRHP) in 2007, the program evolved and extended its reach via the Regional Health Programme at the (FSPI) from 2009. Since then, a number of relevant initiatives have been implemented within the Stepping Stones Program with useful partnerships formed, successes gained and lessons learned. They include projects such as ‘Linking HIV and Gender Inequity’ with particular emphasis on roles men and boys have in addressing gender inequity in Fiji and a regional initiative on HIV/AIDS workplace policy. Key opportunities that increased the capacity of Stepping Stones Programme Officer (Leaine Robinson) and male advocates (Tura Lewai and I) included participation in the Global Symposium on Engaging Men and boys to prevent Gender-Based Violence in 2009; Co-facilitating a participatory presentation on Youths and GBV at the 2009 Pacific Youth Festival; Joint facilitation exercise with UNDP Partners for Prevention – FSPI ‘Gender-Based Violence’ Pacific mapping exercise and participation at the UN Partners for Prevention South East Asia Regional Consultation in 2009; and exposure to the Fiji Womens Crisis Centre (FWCC) Regional Human Rights training in 2010 and on-going involvement in their Male Advocacy Program.

Aside from the successful roll out of the Stepping Stones 2-week trainings in a number of countries, key highlights of its success has been the use of drama and creative arts as vehicles for challenging common misconceptions about the justification of violence in Pacific homes and communities. Two scripts (On Rape and Domestic Violence) for theatre were developed and performed in a number of national and regional retreats and selected stakeholder gatherings. The drama performances, by far, have made some of the most significant impacts in changing male participants own personal attitudes and behaviours towards women and girls. ‘Responsible Fatherhood’ photography and Acapella Singing competitions as part of the 16-days of activism against Violence Against Women in 2009 and 2010 respectively, have also promoted the role Pacific men and boys can have in preventing gender based violence
Whilst the Stepping Stones Program has made in-roads in the Pacific in addressing gender based violence, many lessons have been learned along the way. The first hurdle that men and boys must overcome before taking on initiatives that address all forms of violence begins on a personal level. An influential advocate for womens issues in the region says, ‘personal is political’. You have to believe and practice what you preach in order for your message to be accepted and effective. Secondly, the role of relationships and partnerships cannot be under-estimated in addressing violence. Families, communities, other like-minded NGOs and groups, policy-makers and even donors all play pivotal roles in assisting to prevent further violence against women and girls. Thirdly, preparation proves a vital ingredient in responding to GBV arguments and justifications. Whilst tradition and religious beliefs and practices are often used as justification for some forms of violence in the Pacific, Stepping Stones facilitators must be courageous enough to challenge what is quite often an intimidating audience of religious leaders.

For more information about any of the issues raised here, contact Albert Cerelala at

In Fiji, Violence remains a huge problem for many Fijian women. Whats more, tolerance of domestic violence within Fiji is still high and social and cultural factors play a leading role in maintaining this situation. Stepping Stones has been adopted and adapted by the Foundation of the Peoples of the South Pacific International (FSPI) to try to confront theses important issues of violence. For example, the FSPI has adapted the Stepping Stones manual to include a specific session on 'gender violence within the home.' 
Below are testimonials taken from an evaluation done to measure the effectiveness of Stepping Stones workshops in Fiji at changing attitudes towards HIV, violence, gender and male/female communication. The evaluation shows a change in attitudes (in both male and female) towards violence. Before the workshop, as part of a pre-assessment done in Sasa village, it was shown that men ‘partially agreed’ with the flowing statement, ‘a woman should tolerate violence in order to keep her family together’. A post-assessment with the same men found that all of the men now disagreed with this statement. Click here to read the evaluation in full. An even more dramatic attitudinal change can be seen in the views of men about women who carry condoms. In a pre-assessment, the men of the workshop "agreed" that women that carry condoms are "easy". In the post-assessment, they "disagreed" with the same statement, having reformed their attitudes.

Here are some more testimonials taken from women involved in the workshops:
 Older female (42yrs) Stepping Stones participant, Waikubukubu village, Fiji
“Before Stepping Stones I wondered if my husband ever had sex with other women, but I would never ask him about this. I just thought that was something that men did and having sex with other women was something that you should tolerate for your family. After talking with the other women during Stepping Stones, we all thought that way and it was good to listen to how they felt. We were all scared about it and decided that we should not tolerate it from our husbands. We all decided to talk with our husbands about it and tell them they weren’t allowed to have sex with other women”
Older female (37 yrs) Stepping Stones participant and later Stepping Stones facilitator, Waikubukubu village Fiji

“Before Stepping Stones, I thought that my husband leaving me was my fault and I was ashamed and thought that everyone in my village thought I was not a good wife or mother. I didn’t like living in my community and I would not be involved in community activities.  After Stepping Stones and talking openly about taboo topics such as sex and relationships, I found out that many young women have problems like mine. It has made me feel less alone and being an Stepping Stones trainer, I can share my new knowledge and help other young women through their relationship problems. Women don’t get much power in Fiji and Stepping Stones and the other women gave me confidence.”

              Boys in Fiji doing the Body Mapping exercise.



Isimeli is a married man, living and working in Fiji. Last year he participated in a Stepping Stones workshop. Here he records how the experience affected his relationship with his
wife and children and his attitude towards Violence against Women

Isimeli's Story: My Future, My Family

When my married life started I have always been very tough on my wife, we would fight a lot and when I got angry on her I would sometimes hit her just so she knows where she stands (I wouldn’t hit her hard… just to remind her of her place) And I would use the bible to justify my actions. I am always tough on my wife, if she doesn’t listen to me I would make sure she knows how I feel about it.My wife & I have 2 children a boy aged 4 years and a girl aged 1.  When I decided to come and attend the sessions my wife supported me throughout      
the whole time. When I go back home she would ask me to sit with her and discuss about the sessions and the topics.My turning point was the Gender Violence session. It was such an eye opener for me. I finally realized how I have been mistreating my wife and how she must be broken hearted by the way I have treated her ever since we got married. At first I was sorry and felt very guilty, I sit many times when I’m alone and think of all the bad words that I throw at her when I’m angry and how she would just take it without saying anything in response (it hurts to think about it) but I also realized because I was not informed on Gender Violence issues I was not aware of what I was doing was hurting my wife. That same evening when I got home, she had just finished feeding the children and was putting them to bed. I decided to help her and when the house was quiet and we were alone. I took her hands and gave her a very genuine apology straight from my heart for all the bad things I had done to her and that if I had hurt her feelings in any way for her to find it in her heart to forgive me. My wife cried, I know they were not tears of sadness but of joy for I know that that night was a new beginning in our relationship.
Things have changed in my home. I am a helper to my wife, when we have issues we sit as a couple and discuss it and try and find solutions.
As a father my thoughts are now with my children. I don’t want them to grow up with the kind of life I had. I was fortunate to have participated in the sessions if not my life wouldn’t have changed. Now I have promised my wife that our son will grow up with the same teachings and knowledge that I have learnt from Leba and her team. To love, respect and value women and his family. You know I thought to myself if the married men of Matata had gone through the same sessions, our area would have a big change and in turn our children would probably turn out better as well. Because I believe that everything is linked from community to parents and their children.


Stepping Stones Plus is a supplement to the original workshop manual. It addresses the complex issues of gender violence in even greater depth than the original manual. Strategies for Hope publishes Stepping Stones manuals and then TALC distributes them all over the globe. Read more about it by clicking on the blue link above.



I hope you have enjoyed this newsletter. Please forward it to anyone you know that might be interested.
If you have any feedback or if you would like to contribute to future newsletters then please contact me at nell@steppingstonesfeedback.
Or visit the Stepping Stones website, which is packed with useful resources and can be found at 

Best Wishes,
Nell Osborne
(Communications Assistant)
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