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Can co-designing interventions with affected communities help prevent violence against women? Findings from a process evaluation of the E le Saua le Alofa (“Love Shouldn’t Hurt”) pilot in Samoa

Mannell, Jenevieve; Lowe, Hattie; Tanielu, Helen; Hosea, Ene Isaako; Tevaga, Pepe; Apelu, Louisa; Fesili, Fa'afetai Alisi; (2026) Can co-designing interventions with affected communities help prevent violence against women? Findings from a process evaluation of the E le Saua le Alofa (“Love Shouldn’t Hurt”) pilot in Samoa. Health Policy and Planning , Article czag009. 10.1093/heapol/czag009. (In press). Green open access

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Abstract

There has been increasing interest in co-designing interventions with end users to prevent violence against women (VAW). Co-design is theorised as an ethical approach to research able to engage some of the most marginalised groups in VAW prevention. However, there is little evidence of whether co-designing interventions can reduce violence against women, or theoretical consideration of how it might do so. This paper contributes to current discussions about co-design by examining the results of the E le Saua le Alofa (“Love Shouldn’t Hurt”)—a pilot intervention that engaged Samoan communities in co-designing violence prevention activities. A mixed methods evaluation of the pilot has shown promising results, and in this paper we consider how the co-design process may have contributed to these results. The evaluation of the co-design process assessed four theorised mechanisms: (1) increased ownership of the problem of violence; (2) improved health behaviours and social norms; (3) relevance of actions taken to address VAW; (4) addressing power structures arising from coloniality. Our results show that change in violence outcomes occurred through the pilot’s ability to revisit previous conversations about violence in Samoa, prompting new activities by local leaders, and tightening village rules on violence. Yet, the activities implemented by local leaders were largely unpredictability and sometimes conflicted with global evidence. We argue that such actions should not be construed by policymakers as the ‘unpredictable outcomes’ of an intervention, but rather understood within a broader framework of diversified knowledge systems. The need for balance in co-designing VAW interventions with communities affected by violence highlights a key challenge of decolonising VAW practice within a co-production framework.

Type: Article
Title: Can co-designing interventions with affected communities help prevent violence against women? Findings from a process evaluation of the E le Saua le Alofa (“Love Shouldn’t Hurt”) pilot in Samoa
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/heapol/czag009
Publisher version: https://doi.org/10.1093/heapol/czag009
Language: English
Additional information: Copyright © The Author(s) 2026. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Co-production; violence against women prevention; interventions; mixed methods; pilot evaluation; Samoa
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10221304
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