Addressing Alcohol Abuse Critical to Preventing Intimate Partner Violence in Cambodia
In 2014, Cambodia’s government endorsed its second National Action Plan for Violence Against Women—one of a handful of critical steps the country has taken recently in eliminating violence against women. While this is good news, the overall prevalence rate of intimate partner violence (IPV) in the last decade has changed little.
According to the Cambodia Demographic and Health Survey, the proportion of ever-married women aged 15-49 who have experienced physical violence once in their lifetime was 22.3 percent in 2005, and dropped only slightly to 21.1 percent in 2014. Similarly, for the prevalence rate in the preceding 12 months of each survey, the same reports indicate that it was 10.3 percent in 2005 and slightly decreased to 8.8 percent in 2014. The fact that the improvement rate remains so low has provoked discussions on how to deal with IPV issues, and suggests that it is time to take another look at the risk factors of IPV and how we think about prevention.
The Asia Foundation’s research in 2015 on contributing factors for IPV found alcohol abuse to be a significant risk factor in triggering IPV, both in frequency and severity. Despite the wide-ranging presence of international and local alcohol brands and products, Cambodia still has no enforceable minimum drinking age, no limitation on serving alcohol (not even to people who are already intoxicated), and no restrictions on alcohol advertising. In addition, alcohol is only modestly taxed in Cambodia, making manufactured products such as beer affordable to the general public.
As a first step to fill this policy vacuum, since March 2015 The Asia Foundation and local partners, Punleu Komar Kampuchea Organization (PKKO) and People Center for Development and Peace (PDP-C), have been implementing the Commune Alcohol Notification (CAN)—a system implemented voluntarily by the government authorities at the commune level with support from non-government organizations. Following a participatory process involving community members, the commune adopts a “commune alcohol notification” (CAN), a type of by-law that sets limits on the sale, consumption, and advertising of alcohol in the commune.
CAN uses a holistic, commune-wide approach involving activities to raise awareness of the harms associated with alcohol abuse (primary prevention) and to help people who abuse alcohol (and may commit IPV) change their behavior (secondary prevention). This includes community talks and meetings, an awareness campaign with door-to-door outreach, workshops, and a radio talk show. In each commune, a core group of people including commune and village leaders, teachers, health practitioners, peer educators, monks, alcohol abusers, and IPV victims and perpetrators receive alcohol-related education and in turn inform and support villagers. The CAN model is particularly cost-effective because it addresses alcohol abuse at the community level and also has the potential to prevent other social harms such as poverty, lack of education, child abuse, diseases, accidents, and other types of violence, and disrupt the intergenerational cycle of IPV.
Our preliminary studies in the two target provinces of Svay Rieng and Kratie found that the average quantity of beer consumption per person in the month prior to the baseline survey (and before CAN intervention) was 2.5 cans per time. After the CAN intervention, this figure dropped to 2.2 cans in the midline survey. For rice wine, this figure also reduced from 0.4 liter in the baseline survey to 0.2 liter per person in the midline survey. Our study also found that all four types of IPV incidents in the target communes had been reduced after the implementation of CAN. According to the baseline and midline surveys, the physical IPV rate in the preceding 12 months of the survey declined from 12 to 8 percent. The qualitative midline evaluation conducted in May 2016 also confirmed this drop. The data also indicates that decrease in IPV rate after the implementation of CAN is significantly higher than that of the decrease in the national rate of IPV.
These are all promising signs that CAN appears to be contributing to a reduction in alcohol abuse and IPV. Behind CAN lies the potential of a new way to approach prevention. Isolating significant correlations in prevalence data for different demographic groups offers the opportunity to identify specific risk and protective factors for each group. With these important identifiers—location, age, and income—the next step is then finding successful interventions that are already having impacts on these group. Ultimately, it is these individuals who are the core of any solution, where vulnerability and risk are transformed into opportunity and protection.
While we are optimistic, CAN is only a start. Sustaining the results of CAN will require broader integration of the initiative into the programs of sub-national governments. Such a move would certainly be strengthened by policy changes at the national level, in particular a law on alcohol control. While such a law may be years away, in the meantime we hope to learn more about the effectiveness and impact of CAN through its continued use and testing.
The Commune Alcohol Notification (CAN) system is supported by Australian Aid.
Sambath My is a program advisor for The Asia Foundation in Cambodia. The views and opinions expressed here are those of the individual author and not those of The Asia Foundation or its funders.
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