Daughters-in-law's perceptions and experiences with MILAP, a family-based intervention to reduce intimate partner violence and improve mental health in Nepal.

backgroundIntimate partner violence (IPV) and mental health (MH) issues among women in Nepal are deeply influenced by complex intergenerational family dynamics and power hierarchies. The traditional power hierarchies often place mothers-in-law (MILs) in authoritative roles over daughters-in-law (DILs), limiting the latter's autonomy and decision-making power. We designed a multi-component family intervention called MILAP to lower depression and address intimate partner violence by improving communication, promoting gender equity, and improving family relationships. This paper explores the perceptions and experiences of DILs who received the MILAP intervention.

methodsA total of 61 families participated in a pilot study of the MILAP intervention. Of these, 8 families (comprising triads of daughter-in-law, mother-in-law, and husband) were purposively selected for in-depth interviews (IDIs). All interviews were conducted immediately after the intervention and at the 6-month follow-up to assess MILAP's sustainability and impact. A thematic approach was used to analyze the data, utilizing Dedoose data management software.

resultsFour major themes were identified: (1) Enhanced communication within the family, (2) Strengthened DIL's empowerment, (3) Improved relationship quality, and (4) Increased DIL's freedom of movement. Participants reported improvement in communication among family members, particularly by using active listening skills which in turn contributed to conflict reduction and a more harmonious family environment. DILs experienced increased empowerment. They were more involved in family decision-making as the family unit adopted more equitable gender norms. The intervention strengthened spousal relationship improved MIL-DIL interactions, facilitated mutual understanding, and reduced household stress. Additionally, MILAP enabled DILs to move more freely outside the home. This increased mobility expanded their social networks, as DILs participated in community events, visited natal families, and accessed health services. However, some participants expressed concerns about the long-term sustainability of these changes, highlighting the need for continued reinforcement.

conclusionOur study underscores the importance of a family-based intervention in improving relationship quality and promoting autonomy among DILs experiencing IPV. The positive shifts perceived within families suggest promise for MILAP to strengthen support structures and address factors that may influence DIL's mental health. However, ongoing follow-up and reinforcement strategies are recommended to maintain the gains achieved from the intervention.