Feasibility and preliminary effectiveness of a combined intimate partner violence (IPV) and mental health intervention (WINGS+PM+) for women in informal settlements in Kenya.

Violence against women is a critical global health issue, with especially high prevalence rates in informal settlements in low-income countries. Over one billion people live in informal settlements. In Kenyan settlements, lifetime rates of intimate partner violence (IPV) reach up to 85%, and are closely linked to common mental health disorders. Despite urgent need, access to IPV and mental health services is scarce. Low-cost interventions like Problem Management Plus (PM+)-a World Health Organization intervention designed to reduce psychological distress-and Wings of Hope (WINGS)-a screening, brief intervention, and referral to treatment intervention-deliverable by non-specialists in healthcare and community settings could provide an effective strategy to address this need, but their combined effectiveness has not been tested. We conducted a pilot randomized controlled trial of an adapted, combined IPV and mental health intervention (WINGS + PM+) compared to PM + only among 260 women recruited from two public health clinics in Nairobi informal settlements. Screening, assessment, and intervention were facilitated by community health promoters. The feasibility trial achieved 93.5% retention at six months, excellent session completion, and nearly universal participant satisfaction, with no study-related adverse events. We also analyzed primary and secondary IPV and mental health outcomes, including depression, anxiety, and post-traumatic stress. Both intervention arms showed significant reductions in IPV and improvements in mental health over six months. Leveraging existing community health promoter and public health networks proved essential, underscoring the promise of scaling up these interventions to fill critical gaps in services in resource-limited settings.