Shared perceived causes of suicide among young men and violence against young women offer potential for co-designed solutions: intervention soft-modelling with fuzzy cognitive mapping

ABSTRACT

Violence against young women (VAW) and suicide among young men are serious concerns in Botswana and elsewhere. We examined the overlap in locally perceived causes of these two forms of violence in Botswana using the results from separate studies that used fuzzy cognitive mapping (FCM) to explore perceived causes of the two outcomes. FCM depicts perceived causes of an outcome and their links to the outcome and each other, with weights denoting the perceived strength of each link. The two studies engaged groups of young women, young men, older women, and older men in rural communities. We grouped related concepts into broader categories, then combined category maps for each outcome into a single map including both forms of violence. Based on social network analysis, we calculated the out-degree centrality of each category indicating its influence within the network. Intervention soft-modelling explored the effects of removing individual categories on suicide and VAW. Of 24 causal categories in the combined map, six were shared between both outcomes, 10 were for suicide only, and seven were for VAW only. The six shared categories accounted for 60% of cumulative influence of all categories in the combined map. The three most influential shared categories were financial difficulties, conflict in relationships, and parenting and family issues. Based on local perceptions, avoiding conflict in relationships could reduce suicide by 4.8% and VAW by 18.5%. Eliminating parenting and family issues could reduce suicide by 3% and VAW by 5.4%. Preventing financial difficulties could reduce suicide by 9.3% and VAW by 2.9%. The findings support the idea that some interventions might reduce both personal and interpersonal violence among youth. Analysis of stakeholder perceived causes and soft-modelling of potential interventions could inform community-led co-design of strategies to reduce youth suicide and violence against young women in Botswana.

KEYWORDS:

• Soft models
• violence against women
• suicide of young men
• Interpersonal violence
• fuzzy cognitive mapping

Acknowledgments

We thank the men and women who contributed their time and knowledge in the FCM sessions. The members of Participatory Research at McGill (PRAM) kindly participated in earlier discussions of our results and intervention soft-modelling.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data supporting this study’s findings are available with the publication.

Ethics review

This study is part of a Grand Challenges Canada project (Grant number R-ST-POC-1909–28463), which received ethical approval from the Botswana Ministry of Health under the Health Research and Development Division IRB (Reference HPDME 13/18/1).

Additional information

Funding

Grand Challenges Canada funded this work under Grant number R-ST-POC-1909-28463

Notes on contributors

Anne Cockcroft

Anne Cockcroft is a professor of family medicine in CIET-Participatory Research at McGill (PRAM) with a background in respiratory and occupational medicine. Over the last 25 years, she has undertaken large scale community-based participatory research projects in some 20 countries. She works with vulnerable populations to document their access to and experience of health and other services, and with service providers and policy makers to use evidence to develop equitable and effective services. In the last decade, her work has focussed on co-designing interventions, implementing them, and measuring the impact. Her current work includes participatory research to improve adolescent sexual and reproductive health and community responses to the impacts of COVID-19 pandemic in Bauchi State, Nigeria, and a study of community-based interventions to reduce youth personal and interpersonal violence in Botswana.

Ivan Sarmiento

Iván Sarmiento is an independent researcher at CIET, a member of the Groups of Studies in Traditional Health Systems, and the program administrator of Participatory Research @ McGill (PRAM). He has over two decades of experience collaborating with local and Indigenous groups in Colombia. His main interest is in promoting intercultural dialogue between Indigenous traditional medicine and Western medicine, particularly for primary health care. He has contributed to developing procedures for participatory modelling of health issues using fuzzy cognitive mapping, applying these methods in over 20 projects across eight countries.

Neil Andersson

Neil Andersson is a Professor of Family Medicine, director of the amalgamated CIET and Participatory Research at McGill (PRAM) and co-director of the McGill Institute of Human Development and Well-being. His main focus is on method development for large scale participatory approaches that address different health issues. He is particularly concerned about reproducible and culturally safe techniques to build stakeholder voices into systematic reviews, research conceptualization and co-design, intervention development, implementation and analysis. Dr. Andersson’s current interest is in community-led randomized trials of older adult participation in dementia prevention.