Logo UNICEF Innocenti
Office of Research-Innocenti
menu icon

Evidence for Action Blog

61 - 72 of 170
Raquel López lava la ropa con agua
Blog

¿Son sensibles al género las transferencias monetarias en América Latina?

La división de tareas de cuidado infantil entre madres y padres es desigual incluso en aquellos países donde la perspectiva de género es la principal motivación en el diseño de la política. Por ello, necesitamos preguntarnos: ¿Estamos haciendo lo suficiente para promover la igualdad de género? ¿Cómo las políticas sociales podrían diseñarse mejor para contribuir al cierre de la brecha de género y promover el empoderamiento de mujeres y niñas? ¿De qué manera las políticas sociales pueden incluir en su diseño las necesidades específicas de mujeres y niñas?Recientemente me uní a un equipo de expertos en UNICEF Innocenti para buscar respuestas a estas preguntas, analizando los componentes de género de programas de protección social (PPS) destinados a niñas, niños y a sus hogares. Para llevar a cabo esta labor, analizamos documentos programáticos y reportes de gobiernos, ministerios y otros actores relevantes a nivel nacional e internacional. Utilizando este enfoque, examinamos la medida en que los PPS incorporan el género desde una perspectiva legal. Es importante mencionar que esta metodología no nos permite analizar la cobertura efectiva de los programas, es decir, la implementación de las leyes y políticas seleccionadas. No obstante, evaluar la cobertura legal es fundamental para comprender el PPS en su totalidad, el grado en el que el género se refleja en sus características de diseño y el grado de compromiso del Estado con la igualdad de género en general.En este trabajo, analizamos si los programas seleccionados son sensibles al género utilizando cuatro dimensiones:Marcos legales y políticos en los que está integrado el PPS.Riesgos y desigualdades estructurales abordados en los objetivos del programa.Mecanismos de diseño y entrega, incluidas las condicionalidades.Mecanismos de gobernanza, seguimiento y evaluación.Si bien esta investigación abarca varias regiones y países, en este reporte me enfocaré principalmente en los programas de transferencias monetarias condicionadas (PTMC) en nueve países de América Latina. Los PTMC son pagos en efectivo destinados a personas en situación de pobreza en los que se imponen ciertas condiciones para el cobro del beneficio. Este tipo de protección social es popular en la región, y tiene como objetivo aliviar la pobreza a corto plazo y mejorar la salud y la educación de las niñas y niños, a fin de romper el ciclo intergeneracional de la pobreza en el largo plazo.Agustina Vargas de Esteban, sonriendo, lava platos en el fregadero de la cocina de su casa en el Distrito 7, uno de los barrios más pobres de la ciudad de El Alto, cerca de La Paz, la capital de Bolivia.Algunos hallazgos preliminares¿Los objetivos y los métodos de focalización son sensibles al género?La mayoría de los programas analizados buscan abordar de manera específica la pobreza infantil y a menudo designan a las madres como receptoras principales del PTMC, asumiendo que ellas destinan relativamente más dinero a las necesidades de sus hijas e hijos en comparación con los padres. Algunos programas, como el de Bolivia, tienen el objetivo explícito de brindar cobertura a individuos y hogares que no están cubiertos por ningún otro PPS. Otros programas consideran riesgos y vulnerabilidades, como discapacidades y diversidad de identidades étnico-raciales, y diseñan los programas en consecuencia.Los hallazgos de la investigación realizada sugieren que los métodos de focalización de estos programas no serían sensibles al género. El hecho de que las madres sean quienes reciben la transferencia no los hace receptivos de las necesidades específicas de las mujeres, por el contrario, solo refuerza las expectativas de género hacia ellas, entendidas como principales responsables del cuidado.¿Las condicionalidades y sanciones generan más carga para las mujeres?Las condicionalidades generan mucho debate: las principales críticas cuestionan la imposición de sanciones ante su incumplimiento, y consideran que las mismas asumen que las personas pobres no saben qué es lo mejor para sus hijas/os. Asimismo, la responsabilidad de cumplir con las condiciones impuestas por el programa a menudo recae en las mujeres, generando esto una carga adicional para ellas, mientras que los padres generalmente están ausentes en el diseño de estos PTMC (Cookson, 2018; Molyneux, 2006).En los programas analizados en este trabajo, la mayoría de las condicionalidades están relacionadas con la atención médica y la educación, exigiendo controles médicos obligatorios o determinado porcentaje de asistencia escolar. El incumplimiento de estas condiciones conlleva sanciones o medidas punitivas que resultan en la terminación de la transferencia monetaria inmediatamente (en el caso de Argentina, Bolivia, Chile, Colombia y Uruguay) o gradualmente (en Brasil, Ecuador y Perú).Dado que las madres son las principales receptoras de estos beneficios en la mayoría de los programas, los hallazgos de este trabajo parecen sugerir que las condicionalidades y las sanciones podrían sumar una responsabilidad mayor sobre las mujeres. Después de todo, ellas son las que deben asegurarse de cumplir con los requisitos del programa, más allá de la oferta de servicios de salud y educación que haya disponible.Patrones en la programación de protección social sensible al género en nueve países de América Latina ¿Las características de diseño y entrega del programa tienen en cuenta las desigualdades, riesgos y dinámicas de género?Tres programas (Argentina, Chile y Paraguay) reconocen que las mujeres enfrentan mayores riesgos de pobreza y generalmente tienen menos acceso a recursos, tales como tierra o capital. Como consecuencia de esto, estos programas designan a las mujeres en situación de pobreza como las principales beneficiarias. Solo el programa de Argentina reconoce que el cuidado y el trabajo doméstico no remunerado son realizados principalmente por mujeres, señalando que la asistencia escolar y la mejora de la salud de las niñas y niños ampliarían las posibilidades de que las madres busquen trabajo o se desempeñen mejor en la ocupación que ya poseen.Solo dos países (Argentina y Bolivia) ofrecen cobertura para trabajadoras y trabajadores informales, incluyendo trabajadoras/es domésticas/os, desempleadas/os, contribuyentes solteras/os o sin seguro médico. Esto es crítico considerando el alto nivel de informalidad en el mercado laboral en estos países: 77.7% en Bolivia y 48.1% en Argentina en 2018 (ILOSTAT, 2019). Si bien no parece haber una diferencia significativa en el empleo informal de mujeres y hombres en Argentina, este no es el caso en Bolivia, donde el empleo informal es del 80.2% para las mujeres y del 75.5% para los hombres en 2018 (Banco Mundial, 2019).¿Se integra el género en los mecanismos de gobernanza, seguimiento y evaluación del programa?Los mecanismos de monitoreo y gobernanza ayudan a garantizar una programación efectiva, una cobertura adecuada y dan voz a las destinatarias/os del programa. En nuestro estudio, la mayoría de los PPS incluyen alguna forma de reclamo o retroalimentación que informa la evaluación y el rediseño de los programas. Además, en los PPS de Argentina, Brasil, Perú y Uruguay, los mecanismos de monitoreo y evaluación utilizan datos estadísticos desagregados por sexo y edad para hacer el seguimiento del mismo. Sin embargo, en la mayoría de los PTMC parecen faltar indicadores específicos de género, como por ejemplo referidos a los roles de género y al empoderamiento de mujeres y niñas.Los sistemas de gobernanza que incorporan la participación de mujeres ayudan a garantizar que ellas puedan plantear inquietudes y formen parte de la gestión del programa. En Paraguay, las mujeres son elegidas como “lideresas” por otras destinatarias, para crear grupos dentro de la comunidad y actuar como portavoces entre las usuarias e implementadoras/es del PPS. En Perú, las madres líderes ayudan a capacitar a las madres receptoras del beneficio en temas de salud y educación, las alientan a cumplir con las condiciones del programa y actúan como un punto de contacto entre las beneficiarias y gerentes locales. No se han encontrado datos sobre mecanismos de gobernanza para el resto de los programas seleccionados.Próximos pasosEsta investigación es un avance importante para comprender de qué modo se consideran las necesidades específicas de mujeres y niñas en el diseño de los PTMC latinoamericanos. Aunque la cobertura legal nos proporciona una visión general de estos programas, es necesario continuar explorando estos temas para determinar cómo la protección social afecta a mujeres y niñas en la práctica, reforzando los roles tradicionales de género o aumentando su empoderamiento. Además, es importante indagar con mayor profundidad cómo impactan estos programas en los hombres y diversas estructuras domésticas, como parejas del mismo género u hogares LGBTQ+ en general. Esto podría ayudar a cerrar la brecha de evidencia y llevarnos hacia PPS más sensibles al género. Constanza Ginestra se unió a la Oficina de Investigación de UNICEF - Innocenti en mayo de 2019 para trabajar con nuestro equipo en un análisis de género sobre programas de protección social dirigidos a niñas y niños en países de bajos y medianos ingresos, centrándose en América Latina. Aquí, Constanza relata algunos resultados preliminares de la investigación realizada. Para obtener más información sobre el proyecto GRASSP de UNICEF Innocenti, consulte aquí.
Are cash transfers in Latin America gender-sensitive?
Blog

Are cash transfers in Latin America gender-sensitive?

Even in countries where gender equality is a main driver in policy design, the division of childcare among parents is unequal. We need to ask some important questions: Are we doing enough to promote gender equality? How can social policies be better designed to close the gender gap and empower all women and girls? How can social policies include women’s specific needs? I recently joined a team of experts at UNICEF Innocenti to try to answer these questions by analysing the gender aspects of cash transfer programmes targeted at children and their households. We analysed programmatic documents and reports from governments, ministries and other stakeholders at the national and international level to review the extent to which social protection programmes incorporate gender from a legal and policy perspective. However, this method does not allow us to examine effective coverage, or actual implementation of laws and policies. Nonetheless, assessing legal coverage is critical to understand the overall social protection programme, the extent to which gender is reflected in its design features, and the State’s degree of commitment towards gender equality in general. Using four dimensions, we explored whether the selected social protection programmes are gender-sensitive: Legal and policy frameworks into which the social protection programme is embeddedRisks and structural inequalities addressed in the programme objectivesDesign and delivery mechanisms, including conditionalitiesGovernance, monitoring, and evaluation mechanismsWhile the research is cross-regional and cross-country, in this blog, I will focus on preliminary findings for conditional cash transfers (CCTs) in nine countries in Latin America. CCTs are cash payments given to poor people when they meet certain conditions. This type of social protection is popular in the region and aims to alleviate poverty in the short term while improving children’s health and education in order to break the intergenerational cycle of poverty in the long term. Agustina Vargas de Esteban, smiling, washes dishes in the kitchen sink, at home in District 7, one of the poorest neighbourhoods in the city of El Alto, near La Paz, the capital of Bolivia.Some preliminary findingsAre programme objectives and targeting gender-sensitive? Most programmes look to address child poverty and often assign mothers as recipients of the cash transfer, with the assumption that they spend relatively more on their children's needs compared to male caregivers. Some programmes, such as in Bolivia, have the explicit objective of targeting people who are not covered by any other social protection programme. Others consider intersecting risks and vulnerabilities, such as disabilities and ethnic monitoring, and target programmes accordingly. Overall, the research suggests that targeting methods are not gender-sensitive. Assigning mothers as the transfer recipient does not make the programmes responsive to women’s specific needs. On the contrary, it reinforces gender expectations for mothers as main carers. Do conditionalities and sanctions add more burden on women? Conditionalities are contentious—many critics are opposed to sanctions for not meeting conditions and feel that conditions imply that poor people do not know what is best for their children. The responsibility of meeting conditionalities often falls on women, creating an extra burden for them, while fathers are usually absent in the design of CCTs (Cookson, 2018; Molyneux, 2006). In this study, most conditionalities are related to healthcare and education, such as mandatory medical check-ups or school attendance. Non-compliance of these conditions lead to sanctions or punitive measures resulting in the termination of the cash transfer immediately (Argentina, Bolivia, Chile, Colombia, Uruguay) or gradually (Brazil, Ecuador, Peru). Since mothers are the recipients of these benefits in most programmes, conditionalities and sanctions can risk putting more burden on women who must meet conditions regardless of the availability of health and education services. Patterns in gender-sensitive social protection programming in nine countries in Latin America.Are design and delivery features based on gender risks, inequalities, and dynamics? Three programmes (Argentina, Chile, Paraguay) recognise that women face a greater risk of poverty and have generally less access to resources, such as land or capital. In light of this, these programmes assign women as transfer recipients. Only Argentina’s programme acknowledges that unpaid care and domestic work are primarily carried out by women, highlighting that school attendance and improved children’s health broaden the possibilities for mothers to look for work or perform better in their jobs. Only two countries (Argentina, Bolivia) include coverage for informal workers, including domestic workers, unemployed people, single taxpayers, or those without health insurance. This is critical considering the high level of informality in the labour market in these countries: 77,7% in Bolivia and 48,1% in Argentina (ILOSTAT, 2019). While there is no significant difference between female and male informal employment in Argentina, in Bolivia informal employment is 80,2% for women and 75,5% for men (World Bank, 2019). Is gender integrated into governance, monitoring, and evaluation? Monitoring and evaluation mechanisms help ensure effective programming, including adequate coverage and giving a voice to recipients. In our study, most programmes include some form of grievance or feedback mechanism that informs policy assessment and reform. In Argentina, Brazil, Peru, and Uruguay, the monitoring and evaluation frameworks use sex and age-disaggregated data. However, there is a lack of gender-specific indicators, such as gender norms and women’s empowerment, in most of the cash transfer programmes. Governance systems that integrate women’s participation help ensure that women raise concerns and are part of the programme management. In Paraguay, women are elected as leaders (lideresas) by other recipients, to create groups within the community and act as a spokesperson between the users and the programme implementers. In Peru, the lead mothers (madres líderes) help train recipient mothers in health and education issues, encourage them to meet the programme conditions, and act as a point of contact between the recipients and the local managers. For the rest of the countries, no data was found on governance mechanisms. What’s next? This research is an important step towards understanding how women and girls’ needs are considered in the design of Latin American CCTs. Although legal coverage provides us with an overall picture of these programmes, future research is needed to determine how social protection affects women and girls in practice, including reinforcing traditional gender roles or increasing empowerment.  Furthermore, research on men or diverse household structures, such as same-sex couples or LGBTQ+ households in general, could help close the evidence gap and lead us towards more gender equal social protection.   Constanza Ginestra joined the UNICEF Innocenti as an intern in May 2019 to work with our team on a gender analysis of social protection programmes targeted to children in low- and middle-income countries, focusing on Latin America. Here, Constanza summarises some preliminary results of the research. For further information on UNICEF Innocenti’s GRASSP project, see here.
Can social protection be a driver of gender equality?
Blog

Can social protection be a driver of gender equality?

Social protection programmes have proven to be effective in fighting poverty in various dimensions, but the question remains as to how these same instruments can address other drivers of vulnerability, like gender inequality. Girls and women living in poverty face additional barriers which men and boys do not, driven by conservative social and gender norms and limited access to education and the workforce. As UNICEF Innocenti embarks on its new five-year research programme to begin to answer questions on gender-responsive and age sensitive social protection (GRASSP), we asked researchers and practitioners in the fields of gender and social protection to weigh in on research priorities. We received survey responses from 76 experts around the globe, from both the academic and policy-making spheres. They emphasized key evidence gaps and challenges relating to the gender-responsiveness of different types of social protection. Below, we highlight some of the key takeaways from the survey. "Measure impact by sex and age” While there is limited evidence on the topic, respondents praised the rigour and quality of emerging research and initiatives. A crucial challenge to building the evidence base is the lack of sex- and age-disaggregated data from programmes. Without this, identifying the social protection policies that aid women’s empowerment and lead to gender-equality is no more than an educated guess. "Optimise evaluations to pinpoint key mechanisms of change”Respondents mentioned the lack of a well-constructed and detailed theory of change. Conducting more complex evaluations can aid learning, while using qualitative methods can better contextualise and help bridge gaps, particularly as results on gender-related outcomes are often mixed. Holding her young child in her arms, a woman uses jerrycans to collect filtered chlorinated water for drinking purpose from a UNICEF supported water point outside village Sami Mahmood Hamid in Rosaries Locality on the bank of the River Nile in the Blue Nile State in Sudan"Consensus on what is meant by ‘gender’” Respondents noted a lack of consensus on what gender and gender-responsiveness entail, with some being critical of the field for having a narrow view of gender as a ‘women-only’ issue, undermining the crucial relational aspect of gender inequality. "Political buy-in is crucial but lacking”A lack of commitment from policy makers and officials across all levels of government limits much-needed resources for evidence building. This lack of buy-in may be due to a narrow view of social protection as aimed exclusively at poverty-reduction and correlated outdated views of poverty. Others see this as a lack of commitment to gender equality itself, with decision-makers prioritising more short-term objectives and their own traditional values—or those of their community—instead. "Better understanding of the role of gender norms is the number one evidence generation priority” Addressing gender norms and practices is high priority for 61% of respondents. While this goal must be placed at the centre of the gender-responsive agenda, we also need to better understand the limitations that this may place on ongoing social protection interventions. Women’s role within the household and their families, their limited access to the labour market (both formal and informal), and the need for contextual specificity were listed as priorities for easing a change in restrictive practices. "Measure empowerment properly”Empowerment was the second highest priority for respondents (59.3%). Some urged for the field to move beyond purely economic measures of empowerment and others emphasised the need to adequately balance empowerment with protection needs. "Labour & childcare policies top social protection policy priorities”Labour policies that help people find work (45.8%) and the availability of affordable childcare (40.7%) are the policy types that experts most believe we should better understand. These results underline the need to economically empower women, rather than reproduce current social conditions that bind many to unpaid care. "Tailor design to context and integrate with existing services”When asked about design features, ‘gender responsive work arrangements’ (e.g. adequate maternity leave) was the top evidence generation priority (67.8% high priority), followed by ‘prioritisation of linkages to productive, protective, and health services’ (57.6%). These results reflect the value placed on integrating social protection into broader government provision systems to improve efficacy and secure sustainability. The importance of context was reiterated, with some highlighting the need to better anticipate and minimise unintended consequences, such as conditionalities that may limit people’s capacity to work. Priorities to address evidence gaps in gender outcomes.What next? Together with a think piece series by leading experts in the field and an experts’ workshop, this survey has helped refine the GRASSP research programme. In better understanding gender inequality as a driver of vulnerability and poverty for women, we can explore whether particular social protection features can be finetuned to achieve gender-transformative goals. This survey of experts reveals that we need to better understand local gender norms and how labour and childcare policies improve women’s access to the workforce and overall empowerment. To do so, we must disaggregate impact by sex, use qualitative research to illuminate change, and focus our evidence generation efforts on gender norms and empowerment.   Alessandra Ipince is now a research consultant working on adolescence, internet use, research methods at UNICEF Innocenti. UNICEF Innocenti’s new research programme on gender-responsive and age sensitive social protection (GRASSP) is funded by DFID, the Italian government, and other core UNICEF partners.
The time is now! Preventing violence against women and children requires quality evidence.
Blog

The time is now! Preventing violence against women and children requires quality evidence.

Reflections from the world’s premier conference on ending violence against women and violence against children from the Sexual Violence Research Initiative Forum 2019  Nearly 800 researchers, policy-makers, practitioners and activists descended on Cape Town, South Africa for the world’s key conference on ending violence against women (VAW), violence against children (VAC) and other forms of violence stemming from gender inequality— the Sexual Violence Research Initiative (SVRI)’s biennial forum 21-25 October, 2019. The energy behind the #TimeIsNow movement to end such violence was channeled into themes including social change, linkages between VAW and VAC, importance of scale, the Sustainable Development Goals, new technologies and more. UNICEF was there to share and meet researchers working on both VAC, as well as VAW, and help build bridges between the two communities. On the heels of a packed week, including stimulating research, networking and agenda setting, we asked three of our experts about key takeaways or points of reflection from the forum. What were our researchers' takeaways? Read their reflections and cues for next steps: Alessandra GuedesManager, Gender and Development Research at UNICEF Innocenti and Co-Chair of the SVRI Leadership Council@AlesscguedesWe can prevent violence!: Although many of us have repeated this phrase numerous times, we have often been met with skepticism and occasionally have been concerned ourselves about the feasibility of documenting measurable reductions of the prevalence of violence within our projects’ lifetime. How reassuring, then, to hear that multiple initiatives have been able to decrease levels of violence within reasonable timeframes, as shown by Rachel Jewkes’ presentation summarizing evidence generated by the Global Program “What works to prevent violence against women and girls?” Now we must ensure the evidence is put to good use, with a sense of urgency that is commensurate with the size of the problem. As DFID’s Emily Esplen emphasized in her closing remarks, evidence alone is not enough, “we need to advocate to build outrage.”Quality is of the essence: As evidence emerges about effective interventions, it is tempting to want to scale these up, but we must not lose sight of the principles and values that made the methodologies effective in the first place. It was repeatedly emphasized that interventions are highly dependent on the specific activities, quality of the training provided to those who are implementing them and such training requires time and resources, both human and financial. Ellen Bajenja and Tina Musuya made a great presentation highlighting additional insights from the Community for Understanding Scale Up (CUSP), including the need to prioritize accountability to communities.Let’s be creative! While we must look for ways to expand and scale up interventions that have been found to be effective, it is crucial that we don’t stymie creativity by over relying in a small number of tried interventions. Donors have a key responsibility to continue to support innovative strategies to end VAW and VAC.Lusajo KajulaSocial Policy Analyst, Social and Economic Policy at UNICEF Innocenti@sajokmIdeas that sound good need to be measured. It is always inspiring to meet like-minded researchers who share their hypotheses and research methodologies on reducing VAW and VAC. It is even more inspiring to meet and listen to different practitioners share their experience from specific programs that address issues related to VAW and VAC. However, while attending different panels and sessions, something became clear to me. I heard from quite a few practitioners who questioned the “lengthy” and sometimes cumbersome processes that are involved with evaluations. I left the forum with the realisation of major responsibility for us as researchers to support and engage programs in the use of evidence to inform policies. Evidence improves practice and therefore a win-win situation for programs!Voices of researchers in the Global South need to be amplified. Despite specific efforts from SVRI to promote inclusivity, we are still missing sufficient involvement at the forum from practitioners and activists from the Global South. The next stage of evidence generation needs diverse groups of women with research from the Global South collaborating on violence prevention studies. This will improve our state of the evidence with a lens that compares the global vs. local gaze. It is also a good opportunity to learn from each other, regarding our similarities and differences. Several questions come to mind – how similar (or different) is the face of VAW/VAC across the Global South? What tools can we borrow from each other in our fight to unroot the deep-rooted issues that are associated with VAC/VAW?We need to invest in social norm transformation. Those who attended or watched the opening plenary may agree with me that it was emotional. Two survivors of intimate partner violence, Josina Machel (Mozambique) and Malebogo (Max) Molefhe (Botswana), shared how they had to fight the system to get the justice they deserved after suffering life-changing injuries from their abusers. According to Josina “Women wake up every day and they're faced with rape, beatings and PTSD just like soldiers at war.” The need for systems that address gender norm transformation has never been greater. We need to identify how norms that protect VAW/VAC serve or contradict our communities' values. Amber PetermanConsultant, Social and Economic Policy at UNICEF Innocenti and Research associate professor at the University of North Carolina@a_petermanMeasurement matters: Maybe it is the data geek in me, but I was quite excited to see a resurgence in thinking about how we can better measure and analyze violence-related outcomes and trajectories. A presentation by Lori Heise stressed that the way we think about program success, relies critically on how we analyze outcome data, what we consider abuse, and if we interrogate how programs affect not only occurrence, but also severity, frequency of violence. There were also intriguing debates around data on couple concordance/discordance of violence reporting, an area which the field is only now starting to grabble with—given an emerging generation of evaluations which have explicitly collected data on couples. I expect lots of innovation in the coming years on measurement, and look forward to new insights gained.Going to scale: There was a lot of (welcomed) emphasis on scale, and the need for innovative programming that we not only know works, but that can reach large populations. Some promising examples presented include social protection, school-based programming and mass media or mobile applications – accompanied by the theme of costing from pilot to national scale up. We need more positive examples of programming across different platforms, including within employment (work) based programs, particularly those that are tested with national Governments if we want to leverage economies of scale for prevention efforts. One example of this is the cash transfer and IPV reseach collaborative which Innocenti is part of, which is exploring how to leverage cash transfers at scale for violence reduction.All hands on deck: Attending a forum with such a wide diversity of actors, helps us understand that GBV is not an issue for one organization or one set of stakeholders—it is everyone’s issue. If we want to end violence, everyone has a role to play. It is encouraging to see non-traditional fields attending the forum and thinking creatively how GBV mitigation and prevention components can be integrated into sectors as wide ranging as climate change and environmental programming, to sport and social policy. The most exciting work in my opinion comes from inter-disciplinary and inter-sectorial collaborations—I’m looking forward to more of this (and more Economists, Political Scientists and Psychologists attending the forum in two years!). SVRI 2019 ended with a big bang and left us pondering how to advance gender equality, social justice and violence prevention through research. We feel optimistic that “We know more than before” (Claudia Garcia-Moreno), and that we seem to be “on the cusp of change” (Tina Musuya). Further reading: Bridging the gaps: a global review of intersections of violence against women and violence against childrenCash Plus Model Improving Adolescent Wellbeing with EvidenceBreaking the Cycle: Understanding and addressing the intersections of violence against children and violence against women in Latin America and the Caribbean
Research on humanitarian social protection is not only possible, but desperately needed
Blog

Research on humanitarian social protection is not only possible, but desperately needed

Rigorous research in humanitarian emergencies is not only feasible but also necessary to determine what constitutes effective assistance in these settings. This column introduces a Special Issue of the Journal of Development Studies which demonstrates that research establishing causal effects is vital for the design of efficient and effective social protection in settings of fragility and displacement. 
Moving the needle on mental health for young people
Blog

Moving the needle on mental health for young people

Leading Minds Call on Global Action to Support and Protect Mental Well-Being for Youth  The following blog is the transcript of the closing remarks for the Leading Minds 2019 Conference for Children and Young People on Mental Health by Chantelle Booysen, Global Mental Health Advocate and Social Impact Entrepreneur. In the last 50-60 years UNICEF, WHO & member states have worked tirelessly in reducing infant mortality rates and succeeding at it. In fact, one could go so far as to say that this is one of the major development-success stories of our time.The thing is though, these surviving infants, who you’ve fought for, and saved, have now grown into children, adolescents and young people that are now in desperate need to have something to stay alive for.Our growth in population also comes at a devastating cost – we damage the planet and the environment; we develop diseases that become ever more difficult to cure; and we end up in hopeless spaces that are immensely difficult to navigate.This blend of very intentional successes coupled with unforeseen and unprepared consequences are what we are facing when we are talking mental health for children and young people.And this is where a conference like Leading Minds, with the influence and power in this room, can spark this intentional action with stakeholders to drive a new success story. A success story that is driven by robust, authentic and exploratory conversations.Different levels of communication are necessary in order for our children and young people to survive and ultimately thrive. I also want to highlight that it will not take only one – or two – organizations, with one solution to fix this problem, but a collaborative approach with enabled environments to remedy this mental health epidemic.Chantelle Booysen delivers the closing remarks at the Leading Minds Conference for Children and Young People on Mental Health, 9 November 2019.Our biology is but one element in an array of elements determining our mental health or ill-health - our environment, our socio-economic status, our placement or displacement, our interaction with violence, our loneliness – these are all real things that affect much of our ability to be mentally healthy.Listening to various accounts of people speaking at this conference, and particularly our young leaders, some very clear themes came up that we should action on.I would like to introduce a policy brief titled Young people will transform Global Mental Health. This policy brief was developed by the Young Leaders for the Lancet Commission on Global Mental Health, as part of the #mymindourhumanity dissemination campaign, a campaign that is supported by the Wellcome Trust, Oxford University and the London School of Hygiene and Tropical Medicine. More importantly, the development of this policy brief was led by young people, with lived experience that does doing work at community level too.As the lead author of this policy brief, together with four other leaders, we used evidence-based research from the Commission’s report to address three key recommendations. These recommendations, although they did not capture all of the key thoughts here today, certainly formed a foundation for youth mental health in a rather practical way for governments to act and react.Chantelle Booysen presented three quick wins for mental health for young people as part of her closing remarks at the Leading Minds Conference for Children and Young People on 9 November 2019.These recommendations are what I would call “QUICK WINS”, that governments can implement with the guidance and pressure of WHO and UNICEF:To ensure full and direct participation of young people and people with lived experience at the beginning, middle and end of policy and initiatives involving adolescent and child mental health;To increase investment in prevention and early intervention, and this we have seen in the form of direct interventions, implement effective social policies that address social factors that influence mental health during developmentally sensitive periods, including poverty, gender discrimination and violence;To improve and support mental health literacy, promote self-care and connect access to emergency services in all education systems. This can be done by focusing on skills training, screening for at-risk young people and the education of teachers, primary care physicians and media. Integrated youth mental health or brain health curricula should be integrated in the same way as physically active programmes.There are many other points that are VERY important, but I would like to highlight the following points that came out of the Leading Minds conference that needs a critical lens, is:The need for evidence-based initiatives and for institutions, governments and global custodians of well-being of children and adolescents to financially support youth to develop good evidence and financially support them in that process. This is even more important in the global South where only 5% of global research on youth and adolescents account for these regions.Bridging supportive tools and platforms between fast moving innovations by young people trying to fill the void of lack of services and the slow movement of traditional and formal structures.They say humans change slowly and incrementally, over time – but right now we need to be the wind, that forces the sails of the boat to change direction.These points also highlight where leadership is failing young people. Young people are protesting in Hong Kong, in Beirut, in Algeria, to name a few. Does it mean that the only way that young people will be heard is through strike action?Does it mean that we let people rest over the weekend, after #Fridays4Future just so we can continue the protest first thing Monday morning? Should we call it #MondayFutureMoods or #nomoremondayblues?Time has come for those advocating for mental health and wellbeing to scale up our asks, to be more unreasonable and bolder with our requests. For too long we have been silent and felt undermined within the global health setting. The needle needs to shift and it won’t shift without unreasonable demands in order to settle reasonable action.They say humans change slowly and incrementally, over time – but right now we need to be the wind, that forces the sails of the boat to change direction.What will it take for every not-for-profit initiative to include additional funding requests toward mental health checks?What will it take for every for-profit organisation to allocate additional funding to mental health checks and access to services?What will it take for governments and member states to allocate funds to incorporate and include mental health services in every national, regional or municipal departments?And what will it take for philanthropists, donors and social funders to include the requirement and provide additional funding for mental checks and provisions for all interventions funded?I want to end with the following by addressing the white (and blue) elephant in the room: STIGMA, stigma in funding allocation, stigma in policies, stigma in inclusion of lived experience, stigma in every sphere of society.Only once governments, funders, organizations and companies really take mental health seriously, will there be a shift in stigma and its impact in communities.Only once people feel truly supported and protected can we begin to eliminate stigma-related behavior in our society.Thank you.Chantelle Booysen  (@channy_bird) is Global Mental Health Advocate and Social Impact Entrepreneur and a Youth Leader at the 2019 Leading Minds Conference for Children and Young People, co-hosted by UNICEF and WHO.
Inclusive learning: How WASH in schools empowers girls’ education
Blog

Inclusive learning: How WASH in schools empowers girls’ education

In this blog, Anja Nielsen and Alexander Carnwath from UNICEF UK explore how WASH programming supports girls’ education in fragile and conflict-affected states.   Ensuring no child is excluded on the basis of gender is a priority identified in UNICEF’s new Education Strategy. To reach this goal, a commitment to strong intersectoral work is paramount. To understand what this means in practice, this blog outlines how Water, Sanitation and Hygiene (WASH) plays a significant role in girls’ access to education and could help unlock the future for millions of girls around the world.   WASH is fundamental for girls’ education Every child – including every girl – has the right to a quality education, enshrined in the Convention on the Rights of the Child 30 years ago. The Sustainable Development Goal targets recognise that building safe, inclusive and effective learning environments is fundamental to increasing children’s access to education and improving learning outcomes. But nearly one third of schools around the world still lacked basic water, sanitation and hygiene services in 2016. For girls, appropriate WASH facilities are a particularly important part of ensuring their safe and healthy participation in school. WASH facilities have both ‘push’ and ‘pull’ factors for girls’ education. Girls can struggle to attend and stay in school if they do not have safe, single-sex and hygienic facilities, which are essential for menstrual hygiene management (MHM). Although there is still little evidence, reports have recognised that ‘the introduction of appropriate water and sanitation facilities has been associated with improved girls’ attendance.’ In addition, WaterAid notes that ‘girls are particularly at risk of sexual violence when using unsafe facilities at school.’ Indeed, girls in the Cox’s Bazaar refugee camp in Bangladesh have reported feeling fearful in accessing latrines, and UNHCR notes that ‘young girls/children and women who walk long distances to water points are at risk of sexual violence.’ Conversely, learning about menstrual hygiene and pubertal changes can encourage girls to come to school during their menstruation. WASH facilities in schools and the wider community can also free girls from having to collect water, allowing them to have more time in education.   But conflict and crisis hinder development Conflict has a huge impact on girls’ education and access to WASH. Conflict and crisis has led to 75 million children in urgent need of educational support, with girls in conflict-affected areas more than twice as likely to be out of school. Meanwhile, in extremely fragile contexts, people are eight times as likely to lack basic drinking water services and almost four times as likely to lack basic sanitation services, a situation which has a particular impact on children, and especially girls given the important role WASH plays in girls’ access to education and services. Therefore, any attempt to meaningfully address global access to WASH and education for girls, must include a focus on fragile and conflict-affected areas.   Why we must take a combined humanitarian-development approach The growing number of protracted conflicts and longstanding humanitarian crises also make it increasingly important that programming on WASH and education address both emergency and longer-term needs, combining humanitarian and development programming. As articulated by UNICEF Chief of WASH Kelly Ann Naylor, ‘We can no longer respond to crises with humanitarian assistance alone; we must work towards building sustainable and resilient services that can help to create a more stable future for children and their families.’   What should be done? It is crucial to support integrated programmes that improve access to both education and WASH, across the humanitarian-development nexus, in fragile and conflict-affected states. UNICEF recognises the importance of an integrated approach to safe, single-sex WASH facilities for girls in education. In 2018, 94 per cent of the more than 8,000 schools directly supported in accessing WASH facilities had gender-segregated toilets and washing facilities. Also in 2018, UNICEF ‘provided 4.4 million children with access to appropriate male and female WASH facilities and hygiene education in schools, temporary learning spaces and other child-friendly spaces’ through humanitarian response programmes. However, this is a shared responsibility and will require donors, governments, and those involved in both WASH and education sectors to step up activity in a number of areas. These include: strengthening multisectoral collaboration, especially between education and WASH, to secure multiple outcomes for children; ensuring gender-sensitive WASH facilities are addressed in humanitarian-development education programmes in conflict areas, and champion this work at the global level; advocating for more durable WASH solutions from the onset of an emergency, ensuring school and education authorities are a part of the planning process; and investing in WASH and education monitoring systems to enable effective monitoring of progress and to better target those children at risk of being left behind.   In 2015, the world committed to achieving gender parity in education and to build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all with Sustainable Development Goal 4. Approaching this via WASH might seem like a circuitous route. But, in fact, supporting access to safe, hygienic WASH facilities in fragile states is an important step in the road to achieving education for all girls. Read more in UNICEF UK’s forthcoming briefing Education and Water under Fire: Ensuring Every Girl Learns and in UNICEF’s report Water Under Fire, Volume 1: Emergencies, development and peace in fragile and conflict-affected contexts.
Time to ramp up psychosocial support for adolescents in crisis settings
Blog

Time to ramp up psychosocial support for adolescents in crisis settings

Globally, the increase in humanitarian crises, protracted conflicts, displacement, violence, terrorism, disease outbreaks, natural disasters and climate change is putting children and adolescents at significant risk of mental and emotional ill-health.Around a quarter of the world’s 1.8 billion young people live in areas affected by armed conflict and organised violence. Yet for most adolescents, rather than getting caught up in violent extremism, violence manifests in their everyday lives: at school at home, when accessing health care and other services, and when spending time with peers – all of which can affect their mental health. These exposures risk fracturing young people’s aspirations and identities and limiting their future opportunities.Two things worry me: the night and war. I worry about everyone in my family. I am afraid to even leave the house."  – 14-year-old girl, Gaza StripIf this alone were not enough to spur urgent action, there is an economic imperative too: unless young people receive the psychosocial support they need, mental health disorders that emerge before adulthood can cost 10 times more to deal with than those that emerge later in life.Adversity and toxic stress lead to poor (gendered) psychosocial outcomesAdolescent biology and neural wiring create a natural adaptability to learning and innovation but also make adolescents vulnerable to shocks and trauma. The emerging science confirms the plasticity of the brain and the importance of the social and economic environment in shaping adolescents’ behaviours and responses.Gender disparities in mental health are substantial (almost twice as many girls than boys report symptoms between the ages of 13 and 15) and increase with age. Early adversities and social factors (such as girls being expected to care for other family members) may put girls at greater risk of depression and anxiety. Evidence shows that girls from low- and middle-income countries (LMICs) experience a range of adversities such as gender-based violence (GBV), school dropout and child marriage.Sexual and gender-based violence has also been linked to higher rates of depression and anxiety among adolescent girls, with social media opening up potential new avenues for bullying and sexual harassment. Social norms also increase girls’ risk: compared to boys, they lack the free time to play and ‘be’ that is critical for young people to develop identity, self-esteem and broader well-being.Amadou, age 15, a young shepherd from Mali's northern region of Kidal, was caught in a raid by the security forces, put in prison and interrogated on suspicion of being associated with armed groups. He's now at a UNICEF-supported center for children like him in Bamako. This is a detail of his drawing of his memories of home, which show him riding a camel. Bamako, Mali, June 2019.In Mali, for example, a shocking 96% of girls and women report being survivors of some type of GBV. Almost one-fifth (19%) of reported cases were rape, 21% were sexual assaults (including female genital mutilation), 20% were physical violence, 17% psychosocial violence, 14% denial of access to resources, and 9% were child marriage. Of all cases, 60% were reported by girls. Yet government support services are thinly spread and often not functional.Vulnerable adolescent girls such as child brides or adolescent mothers are often overlooked in research, though these girls are often at greater risk of mental health disorders (including suicide attempts. Adolescent mothers are more prone to postnatal depression than older mothers, yet their needs are rarely addressed in service provision.Boys also face gendered expectations, though different from those experienced by girls. Early adversity (including inequality and social factors) may increase anti-social behavior and exacerbate hyperactivity and other mental health problems. A study in Mexico (Gonzalez-Foretez 2015) shows that while adolescent girls have higher rates of depression, boys may face different risks, attempting to mask the symptoms of depression through high-risk behaviours such as alcohol or drug use, or violence. High-risk behaviours among adolescent boys also emerged as a key finding in the Gender and Adolescence: Global Evidence (GAGE) research programme in Gaza following the 2014 Israeli–Gaza war and protracted siege of the Gaza Strip.Cumulative and compound exposures create cycles of disadvantageEvidence clearly demonstrates that the risk of psychosocial problems among children and adolescents is exacerbated when they are exposed to chronic stressors, such as everyday violence, insecurity or poverty. The damage wrought by conflict – especially protracted conflict – can steeply reverse development gains, and inequalities intensify as adolescents grow older, leading to poorer employment and earnings, and poorer outcomes for themselves and the next generation.Mariam Barry, 14 years old, and Rokiyatou Barry, 11 years old, both displaced children, discuss their exercises in the UNICEF-provided tent that acts as their temporary learning space. Official IDP camp of Socoura, Mopti region, in central Mali, April 2019.Tapping into adolescent resilienceEvidence highlights that adolescence is also a time when young girls and boys can develop resilience, changing what they do and how they behave to be better equipped to handle adversity. In recent years, this has led to recognition of the positive role that young people can play as agents of peace and security, prompting some development and humanitarian actors to re-orient their approaches toward greater participation and engagement by adolescents.Yet the evidence suggests there are also gendered patterns to adolescent coping strategies. Girls are seemingly more likely to find ways to address their emotions (e.g. through talking to family members or friends, taking part in group therapy sessions, or turning to art or extra study), whereas boys are more likely to resort to negative strategies that mask difficult emotions.Agenda for adolescent mental health in crisis settingsAs the global community looks to develop an aspirational agenda of mental health for all in line with SDG3, it’s time to ensure that adolescents’ needs are no longer invisible. To ensure that those living in conflict-affected settings are not left behind, an action agenda for adolescents’ mental health should include:Investment in a minimum package of interventions that includes: access to safe spaces; opportunities to interact with peers; life skills curricula focusing on interpersonal communication and emotional resilience; accessible reporting and referral pathways; and adequately resourced case worker support.Support for community-based models of prevention and response that focus on addressing underlying stigma associated with mental health.Strengthening the evidence base on the social determinants of mental health in young people to inform context-appropriate, actionable and scalable approaches.Changes in how we assess mental health interventions to better capture age- and gender-specific dimensions. About the authors: Dr Banati is Regional Advisor for Adolescent Development and Gender at UNICEF and former Deputy Director at UNICEF Innocenti; Dr Jones is Principal Research Fellow, Gender, Equality and Social Inclusion, Overseas Development Institute and Director of the Gender and Adolescence: Global Evidence (GAGE) research programme.
Child mental health emerging from the shadows
Blog

Child mental health emerging from the shadows

With suicide and self-harm now leading causes of death and injury among young people between 15 to 19 years, UNICEF and WHO are coming together for the first time at the Leading Minds for children conference to tackle the growing scale of mental health disorders among children and young people. On World Mental Health Day (10 October) this interview, extracted from the full podcast, presents a fascinating discussion on this emerging global priority for children and young people.   Dr. Vikram PatelSarah Crowe: As a specialist in mental health over many decades, how do you see the scale of mental health concerns facing children today? How has it evolved over the last 30 years since the convention of the rights of the child? Vikram Patel: Mental health in the global context has been the orphan child of global health, and children's mental health has been the orphan child of global mental health. The real scale of the crisis is that we know so little about mental health problems in children in the global context and that the overwhelming majority of children who are already experiencing mental health problems receive neither the recognition, nor do they receive any form of intervention that we know can transform their lives. If you had to ask me what is the actual proportion of children who suffer this kind of neglect, I would say that in most parts of the world - particularly in low income countries - it is virtually 100 percent of children. I think this is the real scale of the crisis: the complete lack of recognition of the mental health needs of children globally. ...the focus of children's health and well-being has moved from children surviving to children thriving.SC: Is it true to say that for underdeveloped countries or communities, mental illness in children is becoming more apparent? VP: Absolutely. I think that is certainly one reason why children's mental health is emerging as it were from the shadows as the focus of children's health and well-being has moved from children surviving to children thriving. It's becoming very apparent that to thrive one needs to have good mental health and that children's mental health problems become more visible, as childhood mortality and physical causes of sickness become much better controlled. Thankfully, it's emerging from the shadows. SC: Can you take us through the child mental health risk factors? At which points in a child's development do they arise? VP: In the earliest years of childhood, the major concerns are those to do with early-life brain development. Intellectual disability and autism being the examples of what some refer to as developmental disabilities. In middle childhood, you begin to see the emergence of emotional disorders, particularly, anxiety disorders. And in adolescence you see the greatest surge of emotional and behavioral disorders, particularly in post puberty years, where you see the emergence of mood disorders, self-harm behaviors, conduct problems and substance use conditions. So, you see quite different conditions occurring at these broad developmental phases of early childhood, middle childhood and adolescence.   Find out about the World Mental Health Day 2019 "A Day for 40 Seconds of Action Campaign"  SC: What about the growth of gender fluidity, or young people choosing actively to associate themselves with being non-binary or searching and exploring a new identity? Is this influencing adolescent mental health at this vulnerable stage of their lives? VP: I don't think this is necessarily a recent development. I think this has historically always been part of our sexual identity, but that it has been more suppressed by rigid and inflexible social norms for a very long time. And I think we should celebrate the fact that many of those orthodox and rigid social norms are being challenged now. And so that it gives greater freedom of space for young people to reject the binary approach of sexual identity. Obviously, where mental health problems arise is when they encounter continuing rejection of those identities by orthodox social norms. Let's be honest: in most parts of the world, orthodox social norms continue to be a major cause of mental health problems. And this has to do not only to fluid gender identity, but with a variety of other denials of autonomy and freedoms that young people continue to experience in many populations around the world. Rondiney Diniz, 20, looks at his mobile phone, inside his home in the city of Fortaleza, in Northeastern Brazil.SC: Has the digital era created greater burdens, greater levels of toxic stress? VP: I certainly think there are unknown perils to do with the digital world. Particularly in childhood and early adolescence, when the brain is very rapidly developing. It is very plastic, it's responding to the environment in exquisitely sensitive ways. And if that environment is one in which you've replaced interaction with real people with a digital world in which your interactions are with virtual people, it's hard for me to know exactly what that impact might be on the brain, but it's not something that we were evolutionary developed to deal with. I think the jury's out about the exact nature of those risks. SC: You've written a lot about the prevention of mental illness and authoritative parenting. What can teachers, caregivers, parents do to put their children on the right path to mental health, whether it's online or off line? VP: Authoritative parenting, in my mind, is the balance between laissez faire parenting - which says, 'whatever you want to do is fine' - and this is different from authoritarian parenting - which says, 'whatever I want you to do is the only acceptable way to do it'. Authoritative parenting is recognizing the growing needs for autonomy as a child transitions into adolescence and then ultimately into young adulthood. It is really a fine art. There isn't necessarily a set of rules that one can apply to identify when a child is entitled to be making more and more decisions of their own. In terms of what parents, children and teachers can do, one most important thing is that we know about children's mental health. While all mental health problems will finally involve some biological dysfunction in the brain, we also know that the most profound influences on brain development and mental health are in the environment. A single way of describing what promotes good mental health is that the environments are nurturing and that they provide a secure space for young people and children to express themselves and be heard. Clcik the image to hear the full interview with Dr. Patel covering a wide range of key issues on global child and youth mental health.SC: How helpful do you think the Convention of the Rights of the Child has been in prompting action against the worst side of stigma, which often leads to horrendous abuses committed by states, communities, families? VP: I think the convention's been a singularly important tool to enshrine the right for a child to live in an environment which is free of fear, of abuse, of neglect and of violence. I think it has been the foundation for many legislations in countries around the world that protect children. However, it would also be fair for me to say that in most of these countries, the actual implementation of these aspirations in the real world has been marred by a number of different barriers. Not least, the fact that most states are unable to in fact see the child as being autonomous from their parents and it is the home environment, especially in early childhood, when so much of the neglect experiences occur. SC: And can you share examples that show these violations up for what they are? Could you give us something you might have seen or experienced or heard from young people? VP: The most important violation is growing up in extreme poverty, in circumstances where parents are unable to provide their children with the necessary emotional nurturing that is so essential to their development and well-being. So, this is not about parent blaming: I want to really stress that. I want to emphasize that families are caught in a vicious trap of poverty, and the failure of the state and of society more generally to recognize children's needs in those extremely marginal settings is what I consider the single biggest threat to well-being in the global context. SC: If we could look forward what are the trends that you see unfolding? What makes you most optimistic about the prevention, care and treatment of mental illness? VP: What gives me greatest hope is the recognition of mental health more generally and children’s mental health more specifically. Mental health is being seen as a global priority. This is not something I witnessed 20 years ago and the very fact that UNICEF, for example, is championing children's mental health, is a sufficient indicator of that transformation. I also see a wonderful opportunity because of the science that we have, of neurodevelopment, clinical and public health interventions for children. We are not working in a vacuum of knowledge. We actually have a lot of things we know can be transformative. I think the real challenge is delivering what we know can be transformative. Another major challenge of course is the continuing stigma attached to the discussions around mental health and well-being. Adolescents don't like to see doctors for any condition, not least for their mental health. Because of a very narrow medical approach to child mental health it is rejected by most children and adolescents. We need to put them front and center in thinking how that should be done. SC: “Nothing about us, without us” is the way forward and we hope to be able to take this on very seriously, going forward to Leading Minds 2019.   Dr. Vikram Patel,  professor of global health at the Harvard University School of medicine and co-founder of Sangath Foundation in India . His work over the past two decades has focused on reducing the treatment gap for mental disorders in low resource countries.  Dr. Patel will be a keynote speaker at the first Leading Minds 2019  conference at the UNICEF Office of Research – Innocenti in Florence, Italy.    
Turning the tide together on mental ill health for children
Blog

Turning the tide together on mental ill health for children

In some way, mental ill health has touched everyone. The statistics are alarming, and by some accounts constitute a public health emergency. Today, around 10-20 per cent of all children and adolescents suffer from some type of mental health disorder and mental health conditions account for around 16 per cent of the global burden of disease and injury among adolescents. Worldwide depression is among the leading causes of disability among young people and suicides are the third leading cause of death among adolescents worldwide, and the second among 15-19-year-old adolescent girls. Fifty percent of mental health conditions arise before the age of 14, and 75 per cent by the mid-20s. Given the age-sensitive nature of predictors, early life investment makes good sense. However, globally relatively small sums have been allocated, with an estimate of less than 1 per cent of national health budgets in low-income countries being devoted to mental health. Yet the economic cost of mental health is enormous, amounting to around 4 per cent of GDP. Evidence supports early investment -- if left untreated, it is estimated that mental health disorders which emerge before adulthood can impose a health cost 10 times higher than those that emerge later in life. mental health disorders which emerge before adulthood can impose a health cost 10 times higher than those that emerge later in life.Emerging evidence indicates that the prevalence of mental ill-health is growing. Issues such as climate change, environmental degradation, unplanned and rapid urbanization, migration, demographic transition, youth unemployment, and technological leaps are implicated. These may have profound impacts on the minds of children and young people. Yet we know very little today about how to manage or harness these changes to improve the mental wellbeing of children. The 2018 Lancet Commission report compellingly illustrated the value of addressing mental health to advance a number of sustainable development goals. This suggests that effective mental health interventions may be potential development accelerators – with provisions that lead to progress across multiple SDGs. In the context of shrinking fiscal space, this makes it a highly desirable area of investment. Rafeya Akhter Moni, 14, plays a game with friends at a UNICEF-supported Adolescent Club near her home in Dhaka’s Duaripara slum. Twice each week Moni and 35-40 other young people have the opportunity to get together and be ordinary teenagers in a safe space.More work is needed to examine the state-of-the-art evidence, and the corresponding programmatic and policy responses on children’s mental health in the first decade of life, beginning in utero, through the first five years, and then into middle childhood (5-9 years). The evidence agenda is clear: we need to look at the latest findings from neuroscience; the overall prevalence and spread of mental ill health across ages and geographies; causes and contributing factors; and methods of preventing and treating mental ill health. These are all important parts of the puzzle, and critical to the response effort. Adolescence is a critically important stage of life when many of the mental health conditions prevalent in adulthood first manifest, and also the most challenging time for those entrusted with the care and protection of young people to reach them with solutions. Addressing the mental health of our children is imperative. Greater leadership and political commitment on policy, research and implementation is needed to turn the tide and advance healthy minds and healthy bodies of children and young people. A dedicated global plan or alliance through a shared value partnership for the mental health of children and young people is long overdue. On November 7 – 9 2019, UNICEF and WHO will convene a conference co-chaired by UNICEF’s Executive Director Henrietta H. Fore and WHO’s Director General Tedros Adhanom Ghebreyesus. The Inaugural Leading Minds for Children and Young People conference will focus on advancing the global agenda on mental health in children. This first year will bring together a broad array of the world’s thought leaders and decison makers – from academia, business, civil society, government, international development, philanthropy and of course, children and young people – to accelerate global progress to respond to this neglected issue. This will be the start of a critical conversation about what is needed to ensure children grow up with ‘healthy minds and healthy bodies.’ Throughout, the focus will be on the scale of the challenge and the proven and promising solutions to meet it. The conference’s final session will conclude with a deep dive into the pathways that global actors can take to tackle the issue of child and youth mental health. Crucially the voices of children living in challenging situations will be central. Sessions will be co-designed and run with and by the Youth Leaders of the conference. We need to understand and listen to them: their emotions, fears, coping strategies, and hopes. We need to engage with how they cope, what they do to support others, and what must be done for young people themselves to feel supported and thrive in a complex world.   Priscilla Idele is Director of the UNICEF Office of Research – Innocenti; Prerna Banati is former Deputy Director at UNICEF Innocenti and currently UNICEF Regional Advisor on Adolescent Development and Gender; David Anthony is Chief of Strategy and Policy at UNICEF Innocenti.
The forgotten minority: A personal story sheds light on the added dangers facing migrant girls and women
Blog

The forgotten minority: A personal story sheds light on the added dangers facing migrant girls and women

Maryama* is just 17 years old, but already she has attempted to migrate from Hargeisa in the Horn of Africa to Europe twice. While most migrants face harrowing journeys, her story can help us understand some of the additional challenges facing young women and girls on the move in the Horn of Africa. She was interviewed as part of a broader study on the situation of children on the move in the Horn of Africa carried out by the Innocenti Office of Research.   The forgotten minority.Conversations about migration are often focused on young men. To a certain extent, this focus is understandable. Although statistics on those who begin the journey are difficult to obtain, we do know that those who arrive in Europe are predominantly male, between 67-73% according to the Pew Research Center. But women are also on the move in significant numbers and their experiences both mirror and differ from those of their male counterparts.   In search of a better life.The first time Maryama left home, she was 13 years old. At the time, she didn’t have a “clear vision on how and why. The only thing that I knew was that I wanted to go to Germany because I heard that those who immigrate get money and a better life.” Maryama’s focus on finding a better life is shared by the majority of young people who participated in this research. For them, a better life means a better job and enhanced educational opportunities. As Maryama says, “I did not go to school… My family never treated the girls and boys of the family equally, they always gave priority to my brothers, whether to send them to school or other things.” Other young women interviewed for this study echoed this sentiment, stating that boys are always given priority in their families.  Women in northern Somalia generally have lower levels of education and experience higher rates of unemployment than their male counterparts. For example, 30% of the girls that we interviewed had no education, compared to 12% of boys. In this context, it is unsurprising that lack of education drives young women to migrate. There are also reasons for leaving that affect women in particular. Maryama left home a second time at 14 years old to avoid being forced into marriage. In her words: “my family was forcing me to marry an old man. I didn’t even know him, and I didn’t want him, so I decided to leave the country any way I could.” While the search for jobs and education are often then most common reasons for leaving, some girls also cited physical abuse within their families as a driver.   Maryama’s first journey.Once she decided to migrate, Maryama looked for a smuggler to assist her. “I told some friends whom I knew could get information and contacts because they had friends who had immigrated before. Then a few days later, they told me I had contact and I should get ready.” Like many young people interviewed, however, Maryama did not have the funds to travel. She stole some gold earrings and sold them to finance the first part of the trip. The costs at this first stage tend to be small, so selling possessions or stealing small items is a common way to get started. Maryama got as far as Bosaso in north-eastern Somalia before her father and brothers found her as she was waiting for a boat to take her on to Yemen. “When I got up, I found my father and my brother in the house. I have no idea who told them where I was.” They took her home. “It was shocking, of course, but there was no choice but to go back with them.” I am also afraid my brothers may kill me if they hear that I tried to migrate again.Her story is similar to those of many other young migrants who are stopped mid-journey by relatives. This helps explain why many young people plan their journeys and leave surreptitiously. Most rightly assume that their parents would oppose their decisions and seek to prevent them from leaving if they knew. Many young migrants, both male and female, reported that they were scared of their parents’ reactions to their migration and that this discouraged them from reaching out for help. Young women, however, sometimes expressed fear of violence, not just anger and disappointment. In Maryama’s words, “My father didn’t threaten me. He was so happy to see me alive, but my brothers did threaten and even beat me… I am also afraid my brothers may kill me if they hear that I tried to migrate again.” Maryama, like other young woman who seek to leave, also faced stigma in a culture that expects women to stay at home and which can interpret their movement itself as an abandonment of virtue.   A perilous route.The second time she left, Maryama once again found a smuggler through friends, but this time she got much farther, as far as Libya, but faced many more difficulties. The night she left, she says, “my life changed because I started to realize what it meant to be abused, hungry, and thirsty.” She took a bus from Hargeisa to Wajaale and then on to Jigjiga in Ethiopia. Here she was held by smugglers for 18 days before they gathered a large enough group to continue to Addis. She stayed in Addis for another ten days. During this time, she says, “we did not have enough to eat or drink and all the men and women slept together in a hall.” From Addis, the group moved on to Sudan. On the way, she faced a danger to which young women are particularly vulnerable – sexual violence. “To reach Sudan we walked for hours in very scary places for five days. We met some guys and they raped some of us. Me, fortunately I wasn’t because I was the youngest and shortest one and I pretended to be married to one of the other migrants I was travelling with.” The situation further deteriorated in Libya, where smugglers demanded ransom from her: “Smugglers asked us to pay US$7,000-$10,000. They tortured us whenever money was delayed and my family couldn’t avoid paying all this money. Smugglers tortured me, abused me and did whatever they wanted.” Eventually she was approached by an NGO that offered to assist her to return.   UNICEF Office of Research- Innocenti · 'No Mother Wants Her Child to Migrate' Research on Child Migration in the Horn of AfricaA new beginning.I called my family, but they wouldn’t believe me and told me. ‘you are not our daughter because our daughter is in Libya,’ and cut the call…. When I came home everyone was shocked because they thought I would never reach them alive.She returned by road and when she finally arrived back her family greeted her with disbelief, “I called my family, but they wouldn’t believe me and told me. ‘you are not our daughter because our daughter is in Libya,’ and cut the call…. When I came home everyone was shocked because they thought I would never reach them alive.” Maryama is currently being assisted by the General Assistance and Volunteer Organization (GAVO), which is supported by UNICEF, to learn tailoring and improve her livelihood prospects for the future. “My plan in the future is to be a tailor and stylist in the country and produce a very unique product. Good hope came to my life and I’m very happy for it.” Maryama hopes that she can get support to start her own business when she finishes the course. She wishes that others like her can be assisted through initiatives for youth businesses, education, and vocational training. Such efforts can contribute significantly to reintegrating individuals, like Maryama, who are struggling to build a new life for themselves at home. Lives that they might not even have imagined possible before they left.   Maryama’s story is one of many encountered in Innocenti’s research on the situation of children on the move in the Horn of Africa. The results of the first phase of this research were published in July 2019 as “No Mother Wants her Child to Migrate: Vulnerability of Children on the Move in the Horn of Africa.” Additional publications are forthcoming.   * Name changed to protect the privacy of the individual.    Olivia Bueno is the lead researcher and author of ‘No Mother Wants Her Child to Migrate: Vulnerability of Children on the Move in the Horn of Africa’. She has been working on migration and human rights issues in the Horn and Great Lakes regions of Africa for the last fifteen years. She has consulted with a number of organizations in the region, including local women’s and human rights organizations. She is also a co-founder of the International Refugee Rights Initiative, a non-governmental organization based in Kampala and conducting research and advocacy on both the causes and consequences of displacement. She has a Masters degree in International Affairs from the School for International and Public Affairs at Columbia University. 
The Transfer Project Impact Evaluation Methods Workshop
Blog

The Quest for the Missing Counterfactual: Transfer Project Trains African Researchers in Impact Evaluation

How do we know if a programme made a difference? The answer to this question is not as straightforward as it seems, because we never know what would have happened without the programme. This concept is referred to as the ‘missing counterfactual’ (or simply 'the counterfactual' since, by definition, a counterfactual is missing). Impact evaluation is the science of estimating the missing counterfactual; getting it right is the necessary first step in any evidence-based approach to policy design. The science of impact evaluation was the subject of a two-week technical training workshop organized jointly by the Transfer Project and the African Economic Research Consortium (AERC) in Nairobi, Kenya from June 24 to July 4 2019. The training attracted 24 participants (15 women) from 22 African countries who were selected by the AERC from over 350 applicants. Participants were primarily university lecturers working in the fields of applied and agricultural economics. The workshop is part of a larger collaboration between the Transfer Project and AERC focused on promoting evidence-informed decision-making in sub-Saharan Africa funded by the Hewlett Foundation. The workshop content was structured around this core question (“How do we know if a programme made a difference?”) and the related fact that unless we can invent a machine to take us back in time, we can never observe the outcomes both with and without the programme. The job of the evaluator is to estimate the “missing counterfactual” using the tools of research design and statistics. 'Greatest Hits' During the first week of training, participants were taught the ‘greatest hits’ of estimating a counterfactual, beginning with randomized designs and followed by non-randomized designs, such as propensity score matching, discontinuity design, instrumental variables, and natural experiments. They also learned how to add ‘design elements’ to strengthen their studies - for example through baselines or repeated follow-up observations - and to estimate sample sizes in both simple and complex sampling scenarios. Theoretical lectures were complemented with hands-on computer-based demonstrations and case studies from Transfer Project impact evaluations in Ghana, Malawi and Zambia. In the second week, participants were given a hypothetical “Request for Proposals” for an impact evaluation and worked in groups to develop a response using the tools they had learned throughout the course. Final presentations included proposal designs for a new impact evaluation of the Ghanaian LEAP cash transfer, an evaluation of the Kenya NICHE programme, and an evaluation of the Government of China/UNICEF joint pilot conditional cash transfer programme for child nutrition. These are all actual programmes undergoing or seeking to undergo an evaluation—implementers should feel free to contact the study teams for their full proposals! Impact Evaluation Training with AERC: Ghana's LEAP Programme Technical Research Proposal from The Transfer Project It was clear the participants had absorbed the course contents when, by the end of the second week, we noticed an increasing number of jokes and statements using evaluation language. Patrice from Congo suggested that we didn’t know if we could replicate the success of the course again because he and the other participants were “self-selected”; Isabelle from Cote d’Ivoire suggested we use ‘exact matching’ to figure out who should stand next to whom for the group photo; and everyone supported the idea that the order of group presentations should be randomly assigned... If nothing else, at least we have increased the number of nerdy evaluation jokes that are likely to be cracked across sub-Saharan Africa. In the closing session, Gustavo Angeles from the University of North Carolina at Chapel Hill told participants that the workshop itself was an intervention, and he was expecting a steep upward slope in the intervention group relative to the counterfactual. AERC Executive Director Dr. Njuguna Ndung’u encouraged participants to make the most of the training by using impact evaluation techniques to make a difference in their home countries. While increasingly used to inform policymakers on the effects of policies, impact evaluation methods are not always included in curricula of undergraduate economics degrees, and even when they are, the focus is merely theoretical with few methods covered. There is increasing demand for comprehensive courses on impact evaluation methods, which has led to the proliferation of several intensive workshops worldwide. In developing countries, however, the supply of such courses has not yet met the demand. The Transfer Project is beginning to close this gap with its capacity building work, but it is clear from the large number of applications for this training that there is a large appetite in the region for more information on this technical topic.   Assess your own knowledge of impact evaluation techniques—take our ‘Who Wants to be a Millionaire?’ quiz and see whether you would benefit from this course! Ashu Handa, University of North Carolina: Ashu is Lawrence I. Gilbert Distinguished Professor in UNC’s Department of Public Policy. Elsa Valli, UNICEF Innocenti: Elsa is a Research Analyst with UNICEF’s Office of Research - Innocenti in Florence. Gustavo Angeles, University of North Carolina: Gustavo is the Senior Evaluation Advisor for MEASURE Evaluation & Associate Professor at UNC. All three authors contribute to the work of the Transfer Project research and learning collaborative.
61 - 72 of 170