Journal Articles

This is the protocol for a Campbell review. The review aims to systematically collect, appraise, map and synthesise the evidence from systematic reviews on the differential gender impacts of social protection programmes in Low‐ and Middle‐Income Countries (LMICs). Therefore, it will answer the following questions: (1) What is known from systematic reviews on the gender‐differentiated impacts of social protection programmes in LMICs? (2) What is known from systematic reviews about the factors that determine these gender‐differentiated impacts? (3) What is known from existing systematic reviews about design and implementation features of social protection programmes and their association with gender outcomes?

We examine whether a government cash transfer program, paired with a health insurance premium waiver and targeted to pregnant women and mothers of young children in Ghana, reduced intimate partner violence (IPV). The evaluation took place in two northern regions and followed a 24-month longitudinal quasi-experimental design. Findings show significant decreases in the 12-month frequency of emotional, physical and combined IPV (0.09 – 0.12 standard deviations). Analysis of pathways indicate improvements in economic security and women’s empowerment may account for reductions in IPV. Results indicate a promising role for social protection in improving the lives of pregnant women and new mothers.

The COVID-19 pandemic has exposed the urgent need to tackle the crisis of mental health among children and young people. We call for a multi-stakeholder Global Mental Health Alliance for Children, which would achieve the following objectives: to strengthen evidence and understanding of mental health and well-being, causes and risks for children and young people; to scale up investment in mental health programming for children and young people, and particularly expanding the global cadre of health workers, social workers and community workers, with a focus on prevention and promotion of mental health; to support youth-led, evidence- and rights-based initiatives; to expand advocacy and knowledge of mental health for children and young people among the wider public, and reduce stigma, marginalization and discrimination against those experiencing mental ill-health; and to enhance funding from both the public and private sectors for promotion of mental health, prevention of ill-health and treatment of mental health disorders.

This paper adds to the thin empirical literature estimating the long-term effects of exposure to conflict from in utero to adolescence on adult well-being. The effects through adolescence of the two worst genocides in recent history – those occurring in Rwanda (1994) and Cambodia (1975–79) – are examined. The Rwandan genocide is shown to have produced long-term health outcomes among women exposed to the conflict during adolescence. A further contribution is the analysis of gendered effects during adolescence, which is enabled by the availability of data on men’s height for Rwanda. The long-term effects are confirmed for men, however this appears to be the consequence of exposure during adolescence later than for women, a result that is consistent with the biological literature on the differential timing of the onset of puberty by gender. No significant effects are detected in the case of the Cambodian genocide and we discuss some issues that may influence this result. Although more research and better data are needed, our results are suggestive of adolescent-specific effects of the Rwandan genocide, which may be comparable or larger than those previously found for younger children.

We present evidence on the overall impacts of state-sponsored cash transfer programmes in sub-Saharan Africa, using data from three impact evaluations of government programmes. All three programmes were a key component of the poverty reduction strategy of the respective governments at the time of the evaluations. We show effects across nine broad domains including both protection, production and human development, using baseline and follow-up household surveys on treatment and control groups. We relate the pattern of impacts to programme design parameters to further understand the constraints faced by ultra-poor rural households.

All three programmes have strong effects on their primary objective—food security or food consumption, as well as on secondary objectives that include livelihood strengthening and children’s well-being. The largest and most consistent impacts occur in Malawi, where transfer values are in line with international best practice and payments were made regularly during the study period. All programmes show a positive income multiplier, with the multiplier largest in Malawi at 2.94.

The overall results across three national programmes add to the growing evidence from Africa that government unconditional cash transfers have important positive effects on households, that these effects are not limited to just food security, and that programme design features influence the pattern and size of impacts.

We provide evidence from the Transfer Project to show that methodological design is only one factor in determining credibility in the eyes of policymakers. Policymakers understand concerns around internal validity, but also value collaborative research engagement, which builds trust, allows co-creation of research questions, informs operations throughout the evaluation period and leverages national research expertise. Further, the mere act of engaging in a large-scale, transparent impact evaluation, across quasi- and experimental designs can change the culture of decision-making within an agency, leading to better policy choices in the long run. We advocate for a more inclusive approach to policy research that begins with identifying the most relevant research question and fitting the methods to the question rather than vice-versa. We challenge the field to engage more closely with policymakers to identify their evidence needs in order to prioritize the end objective of improving the lives of the poor—regardless of methodological design choices.

There is growing evidence on positive human capital impacts of large, poverty‐focused cash transfer programs. However, evidence is inconclusive on whether cash transfer programs affect maternal health outcomes, and if so, through which pathways. We use a regression discontinuity design with an implicit threshold to evaluate the impact of Comunidades Solidarias Rurales in El Salvador on four maternal health service utilization outcomes: (a) prenatal care; (b) skilled attendance at birth; (c) birth in health facilities; and (d) postnatal care. We find robust impacts on outcomes at the time of birth but not on prenatal and postnatal care. In addition to income effects, supply‐side health service improvements and gains in women's agency may have played a role in realizing these gains. With growing inequalities in maternal health outcomes globally, results contribute to an understanding of how financial incentives can address health systems and financial barriers that prevent poor women from seeking and receiving care at critical periods for both maternal and infant health.

We examine the effect of the Zambia Child Grant Programme – an unconditional cash transfer (CT) targeted to rural households with children under age five – on height-for-age up to four years after programme initiation. The CT scheme had large positive effects on nutritional inputs like food expenditure and meal frequency, but no impact on child height-for-age. Production function estimates indicate that food carries little weight in the production of child height in the study sample. In settings with poor health infrastructure and harsh disease environments, a stand-alone CT is unlikely to address long-term chronic malnutrition unless accompanied by complementary interventions.

Times of economic uncertainty, civil unrest and disaster are linked to a myriad of risk factors for increased violence against women and children (VAW/C). Pandemics are no exception. In fact, the regional or global nature and associated fear and uncertainty associated with pandemics provide an enabling environment that may exacerbate or spark diverse forms of violence. Understanding mechanisms underlying these dynamics are important for crafting policy and program responses to mitigate adverse effects. Based on existing published and grey literature, we document nine main (direct and indirect) pathways linking pandemics and VAW/C, through effects of (on):(1) economic insecurity and poverty-related stress, (2) quarantines and social isolation, (3) disaster and conflict-related unrest and instability, (4) exposure to exploitative relationships due to changing demographics, (5) reduced health service availability and access to first responders, (6) inability of women to temporarily escape abusive partners, (7) virus-specific sources of violence, (8) exposure to violence and coercion in response efforts, and (9) violence perpetrated against health care workers. We also suggest additional pathways with limited or anecdotal evidence likely to effect smaller sub-groups. Based on these mechanisms, we suggest eight policy and program responses for action by governments, civil society, international and community-based organizations. Finally, as research linking pandemics directly to diverse forms of VAW/C is scarce, we lay out a research agenda comprising three main streams, to better (1) understand the magnitude of the problem, (2) elucidate mechanisms and linkages with other social and economic factors and (3) inform intervention and response options. We hope this paper can be used by researchers, practitioners, and policymakers to help inform further evidence generation and policy action while situating VAW/C within the broader need for intersectional gender- and feminist-informed pandemic response.

Violence against children is a pervasive public health issue, with limited data available across multiple contexts. This study explores the rarely studied prevalence and dynamics around disclosure, reporting and help-seeking behaviours of children who ever experienced physical and/or sexual violence.

Using nationally-representative Violence Against Children Surveys in six countries: Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania, we present descriptive statistics for prevalence of four outcomes among children aged 13–17 years: informal disclosure, knowledge of where to seek formal help, formal disclosure/help seeking and receipt of formal help. We ran country-specific multivariate logistic regressions predicting outcomes on factors at the individual, household and community levels.

The prevalence of help-seeking behaviours ranged from 23 to 54% for informal disclosure, 16 to 28% for knowledge of where to seek formal help, under 1 to 25% for formal disclosure or help seeking, and 1 to 11% for receipt of formal help. Factors consistently correlated with promoting help-seeking behaviours included household number of adult females and absence of biological father, while those correlated with reduced help-seeking behaviours included being male and living in a female-headed household. Primary reasons for not seeking help varied by country, including self-blame, apathy and not needing or wanting services.

Across countries examined, help-seeking and receipt of formal services is low for children experiencing physical and/or sexual violence, with few consistent factors identified which facilitated help-seeking. Further understanding of help seeking, alongside improved data quality and availability will aid prevention responses, including the ability to assist child survivors in a timely manner.