Journal Articles

Shocks can pressure families into negative coping strategies with significant drawbacks for children's lives and development, particularly for children living in disadvantaged households who are at greater risk of falling into a poverty trap. This paper investigates if unconditional Cash Transfers can be effective in protecting children against unexpected negative life events. Using two waves of data, we found that the Lesotho Child Grant Programme (CGP) reduced the incidence and intensity of multidimensional deprivation for children living in labour-constrained female-headed households (FHH) that experienced negative economic or demographic shocks. Programme design in shock-prone contexts should seek to reinforce and widen the protective effect of the Cash Transfer for the most vulnerable.

This study aims to examine the effect of community-based health insurance enrolment among the most vulnerable and extremely poor households participating in Ethiopia’s Productive Safety Net Programme on the utilisation of healthcare services in the Amhara region.

This study examines the risk and protective factors associated with adolescents’ exposure to violence at home and how these differ by gender and age in four regions of Burkina Faso.

Violent discipline of children and intimate partner violence (IPV) against women are global public health and human rights problems. To address calls for more evidence on intersections, this study aimed to expand knowledge about correlates of physical child punishment, physical IPV against women and their co-occurrence (both) in the same household.

Methods: Using national, population-based survey datasets from Colombia, Mexico and Peru, multinomial logistic regressions examined correlates of three mutually exclusive patterns of violence in the household: physical child pun‑ ishment (only), physical IPV ever (only) and co-occurrence (both), each compared with no violence, after adjusting for other factors. Logistic regression was used to analyse odds ratios of physical child punishment in households afected by IPV past year and before past year compared with never, after adjusting for other factors.

Social protection programmes have efectively reduced poverty and improved food security. However, the efects of poverty require an intersectoral approach to adequately address poor nutrition and health. Identifying gaps in knowledge and access to frontline workers who oversee these integrations is critical for understanding the potential for integrated social protection programming to improve these outcomes. We measured levels of social protection programme participants’ knowledge of and interaction with social workers (SWs) and health extension workers (HEWs) in rural Ethiopia

We apply a well-known resilience index developed by the FAO to data from a cash transfer evaluation in Malawi to address two key questions: Is the FAO index a valid measure of resilience? Can an unconditional cash transfer significantly boost household resilience? Our answer to both these questions is affirmative. The resilience index positively predicts future positive coping behaviour among households (predictive validity) and is a stronger predictor of future coping than consumption or assets. We then find that the unconditional cash transfer increased the resilience index by 12 points, or 30 per cent over the baseline mean index value. Results imply that small, regular, predictable cash transfer payments to ultra-poor households not only protect current consumption but can also build resilience and protect against future shocks.

Violence against women (VAW) and violence against children (VAC) are public health issues of global concern. Intimate partner violence (IPV) is a commonly occurring form of VAW and there is evidence to suggest that IPV and VAC frequently co-occur within the same families. This systematic literature review searched for studies published in any language between 1st January 2000 to 16th February 2021 and identified 33 studies that provided findings for co-occurring IPV and VAC in 24 low- and middleincome countries (PROSPERO: CRD42020180179). These studies were split into subgroups based on the types of cooccurring violence they present and meta-analyses were conducted to calculate pooled odds ratios (ORs) within these subgroups. Our results indicate a significant association between IPV and VAC, with all pooled ORs showing a significant positive association between the two. Almost half of the studies focused exclusively on co-occurrence between male-to-female IPV and female caregiver-to-child VAC; few authors reported on male caregiver-to-child violence. Only three studies identified risk factors for co-occurring IPV and VAC, and those that did suggested conflicting findings on the risks associated with maternal age, alcohol and drug use, and parental education level. We also found incongruity in the violence definitions and measurements used across studies. Future research should aim to develop more consistent definitions and measurements for co-occurrence and move beyond solely examining dyadic and unidirectional violence occurrence in families; this will allow us to better understand the interrelationships between these different forms of abuse.

More than half of the global population is not effectively covered by any type of social protection benefit and women's coverage lags behind. Most girls and boys living in low-resource settings have no effective social protection coverage. Interest in these essential programmes in low and middle-income settings is rising and in the context of the COVID-19 pandemic the value of social protection for all has been undoubtedly confirmed. However, evidence on whether the impact of different social protection programmes (social assistance, social insurance and social care services and labour market programmes) differs by gender has not been consistently analysed. Evidence is needed on the structural and contextual factors that determine differential impacts. Questions remain as to whether programme outcomes vary according to intervention implementation and design.

Poverty is a structural driver of risky sexual behaviors. While cash transfers can mitigate some of this risk, complementary interventions have been posited as a way to further reduce multidimensional vulnerability. We examine the impacts of a multicomponent intervention targeted to Tanzanian adolescents on their sexual behaviors and reproductive health. The intervention comprised livelihood and life skills training, mentoring, and health facilities’ strengthening. Data come from a cluster randomized controlled trial, where one study arm received the intervention and the other was randomized to control, but both arms participated in a government cash transfer program. Among 1,933 adolescents interviewed over three rounds, we found increases in contraceptive and HIV knowledge. The program also increased health seeking and HIV testing among boys, but slightly reduced age at sexual debut among girls. There were no impacts on contraceptive use, number of sexual partners, or pregnancy. Findings support the value of an adolescent intervention, and the fact that it was delivered within a social protection platform suggests a potential for scalability. Additional efforts are required to delay sexual debut and reduce the number of sexual partners and pregnancy, possibly through addressing supply-side barriers and social norms, or through additional linkages to economic opportunities.

Globally, around 650 million girls and women married before their 18th birthday. According to recent data, Sub-Saharan Africa accounts for the largest share of child, early, and forced marriage and unions (CEFMU), with 35 percent, followed by South Asia, with 30 percent. But as research expands, new geographies are coming into focus, including Latin America and the Caribbean, where one in four girls under the age of 18 are married.

Despite the evidence emerging from new settings, research still tends to focus on a limited subset of countries. Although the prevalence of CEFMU is greater in low- and middle-income countries, child marriage also occurs in high-income countries: for example, between 2000 and 2015, more than 200,000 minors, of whom 87 percent were girls and 13 percent were boys, were married in the United States.

Scholars and activists agree that the proportion of girls getting married early in many countries across the globe is very high compared to their male counterparts. However, analyses of CEFMU tend to focus solely on age to describe and explain this phenomenon. The underlying assumption is that once girls reach the age of 18, they are at reduced risk of violence and nonconsensual marriage. This ignores other important factors that place girls at risk, such as poverty, gender inequalities, including harmful gender norms, traditional understandings of femininities and girlhood, and gender-based violence.

The role child marriage plays in controlling female bodies, specifically young girls, and regulating their sexuality continues to be under-addressed in the discourse around gender equality and CEFMU. The aim of this special edition of the Journal of Adolescent Health is to present recent research on the diverse manifestations of child marriage around the world. This means going beyond geographies on which rich evidence already exists in order to amplify diverse voices and highlight the intersections between this practice and other manifestations of gender inequality and oppression.

The collection of studies in this supplement takes this wholistic approach, so well captured in the commentary by Kimball and Dwivedi: “Our intention was never simply to work toward stopping child marriage, but to approach it via its root causes and to develop more holistic, transformational processes” for responding to the practice.