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A. M. Buller, M. Hidrobo, Amber Peterman, L. Heise
Intimate partner violence (IPV) is highly prevalent and has detrimental effects on the physical and mental health of women across the world. Despite emerging evidence on the impacts of cash transfers on intimate partner violence, the pathways through which reductions in violence occur remain under-explored. A randomised controlled trial of a cash and in-kind food transfer programme on the northern border of Ecuador showed that transfers reduced physical or sexual violence by 30 %. This mixed methods study aimed to understand the pathways that led to this reduction.
We conducted a mixed methods study that combined secondary analysis from a randomised controlled trial relating to the impact of a transfer programme on IPV with in-depth interviews and focus group discussions with male and female beneficiaries. A sequential analysis strategy was followed, whereby qualitative results guided the choice of variables for the quantitative analysis and qualitative insights were used to help interpret the quantitative findings.
We found qualitative and quantitative evidence that the intervention led to reductions in IPV through three pathways operating at the couple, household and individual level: i) reduced day-to-day conflict and stress in the couple; ii) improved household well-being and happiness; and iii) increased women’s decision making, self-confidence and freedom of movement. We found little evidence that any type of IPV increased as a result of the transfers.
While cash and in-kind transfers can be important programmatic tools for decreasing IPV, the positive effects observed in this study seem to depend on circumstances that may not exist in all settings or programmes, such as the inclusion of a training component. Moreover, the programme built upon rather than challenged traditional gender roles by targeting women as transfer beneficiaries and framing the intervention under the umbrella of food security and nutrition – domains traditionally ascribed to women.
Transfers destined for food consumption combined with nutrition training reduced IPV among marginalised households in northern Ecuador. Evidence suggests that these reductions were realised by decreasing stress and conflict, improving household well-being, and enhancing women’s decision making, self-confidence and freedom of movement.
Sudhanshu Handa, Bruno Martorano, Carolyn T. Halpern, Audrey Pettifor, Harsha Thirumurthy
C. M. Shah, A. M. Griffith, J. Ciera, E. M. Zulu, Tia Palermo
To examine trends in equity in contraceptive use, and in contraceptive-prevalence rates in six East African countries.
In this repeated cross-sectional study, Demographic and Health Surveys Program data from women aged 15–49 years in Ethiopia, Kenya, Malawi, Rwanda, Tanzania, and Uganda between 2000 and 2010 were analyzed. Individuals were ranked according to wealth quintile, stratified urban/rural populations, and calculated concentration index–a statistic integrating information from all wealth quintiles to analyze disparities.
Equity and contraceptive-prevalence rates increased in most country regions over the study period. Notably, in rural Rwanda, contraceptive-prevalence rates increased from 3.9 to 44.0, and urban Kenya became the most equitable country region, with a concentration index of 0.02. The Pearson correlation coefficient between improvements in concentration index and contraceptive-prevalence rates was 0.52 (P = 0.011).
The results indicate that countries seeking to increase contraceptive use should prioritize equity in access to services and contraceptives.
Sudhanshu Handa, D. Seidenfeld, B. David, G. Tembo, Zambia Evaluation Cash Transfer Team
Accumulated evidence from dozens of cash transfer (CT) programs across the world suggests that there are few interventions that can match the range of impacts and cost-effectiveness of a small, predictable monetary transfer to poor families in developing countries. However, individual published impact assessments typically focus on only one program and one outcome. This article presents two-year impacts of the Zambian Government's Child Grant, an unconditional CT to families with children under age 5, across a wide range of domains including consumption, productive activity, and women and children's outcomes, making this one of the first studies to assess both protective and productive impacts of a national unconditional CT program. We show strong impacts on consumption, food security, savings, and productive activity. However, impacts in areas such as child nutritional status and schooling depend on initial conditions of the household, suggesting that cash alone is not enough to solve all constraints faced by these poor, rural households. Nevertheless, the apparent transformative effects of this program suggest that unconditional transfers in very poor settings can contribute to both protection and development outcomes.
Sudhanshu Handa, Tia Palermo, Molly Rosenberg, Audrey Pettifor, Carolyn Tucker Halpern, Harsha Thirumurthy
Sudhanshu Handa, Amber Peterman, D. Seidenfeld, G. Tembo
R. Kidman, Tia Palermo
Kelly Kilburn, Harsha Thirumurthy, Carolyn Tucker Halpern, Audrey Pettifor, Sudhanshu Handa
This study investigates the causal effect of Kenya's unconditional cash transfer program on mental health outcomes of young people.
Selected locations in Kenya were randomly assigned to receive unconditional cash transfers in the first phase of Kenya's Cash Transfer Program for orphans and Vulnerable Children. In intervention locations, low-income households and those with orphans and vulnerable childrens began receiving monthly cash transfers of $20 in 2007. In 2011, 4 years after program onset, data were collected on the psychosocial status for youth aged 15–24 years from households in intervention and control locations (N = 1960). The primary outcome variable was an indicator of depressive symptoms using the 10-question Center for Epidemiologic Studies Depression Scale. Secondary outcomes include an indicator for hopefulness and physical health measures. Logistic regression models that adjusted for individual and household characteristics were used to determine the effect of the cash transfer program.
The cash transfer reduced the odds of depressive symptoms by 24 percent among young persons living in households that received cash transfers. Further analysis by gender and age revealed that the effects were only significant for young men and were larger among men aged 20–24 years and orphans.
This study provides evidence that poverty-targeted unconditional cash transfer programs, can improve the mental health of young people in low-income countries.
C. C. Undie, Mary Catherine Maternowska, M. Mak'anyengo, I. Askew