Cash transfer programs have been shown as effective in reducing poverty, but a growing body of evidence shows that these programs can also be effective in reducing violence against women – in particular, intimate partner violence (IPV). IPV refers to violence perpetrated by a spouse or other intimate partner, and is one of the most common forms of violence against women. More than 1 in 4 women globally reports experiencing physical or sexual IPV in her lifetime, with a range of adverse consequences for women themselves as well as children in their household. Because cash transfer programs are being increasingly implemented around the world and can be provided at large scale, they are increasingly seen as a promising platform to leverage IPV prevention at scale.
However, a core question has remained on whether cash transfer programs can be a sustainable solution to reducing IPV: Do impacts of cash transfer programs on IPV persist after the programs end? And if so, does sustainability of post-program impacts depend on the specific features of the program?
A recent IFPRI study in Bangladesh – forthcoming in the Journal of Human Resources – explored these questions 4 years after the end of a pilot transfer program called the Transfer Modality Research Initiative (TMRI). TMRI was implemented by the World Food Program from 2012-2014 in two regions of Bangladesh. The interventions were implemented in two regions of the country: the Northwest (referred to as the “North”) and the Southern coastal area (referred to as the “South”). Designed as a randomized controlled trial in these two regions, TMRI provided monthly cash transfers or monthly food transfers, with or without an intensive nutrition behavior change communication (BCC) component, to mothers of young children in poor rural households for 2 years.
The nutrition BCC did not explicitly include gender- or violence-focused messaging, but intensively engaged women as well as their household and community members. Components included weekly group meetings for approximately 10 target women per village, led by trained nutrition workers (to which husbands and mothers-in law were also sometimes invited); bimonthly visits by nutrition workers to the women’s homes; and monthly group meetings between program staff and influential community leaders (such as village headmen, religious leaders and educators) to share the information being conveyed to women. BCC topics included themes related to infant and young child feeding. Women’s attendance rates at the BCC sessions was high. Anecdotally, women often arrived early for the meetings and stayed late to talk with other group members, finding it an opportunity for social interaction.
The IFPRI team re-surveyed a subset of TMRI households both 6-10 months and 4 years after the interventions ended, in 2014-2015 and 2018 respectively. Although the original objective of the TMRI interventions was to improve household food security and child nutrition, the post-program rounds also focused on assessing women’s experience of IPV. Questions were asked from the World Health Organization modules on violence against women, following ethical guidelines around safety and confidentiality.
What did the IFPRI analysis find? A prior publication in the Review of Economics and Statistics showed that, 6-10 months post-program, women who had received Cash+BCC in the North or Food+BCC in the South experienced significantly less physical IPV than those who had received transfers alone or no intervention. The new study shows that, even 4 years after TMRI interventions ended, women who had received Cash+BCC in the North continued to experience significantly less IPV. In fact, the magnitude of Cash+BCC’s impact on physical violence grows over time, from a 9 percentage point reduction at 6-10 months post-program to a 14 percentage point reduction at 4 years post-program. However, 4 years post-program, Food+BCC in the South no longer shows significant impacts on IPV. These new findings reflect the first evidence of longer-term sustainability of IPV impacts from cash transfer programs, as well as the first evidence indicating that IPV impacts differ by transfer modality.
Why does Cash+BCC continue to reduce IPV even 4 years after the interventions ended, and why do the same effects not occur from cash transfers alone? The IFPRI analysis shows that the combination of cash transfers with complementary nutrition BCC sustained IPV reductions through persistent increases in (1) women’s bargaining power, (2) costs to men of perpetrating violence, and (3) men’s emotional well-being. Companion evidence supports these findings, suggesting that women may have been more empowered due to the increased social interaction and knowledge gained from the transfers combined with BCC, making them less willing to accept violent behavior. Women’s increased social interaction may have made any physical violence more visible to the community, increasing the probability that men inflicting it would face social disapproval, increasing “social costs” of perpetration. Moreover, transfers combined with BCC caused greater improvements in household economic well-being than transfers alone, easing poverty-related stress, a trigger for violence. Although the IFPRI study cannot conclusively distinguish what features of the BCC led to these effects when combined with cash transfers, it suggests that both the content of the BCC and its group-based structure played a role, and both transfer modality and regional context may have influenced how adding BCC affected household economic well-being.
These findings have important implications for program design. They show that a cash transfer program need not have IPV prevention as an explicit objective to result in sustained IPV reduction several years after the end of the program. However, design features must lead to sustained impacts on pathways for IPV reduction. Although TMRI’s results do not imply that nutrition BCC per se is required in every cash transfer program in order for IPV reductions to be sustained, the findings highlight the importance of including some programming relevant to the context that sustainably affects IPV pathways. In the case of TMRI in rural Bangladesh – where women’s social isolation due to poverty and seclusion norms contributed to low status, and where their low status likely contributed to IPV – adding group-based BCC to cash transfers sustainably affected IPV pathways. Ongoing new mixed-method research in Bangladesh further attempts to understand the mechanisms through which TMRI’s effects on IPV have evolved over time, as well as how they have changed since 2018.
Findings also have implications for programming specifically in Bangladesh. Earlier findings from TMRI on the important role of nutrition BCC for child nutrition have already informed inclusion of nutrition BCC in programming in Bangladesh. Thus, these results strengthen the case for including BCC with transfers – reflecting that there may be additional benefits in the form of reduced IPV.
Journal citation:
Roy, Shalini, Melissa Hidrobo, John F. Hoddinott, Bastien Koch, and Akhter U. Ahmed. 2022. Can transfers and complementary nutrition programming reduce intimate partner violence four years post-program? Experimental evidence from Bangladesh. Journal of Human Resources. https://jhr.uwpress.org/content/early/2022/06/01/jhr.0720-11014R2
Read the full article here.
For more information on the Transfer Modality Research Initiative (TMRI), please visit the official project page.