Tia Palermo's (University of Buffalo) presentation for Promundo's Learning Dialogue Series on 4 June 2020.

1. Tia Palermo, Ph.D., University at Buffalo
on behalf of the Cash Transfer and Intimate Partner Violence Research Collaborative
Promundo Learning Meeting: June 4, 2020
EVIDENCE OF CASH TRANSFERS ON VIOLENCE
AGAINST WOMEN AND CHILDREN

2. Cash Transfer and Intimate Partner Violence Research
Collaborative
https://www.ifpri.org/project/cash-transfer-and-intimate-partner-violence-research-collaborative

3. PRESENTATION
OVERVIEW
01. Mixed method review of
cash transfers and intimate
partner violence + new
evidence
02. Review of social safety nets
and childhood violence + new
evidence
03. Conclusion & programmatic
implications

4. Mixed method review of cash transfers on IPV
1) Review quantitative and
qualitative evidence linking
cash transfers (CT) & IPV,
focusing on mechanisms
underlying impacts
2) Build a program theory linking
CT and IPV
3) Propose promising program
design features and research
gaps needed to further
understand linkages/leverage
potential of CTs
Buller AM, Peterman A, Ranganathan M, Bleile A, Hidrobo M, Heise L. (2018). "A mixed-method review of cash transfers
and intimate partner violence in low-and middle-income countries." The World Bank Research Observer 33(2): 218-258.

5. Program characteristics (22 studies)
▪ Nearly all programs targeted women
(*Kenya, South Africa)
▪ 10 quantitative & 3 qualitative Govt run
Program type
▪ ‘Plus’: In-kind transfer; Education, health
sector linkages; trainings; behavior change
communication
▪ Multiple in Mexico, Ecuador, Peru, Uganda
0
2
5
7
9
11
UCT UCT plus CCT CCT plus
Quantitative Qualitative
Geographic Region
0
4
8
12
16
LAC SSA MENA Asia
Quantitative Qualitative

6. 0
4
8
12
16
20
Decrease Increase
Quantiative Qualitative
§ Majority of studies (73%) showed decreases, impacts stronger for
physical/sexual
§ Overall 36% of quant indicators significant & negative; 2% significant &
positive
0
10
20
30
40
Controlling/
psycological/
economic
Emotional Physical and/or
sexual
Decrease Increase Not significant
Overall impacts on IPV
[22 studies]
Quantitative indicators
[56 total by IPV type]
High-level results: Impacts
[11 of 14 studies
show any reduction]

7. Three main pathways
Household level
impact
Marital dynamic
impact
Woman specific
impact

8. IPV
PATHWAY 1: Economic security & emotional
wellbeing
“In my household it was like happiness, we all got along, with my
children, with my husband […] in my house we were happy […]
because before we did not have enough money for those things
[food].”
Female from IDI in cash, food & voucher program in Ecuador (Buller et al. 2016)

9. IPV
IPV
“There had been many fights. Because children needed many
things that we could not have afforded. I asked my husband
and he used to say there is no money. Then I used to get upset
and started to yell. We had many fights because of poverty.
Not only for us, for all poor, fights come from suffering”
PATHWAY 2: Intra-household conflict
Female from IDI in CCT plus in-kind transfers in Turkey (Yidrim et al. 2014)

10. IPV
IPV
PATHWAY 3: Women’s empowerment
“Earlier, … my husband would sometimes sell household items without
consulting me. But now that I have my own money, I can have a say
on how to spend income. ..With the money, a woman may buy seedlings
for planting, and hire an ox-plough or tractor or casual labor to dig for her.”
Female from IDI in UCT in Northern Uganda (Nuwakora 2014)

11. Ghana LEAP 1000: Can a national cash transfer paired with health
insurance premium waiver reduce IPV, and through what pathways?
Peterman A, Valli E, Palermo, T, on behalf of Ghana LEAP 1000 Evaluation Team. (2020). "Government Anti-Poverty
Programming and Intimate Partner Violence in Ghana." Economic Development and Cultural Change In press.
• Overall IPV experience
§ No reductions in overall experience among full
sample
§ 5 - 8 percentage point decreases in overall IPV
experience among monogamous sample only (6 pp
emotional, 5 pp physical & 8 pp combined IPV)
§ However, women in polygamous unions at
increased risk of IPV overall
• Frequency of IPV
§ 0.09 - 0.11 standard deviation decrease among full
sample (0.11 emotional, 0.09 physical & 0.11
combined IPV)

12. Ghana LEAP 1000: Summary of pathway impacts
§ Positive impacts on:
§ Economic security (less likely to be poor
and extremely poor)
§ Monthly total & food expenditures
§ Locus of control
§ Savings
§ Social support
§ Valid NHIS card; health seeking behavior
§ No impacts on:
§ Self perceived stress
§ Life satisfaction
§ Partner drinking
§ Expenditures on alcohol
§ Women’s decision-making
§ Women’s agency

13. § cRCT, implemented by WFP,
evaluated by IFPRI
§ Provided cash or food transfers
– with or without intensive
nutrition behavior change
communication (BCC) – from
2012 to 2014
§ Targeted to mothers of children
0-23 months in poor rural
households
§ 26% ↓ in physical IPV from
Transfers+BCC, 6-10 months
after program ended
Transfer Modality Research Initiative (TMRI)
in Bangladesh
Roy, S., Hidrobo, M., Hoddinott, J., & Ahmed, A. (2019). Transfers, behavior change communication, and intimate partner violence: Postprogram
evidence from rural Bangladesh. Review of Economics and Statistics, 101(5), 865-877.

14. Why? Unintended benefit of BCC was sustained
increases in women’s social interaction and status
§ 3 components of BCC
§ Weekly group meetings of
women with a trained
community nutrition worker
§ Bi-monthly home visits by
community nutrition workers
§ Monthly meetings with
influential community
leaders
§ Material focused on infant
and young child feeding
§ Format led to ↑ in women’s
social interaction & status –
led to sustained ↓ in IPV

15. CTs & IPV: conclusions & research gaps
§ Cash transfers
§ can improve wellbeing beyond primary program objectives
§ are proven ‘structural’ prevention complements to dedicated GBV prevention
programming
§ have design features to allow women to retain control without overtly
challenging male role of breadwinner
§ Pathways include increased resources, emotional wellbeing, women’s
empowerment, reduced stress, social support
§ Evidence gaps:
§ Geographic & humanitarian settings
§ Sustainability of impacts
§ Program design: transfer recipient, plus components
§ Understanding mechanisms/pathways
§ Cost-effectiveness analysis to compare to dedicated GBV programming
§ Target group & family structure matters in delivering impacts – yet we know little
about why or how

16. What about violence against children?
§ Measurement more complex:
o Appropriate & specific violence measures vary
across age ranges
o Ethical issues more acute
§ Mechanisms more complex:
o Violence in different spaces (home, school, &
labor settings)
o Violence from different perpetrators (household
& strangers)
o More indirect pathways
Peterman A, Neijhoft N, Cook S, Palermo T. (2017). "Understanding the linkages between social safety nets and
childhood violence: a review of the evidence from low-and middle-income countries." Health policy and planning
32(7): 1049-1071.

17. Overall results: 57 indicators (11 studies)
§ In total, 19% represent
protective effects of
SSNs (no adverse
effects)
§ Regionally grouped –
sexual violence from
adolescent studies in
SSA, violent discipline
from LAC
§ Only one mixed-methods
study (Palestine)
0%
100%
0%
10%
0%
20%
44%
Homicide
Dating violence
Physical against
minors
Violent discipline
Peer bullying
Sexual exploitation
Sexual abuse

18. Summary: Social safety nets for childhood
violence reduction
• Results are promising for protecting adolescent girls against sexual
exploitation & abuse, less so for other types of violence
• Many evidence gaps: regional, program type—lack of comprehensive studies
showing how SSNs can affect multiple types of risk for children (including in
different settings, witnessing IPV, frequency or severity of violence)
• Mechanisms are diverse: schooling, caregiver stress, adolescent risk
behaviors, exposure to high-risk environments, girls’ empowerment.
• Lack of studies able to test plus components, including links to integrating
child and social protection systems.

19. New Evidence: Tanzania’s Cash Plus Model for Safe Transitions to a
Healthy and Productive Adulthood
• “Plus” components targeted to adolescents in households
participating in Government’s Productive Social Safety Net
(PSSN) – aka “the cash”
• Increased gender equitable attitudes among males in the
violence domain of the Gender Equitable Men’s (GEM) Scale
• Evaluation examined impacts on emotional, physical, sexual
violence experiences and perpetration of physical and
emotional violence
• Pathways: time use, increases in self-esteem, reductions in stress
Tanzania Adolescent Cash Plus Evaluation Team. (2020). Impact Evaluation for a Cash Plus Model for Safe
Transitions to a Healthy and Productive Adulthood: Wave 3 Report. UNICEF Office of Research and EDI. Florence,
Italy/Dar es Salaam, Tanzania. https://transfer.cpc.unc.edu/tools/reports/tanzania-reports-2/

20. What matters for program design (1)?
§ Complementary activities may be important for sustaining
impacts – however what form this takes will vary by
context:
§ Edutainment or aspirational / empowerment
messaging
§ Cognitive behavioral therapy
§ Group or couples' trainings on gender norms / roles
§ Mentoring for girls / guardians
§ Case management
** Depends what drivers of GBV are in a setting / target
group = suggests pre-program gender risk assessment
crucial

21. § Intra-HH relationships are key: design features to allow
women to retain control (messaging, frequency, size of
transfer) micro-changes to gender roles in the
household with “buy in” of men
§ Woman as transfer recipient appears important, but
few tests of this theory
§ Existing research largely evaluates programs that are
gender blind/neutral; a lot of momentum now to
understand programs designed specifically for gender-
transformative effects
What matters for program design (2)?

22. THANK YOU!
Email: tiapaler@buffalo.edu
@tiapalermo | @TransferProjct
transfer.cpc.unc.edu
Cash Transfer and IPV Research Collaborative
https://www.ifpri.org/project/cash-transfer-and-
intimate-partner-violence-research-collaborative

23. ACKNOWLEDGEMENTS
• Slide 1: © FAO/IvanGrifi/19431674444_a702f46a21
• Slide 3: © FAO/IvanGrifi/19431617964_bf1542f18a
• Slide 14: Aminul Khandaker, IFPRI-Dhaka
• Slide 22: © FAO/IvanGrifi/20054330395_0779fb2c94