Cash transfer programs and intimate partner violence – Lessons from 3 case studies around the globe

1. Motivation ▪ 1 in 3 women are victims of intimate partner violence (IPV) (Devries et al 2013) ▪ Economic costs range from 1-4% of GDP (e.g., García-Moreno et al. 2015) o Women: deterioration of physical and mental health (e.g., Ellsberg et al. 2008) o Intergenerational: poorer child development / nutrition / health; greater likelihood of children entering into abusive relationships (e.g., Aizer 2010; Pollak 2004) ▪ Recent lit shows cash transfer (CT) programs in developing countries can reduce IPV (Angelucci 2008; Bobonis et al 2013; Hidrobo et al 2013; Haushofer and Shapiro 2013; Perova and Vakis 2013) o decreases in physical violence by 5–11 percentage points – although some subgroups found at risk for increase in violence ▪ Promising given ~1 billion CT beneficiaries in over 130 countries (DFID 2011; WB 2015)

2. Motivation ▪ CTs are primarily a policy tool to respond to poverty and vulnerability ▪ But variations in design features may have implications for effects on IPV ▪ Previous studies focused on CTs, often with complementary features, targeted primarily to women in Latin America ▪ How far can we generalize these findings? ▪ We examine 3 case studies from around the globe (Ecuador, Bangladesh, and Mali) and address 3 distinct policy-design questions about how transfer programs can reduce IPV o Draw on cluster-randomized controlled trials – “gold standard” o Use mixed methods to understand “what happens” and “why”

3. 3 case studies ▪ Ecuador: Does the modality of transfer provided – food, cash, voucher – matter for impacts on IPV? o Modalities other than cash are widespread around the world and may better serve other objectives – do IPV impacts differ? ▪ Bangladesh: What happens to IPV after a transfer program ends, and does it depend on complementary activities provided along with transfers? o Complementary features can be challenging to implement – are they needed for IPV impacts? o Many CT programs do not continue indefinitely – is this a sustainable approach to reducing IPV? ▪ Mali: What are the impacts on IPV when cash transfers are targeted primarily to men, and does it depend on household structure? o In some regions, targeting women may be viewed as contextually inappropriate – can targeting men affect IPV? o Diverse household structures are common – are impacts on IPV generalizable?

4. Conceptual framework Buller et al (2018). A mixed-method review of cash transfers and intimate partner violence in low and middle-income countries

9. Ecuador: Does the modality of transfer provided – food, cash, voucher – matter for impacts on IPV? ▪ Cash, food, or voucher program, April 2011- September 2011 (WFP) ▪ Design features o Targeting: poor households and Colombian refugees o Recipients: Women within the household o Size and frequency: 6 monthly transfers of $40 USD o Complementary activities: monthly nutrition trainings o Objectives: o Improve food consumption o Reduce tensions between Colombian refugees and Ecuadorians o Improve women’s role in decision-making over food consumption

10. Ecuador: Does the modality of transfer provided – food, cash, voucher – matter for impacts on IPV? ▪ Study design (IFPRI and CEPAR) o Location: Urban centers in 2 northern provinces of Ecuador o Design: Randomly assigned clusters to either receive cash, food, vouchers, or no transfer o Data: o Quantitative: o Longitudinal: baseline, endline right after last transfer o WHO Violence Against Women Instrument in both rounds o Qualitative: o In-depth investigation of pathways o September 2013 – 2 years after last transfer

11. Ecuador: Does the modality of transfer provided – food, cash, voucher – matter for impacts on IPV? ▪ Results: ▪ 25-35%  in physical violence ▪ Impacts do not significantly differ by transfer modality 20% 13% * 15% 14% * 0% 5% 10% 15% 20% 25% Control Food Cash Voucher Percentage Intervention arms Physical violence, endline (Adjusted means)

12. Ecuador: Does the modality of transfer provided – food, cash, voucher – matter for impacts on IPV? ▪ Pathways o Improvements in a women’s empowerment o “When I got that [the transfer] it was both of us [who were head of the household] because with what I got [the transfer] I could buy food and all and he could pay for other things.” o “I always spend my time at home, I do not go out much, I do not know how to relate with people very well and there [in the trainings], you slowly lose the shyness […] I used to be very shy, now I am only a bit shy […]” o Improvements in households economic well-being (food security and food consumption) o “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].” o Decreases in intra-household conflict o “Sometimes problems arise because I am in need [of money] for one or the other thing and there is no money and that is when problems start, the fights […] and it [transfers] helped us a lot, he [the partner] had money to buy other things for the house or pay debts”

13. Bangladesh: What happens to IPV after a transfer program ends, and does it depend on complementary activities provided along with transfers? ▪ Transfer Modality Research Initiative (TMRI): May 2012 - April 2014 (WFP-Bangladesh) ▪ Design features o Targeting: very poor rural households with a child 0-24 months at program start o Recipients: Mother of child 0-24 months o Size and frequency: 2 years of monthly transfers, each worth 1500 Taka (~$18) o Complementary activities: Intensive nutrition behavior change communication (BCC) – weekly group meetings, bimonthly home visits, monthly community meetings o Objectives: o Improve household food security o Improve child nutrition o No explicit gender objective – but gender- sensitive design Photo credit: Aminul Khandaker, IFPRI-Dhaka

14. Bangladesh: What happens to IPV after a transfer program ends, and does it depend on complementary activities provided along with transfers? ▪ Study design (IFPRI and DATA) o Location: Rural villages in northwest and southern coast of Bangladesh o Design: Randomly assigned villages to either receive cash or equal-value food – with or without BCC o Data: o Quantitative: o Longitudinal data, with 6-10 months “post-endline” survey round o At post-endline, WHO Violence Against Women Instrument asked of mothers o Qualitative: o Process evaluation during intervention o Not focused specifically on gender

15. Bangladesh: What happens to IPV after a transfer program ends, and does it depend on complementary activities provided along with transfers? ▪ Results: ▪ 26%  in physical violence from Transfer+BCC, 6-10 months after program ended ▪ No impact on physical violence from Transfer only, 6-10 months post-program 27% 27% 20% ** 0% 5% 10% 15% 20% 25% 30% Control Transfer Transfer+BCC Percentage Intervention arms Physical violence, post-endline (Adjusted means)

16. Bangladesh: What happens to IPV after a transfer program ends, and does it depend on complementary activities provided along with transfers? ▪ Pathways: Sustained effects of Transfers+BCC relative to Transfers on o Improved women’s threat point o  Economic resources: Control over money, participation in work o  Agency: Internal locus of control, self-confidence o  Social capital: “The BCC training boosted their family status within the community. The neighbors regularly come over to hear what the family learned in the latest training session.” (Process evaluation) o Increased men’s “cost” of violence o  Women’s social capital  more detection/social control of physical violence o Reduced household poverty-related stress and conflict o  Household wealth at endline, likely to be sustained o “Previously, if she asked her husband to buy some food when there was none in the house, he would become angry and hit her. Now, she says, he is generally quite pleasant and does not fight with her anymore.” (Process evaluation)

17. Mali: What are the impacts on IPV when cash transfers are targeted primarily to men, and does it depend on household structure? ▪ Programme de Filets Sociaux Au Mali (Jigisemejiri): 2014 – ongoing (Government of Mali) ▪ Design features o Targeting: Poor rural households o Recipients: Heads of household, primarily men o Size and frequency: Quarterly transfers, each 30,000 FCFA (~$18/month) o Complementary activities: Bi-monthly trainings (nutrition, health, finances, use of cash); preventive nutrition packets (not part of this study) o Objectives: o Improve household food security o Improve child nutrition o No gender-related objective

18. Mali: What are the impacts on IPV when cash transfers are targeted primarily to men, and does it depend on household structure? ▪ Study design (IFPRI and IRD) o Location: Five southern regions – Sikasso, Koulikoro, Kayes, Mopti, Segou. o 36% households are polygamous. o Design: Randomly assigned communes to either receive treatment (transfers + training) or control o Data: o Quantitative: o Longitudinal data o Midline round (1-2 years of intervention) used for IPV analysis o Detailed modules on pathways related to men o WHO Violence Against Women Instrument o Qualitative: o In-depth interviews with men and women in polygamous and monogamous households o Analysis underway (not yet presenting)

19. Mali: What are the impacts on IPV when cash transfers are targeted primarily to men, and does it depend on household structure? ▪ Results: ▪ 41%  in physical violence in polygamous households ▪ No impact on physical violence in monogamous households 12% 13% 18% 11% ** 0% 5% 10% 15% 20% Control Treatment Control Treatment MONOGAMOUS POLYGAMOUS Physical violence, midline (Adjusted means)

20. Mali: What are the impacts on IPV when cash transfers are targeted primarily to men, and does it depend on household structure? ▪ Pathways: In polygamous households more than monogamous households, o Improved men’s emotional well-being o  Men’s stress and anxiety o Decreased intra-household conflict o  Self-reported disputes between spouses o No evidence of significant changes in women’s empowerment ▪ Ongoing exploration of why these differ for polygamous vs. monogamous o Higher conflict and stress in polygamous households in the absence of program – more potential for impact? o Do observables explain some of the differences? o Something inherent to intrahousehold dynamics in polygamous households?

21. Take-aways for design of cash transfers to reduce IPV ▪ Commonalities in findings despite diverse program features and context o Cash transfers reduce IPV in all three case studies, even though not the main program objective o Although there is potential for transfers to  IPV, we do not find evidence of this occurring in any of the three case studies ▪ Do variations in program features and context matter? o Cash vs. food vs. voucher will not necessarily change impacts on IPV o Complementary activities may be important for sustaining impacts on IPV o Transfers targeted to men can reduce IPV, but it may depend on context

22. Take-aways for design of cash transfers to reduce IPV ▪ Important when designing CT programs to think about how features and context affect pathways o Impacts on IPV may revert if the program does not sustainably affect pathways o Pathways may depend on household structure or other contextual factors ▪ Transfer programs are promising as a scalable approach to reducing IPV globally, but more rigorous evidence is needed to explore generalizability o Valuable evidence generated by measuring IPV in evaluations even if not the primary program objective o Important to incorporate qualitative work to understand pathways

23. Acknowledgments and references ▪ We gratefully acknowledge funding from the CGIAR Research Program on Policies, Institutions, and Markets (PIM); the Sexual Violence Research Initiative (SVRI); the World Bank; the International Initiative for Impact Evaluation (3ie); the Government of Mali; the Government of Spain via the World Food Programme; and an anonymous donor. ▪ References for case studies: o Buller, A. M., Hidrobo, M., Peterman, A., & Heise, L. (2016). The way to a man’s heart is through his stomach?: a mixed methods study on causal mechanisms through which cash and in-kind food transfers decreased intimate partner violence. BMC Public Health, 16(488), 1–13. o Hidrobo, M., Peterman, A., & Heise, L. (2016). The effect of cash, vouchers, and food transfers on intimate partner violence: Evidence from a randomized experiment in Northern Ecuador. American Economic Journal: Applied Economics, 8(3). o Roy, S., Hidrobo, M., Hoddinott, J. & Akhter, A. (2017).Transfers, Behavior Change Communication, and Intimate Partner Violence: Postprogram Evidence from Rural Bangladesh. IFPRI Discussion Paper 1676. o Buller, A. M., 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. In press, World Bank Research Observer o Heath, R., Hidrobo, M., Roy, S. (2018). Cash transfers, polygamy, and intimate partner violence: Experimental evidence from Mali. (Working paper)

24. Thank you! ▪ Melissa Hidrobo: m.hidrobo@cgiar.org ▪ Shalini Roy: s.roy@cgiar.org