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Shonjibon cash transfer and nutrition counselling trial in rural Bangladesh - the impact on women's empowerment
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This presentation was given by Elizabeth Kirkwood (The University of Sydney), as part of the Annual Scientific Conference hosted by the University of Canberra and co-sponsored by the University of Canberra, the Australian Centre for International Agricultural Research (ACIAR) and CGIAR Collaborative Platform for Gender Research. The event took place on April 2-4, 2019 in Canberra, Australia. Read more: https://www.canberra.edu.au/research/faculty-research-centres/aisc/seeds-of-change and https://gender.cgiar.org/annual-conference-2019/
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Shonjibon cash transfer and nutrition counselling trial in rural Bangladesh - the impact on women's empowerment
- The University of Sydney Page 1 Shonjibon cash transfer and nutrition counselling trial in rural Bangladesh - the impact on women's empowerment Elizabeth K Kirkwood PhD Candidate Sydney School of Public Health Faculty of Medicine and Health Measuring Impacts on Nutrition and Empowerment Seeds of Change, Canberra, April 3, 2019
- The University of Sydney Page 2 Shonjibon Cash and Counselling Trial Trial Setting - Jamalpur, Bangladesh unconditional cash transfer nutrition behaviour change communication delivered on a mobile app and call centre counsellinghttp://www.maps-of-the-world.net/maps-of-asia/maps-of-bangladesh/ https://www.callcenter.com.bd/outsourcing-to-bangladesh - photo credit counselling from call centre
- The University of Sydney Page 3 Shonjibon Cash and Counselling Trial Measuring the impact on women’s empowerment Project Level –Women’s Empowerment in Agriculture Index Malapit HJ, Quisumbing AR, Meinzen-Dick RS, Seymour G, Martinez EM, Heckert J, et al. Development of the Project-Level Women’s Empowerment in Agriculture Index (Pro-WEAI). IFPRI; 2019 January 18, 2019.
- The University of Sydney Page 4 Shonjibon Cash and Counselling Trial Measuring the impact on women’s empowerment
- The University of Sydney Page 5 Shonjibon Cash and Counselling Trial Measuring the impact on women’s empowerment
- The University of Sydney Page 6 Shonjibon Cash and Counselling Trial Measuring the impact on women’s empowerment Addition of Pro-WEAI Health and nutrition module Qualitative Research
- The University of Sydney Page 7 Shonjibon Cash and Counselling Trial – where are we now?
- The University of Sydney Page 8 Shonjibon Cash and Counselling Trial Measuring the impact on women’s empowerment Acknowledge Co Authors: Dr Ashraful Alam Professor Michael Dibley Professor John Hoddinott Dr Tanvir Huda SCC Trial team Implementing partner - icddr,b Thank you IFPRI – generously sharing knowledge and tools Seeds of Change: Australian Centre for International Agricultural Research CGIAR Collaborative Platform for Gender Research University of Canberra
- The University of Sydney Page 9 gender.cgiar.org We would like to acknowledge all CGIAR Research Programs and Centers for supporting the participation of their gender scientists to the Seeds of Change conference. Photo: Neil Palmer/IWMI
Editor's Notes
- Introduction
- Shonjibon – Shustho Notun Jibon in Bangla -Healthy new life Set in Jamalpur in Northern Bangladesh Funded by the Australian NHMRC Longitudinal cluster RCT, recruit 3,450 women – 2 arms Control group will receive usual care from Government SCC Intervention: woman receives unconditional cash transfer and mobile phone with customised app containing nutrition behaviour change communication Women will receive USD 12.50 per month by Bkash mobile banking – for 24 months from 3 months into pregnancy until child is 18 months old Specifically tailored app will include Messages will be audio, video, text, quizzes and woman will have access to counselling via a call centre "counselling from call centre" component. Trained female nutrition counsellors will call the registered women to provide gestational age specific counselling. The SCC trial builds on pilot study that showed that this combination – cash and nutrition BCC significantly reduced childhood stunting Ultimate aim of the SCC trial is to assess the effectiveness of mobile phone nutrition behaviour change communication combined with unconditional cash transfers in reducing the prevalence of stunting Why is it important to monitor WE in the Shonjibon trial? It is well documented that women’s empowerment is an underlying determinant of household food security and agricultural productivity, maternal and child nutrition outcomes (18) (2, 16, 17). Social safety nets, by increasing income and the potential for investment in livelihoods and income generating activities, have been shown to alleviate poverty at a household level and reduce food insecurity (15, 24) further investigation into mHealth and mobile platforms, in terms of implementation and evaluation, in order to establish whether mHealth programs transform rather than reinforce gender inequalities
- Protocol I am presenting today - key objective is to evaluate the impact of a the Shonjibon Trial on the level of empowerment of women in Jamalpur, Bangladesh. This study on women’s empowerment is embedded in the Shonjibon trial and will survey women's experience of empowerment and disempowerment throughout the trial This study will use a mixed methods approach, combining quantitative and qualitative data tools tailored specifically for this study the key component will be the Project Level Women’s empowerment in Agriculture Index Pro-WEAI is based on Kabeer’s conceptual framework of empowerment which focuses on the ability of individuals to make choices – to quote Kabeer ‘‘a process of change during which those who have been denied the ability to make choices acquire such an ability’’ Not sure how much I should say about the development Hx of WEAI? – if any! Describe that there are 3 domains of empowerment on slide and 12 indicators grouped under these domains Due to time limitations today I will show a few examples of the impact we will be measuring
- Domain intrinsic agency – power within SCC gives woman cash, counselling and nutrition BCC on mobile app – influence attitudes about domestic violence or intimate partner violence Some studies have shown that the combination of nutrition counselling and cash transfers can lead to significantly less domestic violence Important to monitor IPV as other studies have shown that woman is the target of the intervention and recipient of the cash and mobile phone, this can challenge gender norms within relationship and household whilst there is limited evidence to show that negative effects such as distrust, domestic violence this may reflect the lack of data whether mHealth programs transform rather than reinforce gender inequalities The additional questions ask about personal experience of IPV, as opposed to perceptions thereof. The questions asked are taken from the Violence Against Women and Girls Survey (Bangladesh 2015) Reinforcing the need to monitor the impact of mHealth on gender relations and women’s empowerment in SCC.
- Domain - Instrumental agency – power to SCC cash transfer, nutrition BCC and phone to woman Control over use of income – the woman is given the cash transfer - will she be able to determine how that money is spent? Will this change what level of input will she has in expenditure and other financial decisions? In addition to the questions in Pro-WEAI we will ask detailed questions on assets, household savings, debt and land. The additional questions are taken from the Transfer Modality Research Institute (TMRI) survey (38). These questions have been extensively pretested in over 5000 households in Bangladesh. Using this combination questions we will survey women to determine if the Shonjibon trial will lead to asset accumulation – specifically by the women in the household. This detailed asset list which will be more adept at detecting changes in household assets and changes in women’s livelihoods
- Household food consumption is powerfully driven by social constructs such as gender roles of women and men particularly in rural Bangladesh The Nutrition and health module ask question about the woman and child's health and nutrition status –decision making, about health care, dietary choices and infant and young child feeding Quantitative data will be collected at baseline, and endline of Shonjibon Trial Qualitative tools are being finalised and will be informed by formative research In depth interviews will take place with women, men, mother in laws and We will explore women and men’s perceptions and definitions of empowerment elicit local understanding of women’s empowerment and the linkages between the intervention design and women’s empowerment outcomes Key domains to explore will be intrahousehold communication, self efficacy and intimate partner violence We will survey woman’s ability to make decisions and have input re productive resources and what control is had over the use of income and freedom of movement.
- Where are we at now? Formative research has been done App is in development – messages finalised Call centre has been set up and training material being developed Recruitment to start in June Intervention to start in August The main objective of this protocol study is to evaluate the impact of a combined nutrition counselling and unconditional cash transfer intervention, delivered on a mobile platform, on the level of empowerment of women in rural Bangladesh. Women’s empowerment is acknowledged as an imperative goal in global public health and key to sustainable development. It is therefore also crucial to monitor the role that women’s empowerment plays, as a contributing factor in combined nutrition sensitive and specific interventions, in food insecure populations This study has several strengths, firstly it is embedded within a NHMRC Shonjibon study Another strength lies in the use of a mixed methods approach. Further strength is gained from the use of tools tailored specifically for this intervention; tools that are based on formative research, piloted in Bangladesh and will provide accurate, comprehensive and appropriate methodology. The core elements of these customised tools will provide translatable results – using measures and indices that will be used in global comparison. Women’s empowerment data will be measured longitudinally in the Shonjibon trial and will enable us to measure beyond national and economic data and will help fill the evidence gap on pathways of impact and highlight areas to target for future policy and programming.
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