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Impacts of Integrated Social Protection on IPV: the case of Ghana's LEAP 1000

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Tia Palermo form UNICEF Innocenti presents her work on the impacts of social protection on intimate partner violence in Ghana at our CSW63 side event in UN Women in New York in March 2019.

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Impacts of Integrated Social Protection on IPV: the case of Ghana's LEAP 1000

  1. 1. unite for children Impacts of integrated social protection on IPV: The case of Ghana’s LEAP 1000 CSW 63: Side Event, March 13, 2019 “Leveraging Cash Transfers to reduce IPV at scale” Tia Palermo, UNICEF Office of Research—Innocenti On behalf of Amber Peterman, Elsa Valli & the LEAP 1000 Evaluation Team
  2. 2. 2 Motivation: Large-scale social protection in Africa • Promising evidence that cash transfers reduce IPV, however majority of evidence from LAC • Evidence from Africa (2 empirical studies) both focused on NGO small-scale studies • Literature has not sufficiently covered cash plus programming—or different vulnerable groups (e.g., pregnant women) • Generally mechanisms hypothesized, but not directly tested
  3. 3. 3 Study objectives  Examine whether a government social protection program targeted to extremely poor, rural households with pregnant and recently pregnant women in Ghana had an impact on past-year prevalence and frequency of IPV;  Through which pathways;  Assess if family structure matters (polygamous v. monogamous)
  4. 4. 4 LEAP 1000 program  Part of government-led, nationwide unconditional cash transfer program: Livelihood Empowerment Against Poverty (LEAP) program  Program objectives: 1) Alleviate short-term poverty and 2) Encourage long-term human capital development  LEAP 1000 specific focus on nutrition and stunting  Targets pregnant women or women with a child <1 year  Bi-monthly cash transfer [approx. GH₵76 (EUR14)] and health insurance (NHIS) premium waiver  Initial coverage of LEAP 1000: 6,220 households in 10 districts in Northern Ghana
  5. 5. 5 LEAP 1000: Evaluation Design & sample  2-year mixed method, quasi- experimental, longitudinal study  8,058 households targeted by government and 3,619 deemed eligible  Baseline (Jul-Sept 2015), Endline (Jul-Sept 2017)  Female enumerators, interviews conducted in privacy  Analysis sample: N=2,083 women (1,060 T & 1,023 C)  Analysis methodology: Difference-in- difference leveraging proxy-means eligibility threshold Districts: Yendi, Karaga, East Mamprusi, Bongo Garu Tempane
  6. 6. 6 Measures: IPV Outcomes  Based on modified Conflict Tactics Scale  Any experience in prior 12 months  Frequency in prior 12 months (0=never, 1=sometimes, 2=often for each item; standardized)  Controlling behaviors, 7 questions (any; frequency 0 – 7)  Emotional IPV, 4 questions (any; frequency range 0 – 8)  Physical IPV, 7 questions (any; frequency range 0 – 14)  Sexual IPV, 2 questions (any; frequency range 0 – 4)  Emotional/Physical/Sexual IPV, 13 questions (any; frequency range 0 – 26)
  7. 7. 7 Comparison of IPV levels in LEAP to national statistics (GDHS 2009) 12-month measures 66% 60% 36% 19% 35% 31% 18% 5% 0% 10% 20% 30% 40% 50% 60% 70% Combined IPV Emotional IPV Physical IPV Sexual IPV LEAP sample National sample ** Controlling behaviors not displayed as DHS only collects lifetime indicators (LEAP sample = 82%)
  8. 8. 8 Emotional IPV Community-level variation IPV (12-month) Physical IPV Sexual IPV
  9. 9. 9 LEAP 1000: Impacts on IPV • 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)
  10. 10. 10 LEAP 1000: Summary of pathway impacts  Positive impacts on:  Economic security (less likely to be poor and extremely poor; 3-5 pp)  Monthly expenditures (~ 7 Cedis AE)  Monthly food expenditures (~ 5-6 Cedis AE)  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
  11. 11. 11 Discussion & conclusion  LEAP 1000 reduced frequency of emotional, physical, any IPV measures in the full sample  Any experience of IPV only reduced in the monogamous sample  No impacts on experience among polygamous sample, which is at highest risk of IPV  Pathways include economic standing/emotional wellbeing & women’s empowerment  Results underscore that cash transfers can have improve wellbeing beyond primary program objectives – frequency/intensity are rarely measured – but may be under-appreciated, positive benefit  Findings indicate that target group & family structure matters in delivering impacts – yet we know little about why or how  We are not able to break out the contribution of the ‘plus’ (health insurance waiver), more research on program design needed
  12. 12. 12 Meda ase Thank you Ghana LEAP 1000 (© Michelle Mills)
  13. 13. 13 LEAP 1000 Evaluation Team: UNICEF Office of Research – Innocenti: Tia Palermo (co-Principal Investigator), Richard de Groot, Elsa Valli; Institute of Statistical, Social and Economic Research (ISSER), University of Ghana: Isaac Osei- Akoto (co-Principal Investigator), Clement Adamba, Joseph K. Darko, Robert Darko Osei, Francis Dompae and Nana Yaw; Carolina Population Center, University of North Carolina at Chapel Hill: Clare Barrington (co- Principal Investigator), Gustavo Angeles, Sudhanshu Handa (co-Principal Investigator), Frank Otchere, Marlous de Miliano; Navrongo Health Research Centre (NHRC): Akalpa J. Akaligaung (co-Principal Investigator) and Raymond Aborigo. For more information: Tia Palermo (tmpalermo@unicef.org) Citation: Peterman A, Valli E, Palermo T, On Behalf of the LEAP 1000 Evaluation Team. “Government Anti-Poverty Programming and Intimate Partner Violence in Ghana.” Under review.
  14. 14. 14 Acknowledgements We are grateful for the support of the Government of Ghana for the implementation of this evaluation, in particular William Niyuni, Mawutor Ablo and Richard Adjetey from the Ministry of Gender, Children and Social Protection. In addition, the UNICEF Ghana team was instrumental to the success of this report: Sara Abdoulayi, Luigi Peter Ragno, Jennifer Yablonski, Sarah Hague, Maxwell Yiryele Kuunyem, Tayllor Spadafora, Christiana Gbedemah and Jonathan Nasonaa Zakaria. We would also like to acknowledge the hard-working field teams of ISSER and NHRC, who conducted the data collection for this study to the highest standards. Funding for the evaluation was generously provided by the United States Agency for International Development (USAID) and the Canadian International Development Agency (CIDA). Additional funding to include intimate partner violence modules in the evaluation and to produce this paper was received from an Anonymous donor and the American World Jewish Services by the UNICEF Office of Research—Innocenti via the US Fund for UNICEF. We thank Laura Meucci and Michelle Kate Godwin for grant administrative support.

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