To stem violence, it is crucial that countries and program implementers are informed by evidence on what works best. There needs to be a stronger, broader knowledge base about prevention and response that can inform investments, policy and practice.
This blog post draws on material from "Can cash transfers prevent intimate partner violence?" which was published on the International Food Policy Research Institute (IFPRI) blog in May.
Intimate partner violence (IPV) is the most pervasive form of violence globally—with 1 in 3 women physically or sexually abused by a partner in her lifetime. Despite knowing a lot about prevalence and detrimental impacts of IPV, we are still at the infancy of knowing what works to prevent violence. Recently, development economists have begun exploring the potential of anti-poverty programming, including cash transfers. Cash transfers are a widely used policy tool for decreasing poverty and improving human capital, reaching up to 1 billion people across Latin America, Africa, and Asia. Cash is often given directly to women, thus potentially changing power dynamics within the household. Their scale and reach to the most vulnerable populations have led many to ask, "If cash can change household well-being and power dynamics within households, can cash transfers also be used to decrease IPV?"
A mixed methods study in Ecuador found that key factors there were decreases in poverty-related stress (leading to less tension and fewer arguments over women needing to ask men for money to buy food) and increases in women’s empowerment due to being targeted (which improved their bargaining power in the household, self-confidence, and freedom of movement). However there is still a lot we do not know. For example, many cash transfer programs—including those in the existing studies—combine transfers with other components, such as nutrition trainings and conditions related to education and health, which may affect women’s social or human capital distinctly from the transfers. So far, no study has been able to disentangle the impacts of cash versus the other components on IPV.
Moreover, the evidence to date on cash transfers and IPV has come from limited contexts. Given that the effects on IPV may depend on gender norms that vary by context, we need to collect evidence from other regions before concluding that transfers can reduce IPV globally. Importantly, we still do not know enough about whether in specific contexts or sub-groups, women might actually be put in danger from receiving cash, due to men utilizing IPV as a method to extract the cash or due to male backlash if men use IPV to re-assert their authority after a shift in power dynamics.
Our ongoing Bangladesh study with co-authors John Hoddinott and Akhter Ahmed, recently awarded funding from the World Bank Group and the Sexual Violence Research Initiative, will help to fill some of these knowledge gaps. First, the intervention has both transfer-only arms and combined transfer-and-child-nutrition-training arms. Since the intervention arms are assigned randomly, we can disentangle whether a transfer is enough for impacts on IPV or whether adding training is really necessary. Second, the study comes from a context where IPV is very high—about 53-62 percent of women in Bangladesh report experiencing it in their lifetimes – and where gender norms are very different from Latin America or Sub-Saharan Africa. For example, female seclusion (women staying inside the home) is a strong sociocultural norm in rural South Asia. This could limit how much power dynamics shift when transfers are given to women, since women may have restricted mobility to use the transfers independently; on the other hand, it could increase the benefits of trainings for women, since trainings provide rare opportunities to leave the home and build social capital. Patriarchal norms in Bangladesh could also plausibly contribute to backlash if large transfers to women subvert traditional power dynamics.
One woman is victimized by violence every 15 seconds in Brazil, with a total of 23% of all Brazilian women experiencing violence in their lifetime. There are many notable consequences affecting victims of gender-based violence, yet many health consequences of violence have not been widely addressed in Brazil. This leads to the question:
Brazil has 730,000 people living with HIV, the largest number in Latin America and the Caribbean. Brazil is also one of 15 countries that account for 75% of the number of people living with HIV worldwide. Although the HIV epidemic in Brazil is classified as stable at the national level, incidence is increasing in various geographic regions and among sub-groups of women.
Rates of violence against women (VAW) are particularly high in the Southeastern and Southern regions of Brazil. These regions also have the highest HIV prevalence, accounting for 56% and 20% of all the people living with HIV in Brazil, respectively. Violence and HIV in Brazil are clearly linked, with 98% of women living with HIV in Brazil reporting a lifetime history of violence and 79% reporting violence prior to an HIV diagnosis.
Despite these statistics, there is limited research in Brazil examining VAW in relation to HIV. Accordingly, a bi-national collaboration of researchers from the University of California, San Diego, University of Campinas, São Paulo and the University of Rio Grande do Sul, Porto Alegre developed an innovative study to investigate these intersecting epidemics.
The focus of the study is in the regions of Brazil with the highest rates of VAW and highest prevalence of HIV: São Paulo in the Southeastern region and Porto Alegre in the Southern region.
The aims of the research were to describe the contextual factors of violence victimization among women in Brazil and to examine the association with HIV infection.
The study merged two population-based studies with identical sampling methodologies conducted in the São Paulo and Porto Alegre, Brazil. Women ages 18-49 years were sampled from public health centers, including 2,000 women from São Paulo and 1,326 from Porto Alegre. These women were administered surveys that gathered extensive data on violence victimization and social-ecological factors on access to preventative health services.
He often used a stick or an iron wire to beat her. Her body was covered in bruises, sometimes in all kinds of colors. Hamada's husband, frustrated with losing his son and his job in warring Syria, directed his anger and depression towards the mother of his children.
It is a fact: War is one of many forms of violence to which women are subjected, and for some Syrian refugee women it is a prolongation of what has been happening already in their war-torn country.
They have been beaten, forced into having sex and asked to never talk about it or else get killed — by their own husbands.
For the helpless women, most of whom are mothers, the abuse has been taking physical, emotional and sexual forms.
So how do you address and understand the reasons behind this major, often undermined, issue that adds to the misery of the already miserable women refugees?
A team of researchers working with the Women and Health Alliance International non-profit organization is working on formative research to prevent intimate partner violence among Syrian refugees in Izmir, Turkey.
"Often, from a worldwide perspective, when we think about conflict, we think about the forms of violence that are highlighted in the media," said team member Jennifer Scott, a physician and researcher at Harvard Medical School.
"But what we are not talking about is what is happening in the household, and the types of violence that are related to stress, cultural norms, or social and gender norms," she added.
To address this issue, Scott and her team talk with men, women, community leaders, policymakers and religious leaders. They ask questions about what is happening in the household, what sorts of violence women and girls experience, and how has this changed as a result of conflict and displacement.
The goal, she said, is to understand that this kind of violence does not have one dimension.
"It's really multiple layers that we need to understand," Scott said. "In our experience as researchers, when we offer women and men the opportunity to speak, they want to talk about it because it's a very important issue."
The research project, set to start in June 2016, will take place at a community center in Izmir that offers services not only to Syrian refugees but also other refugees currently living in Izmir. The project will conduct focus group discussions and interviews among community and religious leaders to examine some of the factors that lead to intimate partner violence, and explore possible solutions.
The research data will inform the development of a future program to prevent intimate partner violence among displaced populations.
The World Bank Group and the Sexual Violence Research Initiative recently awarded this project and eight other teams from around the world a total of $1.2 million in recognition of their innovations to prevent gender-based violence.