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.

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
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
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
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
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
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
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
Emotional IPV
Community-level variation IPV (12-month)
Physical IPV Sexual IPV

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
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

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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
Meda ase
Thank you
Ghana LEAP 1000
(© Michelle Mills)

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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.

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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.