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How a $50-a-year nutrition program cut domestic violence in Bangladesh

Cash alone didn’t help. But group training for nutrition, with home visits, did.

Bangladeshi women in a meeting meant to improve nutrition knowledge
Women attend a weekly group meeting as part of the program.
IFPRI/Mohammad Aminul Islam Khandaker
Dylan Matthews is a senior correspondent and head writer for Vox's Future Perfect section and has worked at Vox since 2014. He is particularly interested in global health and pandemic prevention, anti-poverty efforts, economic policy and theory, and conflicts about the right way to do philanthropy.

I write a lot about the benefits of handing out cash as a way to help extremely poor people in the developing world, but one well-documented benefit found in a number of programs doesn’t get a lot of attention: Cash transfers appear to reduce domestic violence.

Studies examining programs in Mexico, Peru, Kenya, and Ecuador have consistently found that women in households receiving cash are less likely to report being victims of intimate partner violence. They hardly solve the problem — the reduction is about 5 to 11 percentage points — but economists behind the work argue that the transfers had a meaningful effect.

There is a limitation, though. These studies show effects lasting as long as the cash is received, but the researchers usually don’t follow up after cash is discontinued. That’s fine with social protection programs, like Oportunidades in Mexico, where the cash isn’t discontinued. Those programs are meant to provide a regular stream of cash to support poor households and make sure they can buy basic necessities.

But not all cash programs are like that. The Kenya study, for instance, concerned GiveDirectly, a great charity that I support financially but that is primarily focused on big lump-sum grants of cash, not ongoing revenue streams. And what limited evidence we have suggests that after the cash goes away, the effect on intimate partner violence dissipates too.

That’s what makes a new study, released just in the past week, so exciting. Economists Shalini Roy, Melissa Hidrobo, John Hoddinott, and Akhter Ahmed look at a program in Bangladesh that offers either cash or food — and that also invited women to weekly nutrition trainings over the course of two years. “It was focused on young child feeding, no focus on gender or violence,” Roy told me. The nutrition program also involved regular home visits, twice a month.

The group in the study that got cash and food transfers without this community nutrition program didn’t see a reduction in intimate partner violence six to 10 months after the intervention ended. Without the cash or food, there were no visible benefits. But the group that got the transfers plus the community program saw a huge benefit: a 26 percent reduction in physical violence.

The paper walks through a few different reasons why the nutrition program might have had that effect. The nutrition program appeared to significantly increase women’s economic standing in the home: They were likelier to be doing work that brought in cash or food than women who just got the cash. That might have empowered them to stand up to their partners, which could have contributed to a reduction in violence.

Also possible is that the home visits, and regular participation of women in weekly meetings, made the women more visible, and made their partners feel that they were likelier to get caught if they were abusive. It also appears that the nutrition program plus cash was better at building wealth than cash alone, which might have improved incomes even after the program ended, reducing poverty-related stress and reducing violence through that mechanism too.

The program was fairly inexpensive. The community program cost only $50 a year per person, on top of the cash/food costs, and had massive benefits for women in the intervention, even after the program ended.

That’s not the only cost of the program, of course. The food and cash transfers were substantial: about $19 a month for cash, or $228 annually. But even $278 a year per household, for cutting physical violence by 26 percent, plus the reductions in poverty that typically result from handing out cash or food? That’s pretty damn good!

And it’s especially good because it’s a clear model that could be spread, and those are rare in this field. “Intimate partner violence programs are really hard to scale up,” Roy says. “I don’t think there are, at this point, great alternatives available that are scalable and cost-effective and globally relevant.” She notes that if even this program’s cost is too much, other groups could experiment with lighter-touch interventions, like less regular community meetings, or check-ins via texting. A few trials of approaches along those lines are ongoing.

As with all studies like this, I should caveat and say it’s one paper, more are forthcoming, and one should never get too excited about a single study. Nonetheless, it’s a really exciting study! Finding a community program that really works and protects the women it enrolls is a big deal, especially when it costs so little to do.

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