Economic Evaluation of the MEWE Intervention

London School of Economics and Political Science1,536 enrolled

Overview

Cash transfers have shown promise in preventing intimate partner violence, and in reducing recipients' stress levels. Cash transfers with behavioral or psychological interventions have shown limited effectiveness at reducing stress in some African countries. Little is known of the cost-effectiveness of interventions delivered alongside cash transfer programs. The MEWE economic evaluation sub-study (MEWE-EE) runs alongside MEWE, a three-arm cluster-randomized controlled trial in Sindh, Pakistan. MEWE-EE will assess the costs and cost-effectiveness of delivering a cash-transfer program (BISP-CT) combined with a life-skills building curriculum (LSB curriculum), compared to the BISP-CT alone. The LSB curriculum is offered to either women who receive BISP-CT, or to women who receive BISP-CT and their husbands.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

1,536

Conditions

Depression Mental Health Issue Intimate Partner Violence Domestic Violence

Interventions

Life Skills Building (LSB) curriculum for malesBEHAVIORAL

The LSB curriculum offers ten weekly 90-minute sessions. Topics include effective communication, gender roles, power dynamics in the household; work-life balance and time management; conflict resolution; household decision making. The LSB teachers are trained in facilitation techniques to deliver the sessions. All male study participants attending LSB curriculum classes are married to BISP-CT clients. For men, the MEWE intervention provides access to the LSB curriculum only.

Life Skills Building (LSB) curriculum for femalesBEHAVIORAL

The LSB curriculum offers ten weekly 90-minute sessions. Topics include effective communication, gender roles, power dynamics in the household; work-life balance and time management; conflict resolution; household decision making. The LSB teachers are trained in facilitation techniques to deliver the sessions. All female study participants attending LSB curriculum classes are BISP-CT clients. For females, the MEWE intervention comprises access to LSB curriculum + BISP CTs.

Cash transfer to adult femalesOTHER

The BISP intervention offers access to quarterly unconditional cash transfers to adult females.

Eligibility

Sex: ALLMin age: 15 YearsMax age: 49 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * In receipt of Benazir Income Support Program (BISP) cash transfers (CTs) * Parity: have at least one child, at least 18 months old Exclusion Criteria: * Plan for the family to migrate out of the village within the next 2 years

Outcomes

Primary Outcomes

Incremental cost incurred per disability adjusted life year (DALY) averted: provider perspective

Incremental cost per disability-adjusted life year (DALY) averted by the intervention compared to the control group from a provider perspective at 12 months from baseline. DALYs and costs will also be modelled up to a ten-year horizon using a Markov model.