Effects of Government-Implemented Cash Plus Model on Violence Experiences and Perpetration Among Adolescents in Tanzania, 2018‒2019

Abstract

Objectives. To examine the impacts of a government-implemented cash plus program on violence experiences and perpetration among Tanzanian adolescents. Methods. We used data from a cluster randomized controlled trial (n = 130 communities) conducted in the Mbeya and Iringa regions of Tanzania to isolate impacts of the “plus” components of the cash plus intervention. The panel sample comprised 904 adolescents aged 14 to 19 years living in households receiving a government cash transfer. We estimated intent-to-treat impacts on violence experiences, violence perpetration, and pathways of impact. Results. The plus intervention reduced female participants’ experiences of sexual violence by 5 percentage points and male participants’ perpetration of physical violence by 6 percentage points. There were no intervention impacts on emotional violence, physical violence, or help seeking. Examining pathways, we found positive impacts on self-esteem and participation in livestock tending and, among female participants, a positive impact on sexual debut delays and a negative effect on school attendance. Conclusions. By addressing poverty and multidimensional vulnerability, integrated social protection can reduce violence. Public Health Implications. There is high potential for scale-up and sustainability, and this program reaches some of the most vulnerable and marginalized adolescents. (Am J Public Health. 2021;111(12):2227–2238. https://doi.org/10.2105/AJPH.2021.306509 )

A “Plus” Model for Safe Transitions to Adulthood: Impacts of an Integrated Intervention Layered onto A National Social Protection Program on Sexual Behavior and Health Seeking among Tanzania's Youth

“…In line with two existing studies (Bandiera et al 2019;Özler et al 2020), the intervention evaluated here had some protective impacts on sexual behaviors and SRH seeking, increasing health-seeking behavior. Reported elsewhere, the program also reduced experiences of sexual violence and the perpetration of physical violence (Palermo, Prencipe, and Kajula 2021). In line with many studies, however (Austrian and Muthengi 2014;Austrian et al 2016Austrian et al , 2018, the cash plus intervention failed to find impacts on indicators such as contraceptive use, fertility, or a number of sexual partners.…”

“…2020), the intervention evaluated here had some protective impacts on sexual behaviors and SRH seeking, increasing health‐seeking behavior. Reported elsewhere, the program also reduced experiences of sexual violence and the perpetration of physical violence (Palermo, Prencipe, and Kajula 2021). In line with many studies, however (Austrian and Muthengi 2014; Austrian et al.…”

Assessment of Psychosocial Programs to Prevent Sexual Violence During Adolescence

“…We screened 3335 titles and abstracts, removed 2515 (863 were duplicates and 1652 were not relevant), and subsequently assessed 820 full-text articles. Twenty-one studies met the inclusion criteria, and 20 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 provided data for calculating effect sizes (eFigure 1 in the Supplement ). We could not retrieve the necessary data to compute the effect size for 1 study, 44 and this was subsequently excluded.…”

“…Eleven studies (55%) were conducted in North America, 24 , 28 , 29 , 32 , 33 , 34 , 38 , 39 , 40 , 42 , 43 2 (10%) in Europe, 27 , 35 and 7 (35%) in sub-Saharan Africa. 25 , 26 , 30 , 31 , 36 , 37 , 41 The mean age of participants ranged from 11 to 17.6 years old. Fifteen studies (75%) were school-based prevention programs and 5 (25%) were conducted in different settings, such as at a community agency.…”

Effects of Adolescent-Focused Integrated Social Protection on Depression: A Pragmatic Cluster-Randomized Controlled Trial of Tanzania’s Cash Plus Intervention

“…However, the pathway indicators examined here do not fully explain the effects on mental health. In work published elsewhere, investigators found that the intervention increased equitable gender attitudes ( 35 ) and reduced experiences of sexual violence and the perpetration of physical violence ( 36 ). These results may have contributed to better mental health, as violence perpetration among males is associated with increased substance use, less gender-equitable attitudes, and posttraumatic stress disorder and depression ( 37 ).…”