Yekaterina Chzhen1, Leah Prencipe2, Frank Eetaama3, Paul Luchemba4, Tumpe Mnyawami Lukongo4, Tia Palermo5. 1. Department of Sociology, Trinity College Dublin, Dublin, Ireland. Electronic address: chzheny@tcd.ie. 2. Department of Public Health, Erasmus University Medical Center (Erasmus MC), Rotterdam, the Netherlands. 3. Children and AIDS Section, UNICEF Tanzania, Dar es Salaam, Tanzania. 4. Tanzania Social Action Fund, United Republic of Tanzania, Dodoma, Tanzania. 5. Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, New York.
Abstract
PURPOSE: Inequitable attitudes toward men's and women's roles, rights, and responsibilities are associated with poor health-related outcomes, particularly for girls and women. Yet, we know relatively little about what interventions work to improve gender-equitable attitudes among adolescents in low-income countries. This study examines the impact of a government-implemented "cash plus" intervention on gender-equitable attitudes among adolescents in Tanzania. The intervention includes discussions and activities related to gender norms, embedded in broader life skills, livelihoods, and health training. METHODS: The study utilizes a cluster randomized design, using data from 1,933 males and females aged 14-19 years at baseline who took part in the baseline (2017), midline (2018), and endline (2019) surveys. Gender attitudes were measured using 24 items from the Gender-Equitable Men (GEM) Scale. We estimate intent-to-treat impacts on the GEM scale and four subscales (violence, sexual relationships, reproductive health, and domestic chores). RESULTS: The "cash plus" intervention had a significant impact on the overall GEM scale at midline. The intervention increased gender-equitable attitudes on the domestic chores subscale at both midline and endline. The intervention improved gender-equitable attitudes among males on the overall GEM scale and three subscales at midline and on two subscales at endline, but it had no impacts among females. CONCLUSIONS: Gender transformative social protection is currently being advocated as a way to address the gendered nature of poverty and its consequences. Initiatives such as the one studied here, which address the multifaceted drivers of gender inequities, could be a promising way forward.
PURPOSE: Inequitable attitudes toward men's and women's roles, rights, and responsibilities are associated with poor health-related outcomes, particularly for girls and women. Yet, we know relatively little about what interventions work to improve gender-equitable attitudes among adolescents in low-income countries. This study examines the impact of a government-implemented "cash plus" intervention on gender-equitable attitudes among adolescents in Tanzania. The intervention includes discussions and activities related to gender norms, embedded in broader life skills, livelihoods, and health training. METHODS: The study utilizes a cluster randomized design, using data from 1,933 males and females aged 14-19 years at baseline who took part in the baseline (2017), midline (2018), and endline (2019) surveys. Gender attitudes were measured using 24 items from the Gender-Equitable Men (GEM) Scale. We estimate intent-to-treat impacts on the GEM scale and four subscales (violence, sexual relationships, reproductive health, and domestic chores). RESULTS: The "cash plus" intervention had a significant impact on the overall GEM scale at midline. The intervention increased gender-equitable attitudes on the domestic chores subscale at both midline and endline. The intervention improved gender-equitable attitudes among males on the overall GEM scale and three subscales at midline and on two subscales at endline, but it had no impacts among females. CONCLUSIONS: Gender transformative social protection is currently being advocated as a way to address the gendered nature of poverty and its consequences. Initiatives such as the one studied here, which address the multifaceted drivers of gender inequities, could be a promising way forward.
Authors: Leah Prencipe; Tanja A J Houweling; Frank J van Lenthe; Lusajo Kajula; Tia Palermo Journal: Am J Epidemiol Date: 2022-08-22 Impact factor: 5.363