Economic Evaluation of the MEWE Intervention

Not Applicable

Completed

• Conditions: Battered Women; Mental Health Issue; Intimate Partner Violence; Domestic Violence; Gender-based Violence; Rape Sexual Assault; Depression
• Interventions: Other: Cash transfer to adult females; Behavioral: Life Skills Building (LSB) curriculum for females; Behavioral: Life Skills Building (LSB) curriculum for males

• Registration Number: NCT05598697
• Lead Sponsor: London School of Economics and Political Science

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2021-09-15
• Primary Completion: 2022-06-30
• Study First Submitted: 2022-10-25
• Study First Submitted QC: 2022-10-25
• Study First Posted: 2022-10-28
• Study Completion: 2022-11-30
• Status Verified: 2023-12
• Last Update Submitted: 2023-12-06
• Last Update Posted: 2023-12-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1536

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Cash Transfers only	Cash transfer to adult females	Participants allocated to this arm receive cash transfers. They are clients of a nation-wide cash transfer program.
Cash Transfers + LSB curriculum for females clients and their husbands	Cash transfer to adult females	Participants allocated to this arm receive cash transfers and access to LSB curriculum training in gender-segregated groups. Men and women attend 10 life-skills building sessions in parallel. Sessions are held weekly and are 90 minutes long. Two trained facilitators, whose gender matches the participants', run the session for groups of 10 women or men over a ten-week period.
Cash Transfers + LSB curriculum for females clients only	Cash transfer to adult females	Participants allocated to this arm receive cash transfers and access to LSB curriculum training. Female cash transfer recipients attend 10 life-skills building sessions. Sessions are held weekly and are 90 minutes long. Two trained facilitators run the session for groups of 10 women over a ten-week period.
Cash Transfers + LSB curriculum for females clients only	Life Skills Building (LSB) curriculum for females	Participants allocated to this arm receive cash transfers and access to LSB curriculum training. Female cash transfer recipients attend 10 life-skills building sessions. Sessions are held weekly and are 90 minutes long. Two trained facilitators run the session for groups of 10 women over a ten-week period.
Cash Transfers + LSB curriculum for females clients and their husbands	Life Skills Building (LSB) curriculum for females	Participants allocated to this arm receive cash transfers and access to LSB curriculum training in gender-segregated groups. Men and women attend 10 life-skills building sessions in parallel. Sessions are held weekly and are 90 minutes long. Two trained facilitators, whose gender matches the participants', run the session for groups of 10 women or men over a ten-week period.
Cash Transfers + LSB curriculum for females clients and their husbands	Life Skills Building (LSB) curriculum for males	Participants allocated to this arm receive cash transfers and access to LSB curriculum training in gender-segregated groups. Men and women attend 10 life-skills building sessions in parallel. Sessions are held weekly and are 90 minutes long. Two trained facilitators, whose gender matches the participants', run the session for groups of 10 women or men over a ten-week period.

Primary Outcome Measures

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

Secondary Outcome Measures

Name	Time	Method
Mean cost of LSB session	12 months post randomisation	Average cost of LSB session delivery for different intervention models, annuitised
Incremental cost incurred per disability adjusted life year (DALY) averted at scale: societal perspective	12 months post randomisation	Incremental cost per disability-adjusted life year (DALY) averted by the intervention compared to the control group from a societal perspective at scale.
Total incremental cost of the intervention in the modelling cohort	12 months post randomisation	Total additional cost of the intervention for the modelling cohort by intervention type over a ten-year period.
Incremental cost incurred per disability adjusted life year (DALY) averted at scale: provider perspective	12 months post randomisation	Incremental cost per disability-adjusted life year (DALY) averted by the intervention compared to the control group from a provider perspective at scale.
Mean cost of intervention delivery	12 months post randomisation	Cost of intervention delivery for different intervention models per patient, by category, annuitised
Total incremental cost of the intervention in a research setting	12 months post randomisation	Total additional cost of the intervention compared to the BISP-CT only for the study population and by intervention type during the research period.

Trial Locations

Locations (1)

Mirpur Sakro; 🇵🇰 Thatta, Sindh, Pakistan