MEWE-EE: Economic Evaluation of the MEWE Intervention

Sponsor

London School of Economics and Political Science (Other)

Overall Status

Active, not recruiting

CT.gov ID

NCT05598697

Collaborator

Aga Khan University (Other), Bill and Melinda Gates Foundation (Other)

1,536

Enrollment

Location

Arms

14.5

Anticipated Duration (Months)

106

Patients Per Site Per Month

Study Details

Study Description

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.

Condition or Disease	Intervention/Treatment	Phase
Depression Mental Health Issue Intimate Partner Violence Domestic Violence Gender-based Violence Rape Sexual Assault Battered Women	Behavioral: Life Skills Building (LSB) curriculum for males Behavioral: Life Skills Building (LSB) curriculum for females Other: Cash transfer to adult females	N/A

Study Design

Study Type:

Interventional

Actual Enrollment :

1536 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Prevention

Official Title:

Economic Evaluation of the Men Engagement in Women Empowerment (MEWE) Intervention (MEWE-EE)

Actual Study Start Date :

Sep 15, 2021

Actual Primary Completion Date :

Jun 30, 2022

Anticipated Study Completion Date :

Nov 30, 2022

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Cash Transfers only Participants allocated to this arm receive cash transfers. They are clients of a nation-wide cash transfer program.	Other: Cash transfer to adult females The BISP intervention offers access to quarterly unconditional cash transfers to adult females. Other Names: BISP-CT
Experimental: Cash Transfers + LSB curriculum for females clients only 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.	Behavioral: Life Skills Building (LSB) curriculum for females 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. Other Names: MEWE females Other: Cash transfer to adult females The BISP intervention offers access to quarterly unconditional cash transfers to adult females. Other Names: BISP-CT
Experimental: Cash Transfers + LSB curriculum for females clients and their husbands 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.	Behavioral: Life Skills Building (LSB) curriculum for males 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. Other Names: MEWE males Behavioral: Life Skills Building (LSB) curriculum for females 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. Other Names: MEWE females Other: Cash transfer to adult females The BISP intervention offers access to quarterly unconditional cash transfers to adult females. Other Names: BISP-CT

Arm

Intervention/Treatment

Active Comparator: Cash Transfers only

Participants allocated to this arm receive cash transfers. They are clients of a nation-wide cash transfer program.

Other: Cash transfer to adult females

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

Other Names:

BISP-CT

Experimental: Cash Transfers + LSB curriculum for females clients only

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.

Behavioral: Life Skills Building (LSB) curriculum for females

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.

Other Names:

MEWE females

Other: Cash transfer to adult females

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

Other Names:

BISP-CT

Experimental: Cash Transfers + LSB curriculum for females clients and their husbands

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.

Behavioral: Life Skills Building (LSB) curriculum for males

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.

Other Names:

MEWE males

Behavioral: Life Skills Building (LSB) curriculum for females

Other Names:

MEWE females

Other: Cash transfer to adult females

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

Other Names:

BISP-CT

Outcome Measures

Primary Outcome Measures

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

Mean cost of intervention delivery [12 months post randomisation]
Cost of intervention delivery for different intervention models per patient, by category, annuitised
Mean cost of LSB session [12 months post randomisation]
Average cost of LSB session delivery for different intervention models, 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.
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.
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.