一项牲畜生产性资产转移计划的随机对照试验,旨在改善冲突后环境中的经济和健康状况,并减少亲密伴侣暴力。
Randomised controlled trial of a livestock productive asset transfer programme to improve economic and health outcomes and reduce intimate partner violence in a postconflict setting.
作者信息
Glass Nancy, Perrin Nancy A, Kohli Anjalee, Campbell Jacquelyn, Remy Mitima Mpanano
机构信息
Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
出版信息
BMJ Glob Health. 2017 Feb 28;2(1):e000165. doi: 10.1136/bmjgh-2016-000165. eCollection 2017.
BACKGROUND
Diverse economic empowerment programmes (eg, microcredit, village-led savings and loan, cash and productive asset transfers) for the poor have demonstrated mixed results as vehicles for improved economic stability, health and women's empowerment. However, limited rigorous evaluations exist on the impact of financial and non-financial outcomes of these programmes, especially in conflict-affected areas.
METHODS
The team evaluated the effectiveness of an innovative livestock productive asset transfer intervention-Pigs for Peace (PFP)-on economic, health and women's empowerment outcomes with participants in households in 10 villages in Eastern Democratic Republic of Congo. Residual change analysis was used to examine the amount of change from baseline to 18 months between the intervention and delayed control groups, controlling for baseline scores.
FINDINGS
The majority of the 833 household participants were women (84%), 25 years of age or older, married, had on average 3 children and had never attended school. At 18 months postbaseline, the number of participants in the PFP households having outstanding credit/loans was 24.7% lower than households in the control group (p=0.028), and they had an 8.2% greater improvement in subjective health (p=0.026), a 57.1% greater reduction in symptoms of anxiety (p=0.020) and a 5.7% greater improvement in symptoms of post-traumatic stress disorder (p<-0.001). At 18 months postbaseline, partnered women and men reported a reduction in experience and perpetration of all forms of intimate partner violence, although not statistically significant between groups.
INTERPRETATION
The findings support scalability of a livestock productive asset transfer programme in rural and conflict-affected settings where residents have extremely limited access to financial institutions or credit programmes, health or social services and where social norms that sustain gender inequality are strong.
TRIAL REGISTRATION NUMBER
NCT02008708.
背景
针对贫困人口的各种经济赋权计划(如小额信贷、村庄主导的储蓄和贷款、现金及生产性资产转移),作为促进经济稳定、改善健康状况和增强妇女权能的手段,其成效参差不齐。然而,关于这些计划在财务和非财务方面成果影响的严格评估有限,尤其是在受冲突影响的地区。
方法
该团队评估了一项创新的牲畜生产性资产转移干预措施——“和平之猪”(PFP)——对刚果民主共和国东部10个村庄家庭参与者的经济、健康和妇女赋权成果的有效性。采用残差变化分析来检验干预组和延迟对照组从基线到18个月之间的变化量,并对基线分数进行控制。
结果
833户参与家庭中的大多数是女性(84%),年龄在25岁及以上,已婚,平均育有3个孩子,且从未上过学。在基线后18个月,PFP家庭中有未偿还信贷/贷款的参与者数量比对照组家庭低24.7%(p = 0.028),他们的主观健康状况改善了8.2%(p = 0.026),焦虑症状减少了57.1%(p = 0.020),创伤后应激障碍症状改善了5.7%(p < -0.001)。在基线后18个月,有伴侣的女性和男性报告各种形式亲密伴侣暴力的经历和实施情况有所减少,尽管两组之间无统计学显著差异。
解读
研究结果支持在农村和受冲突影响地区扩大牲畜生产性资产转移计划,这些地区居民获得金融机构或信贷计划、健康或社会服务的机会极其有限,且维持性别不平等的社会规范根深蒂固。
试验注册号
NCT02008708。