Evaluation of social policies to reduce intimate partner violence and improve child health in low- and middle-income countries

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Project summary The PI’s long-term objective is to improve the health and well-being of women and their children in low- and middle-income countries (LMICs) through evidence-informed structural interventions, which will be made possible by the training and mentorship provided from the K99/R00 Pathway to Independence Award. The research proposed in this award will evaluate the effect of social policies that protect and support women on reductions in intimate partner violence (IPV) and improvements in the health of their children under 5 years of age in LMICs. This research will fill an important evidence gap. The IPV prevention literature has focused primarily on interventions that target individuals, households, or communities, and the effect of social policies is not well understood. During the K99 portion of the award, the PI will receive training and mentorship at Columbia University’s Mailman School of Public Health from a cross-disciplinary mentoring team with substantial experience mentoring early career investigators. Training areas will include child health, including conceptual knowledge of potential pathways linking IPV to child health; causal mediation analysis; and econometrics, which are methods commonly used to evaluate social policies. This training will enable the PI to conduct three social policy evaluations in diverse LMIC settings. The first project will evaluate adoption of national-level IPV prevention legislation on changes in IPV and improvements in child health. This work will utilize Demographic and Health Survey data from 24 LMICs, linked with policy data collected from the World Bank. The second project will evaluate the effect of availability of a cash grant for low-income, primarily female- headed households in South Africa, on the health of children under 5 years of age. The project will perform a causal mediation analysis to formally test if improvements in child health are mediated through reductions in maternal IPV-related factors. This work will utilize longitudinal data from the South Africa National Income Dynamics Study, which is a large population-based panel survey. The third project will evaluate the degree of implementation of comprehensive IPV-prevention legislation in India on maternal IPV-related factors and child health. This work will utilize longitudinal data from the India Human Development Survey, a large population- based panel survey, linked with legislative data collected from an Indian legal advocacy group. The results of these studies will substantially increase knowledge about the effect of social policies on reducing IPV and improving child health across a wide range of LMIC settings. The training, mentorship, and research afforded by this award will help the PI develop into an independent investigator who evaluates structural interventions to improve the health of mothers and their children in LMICs. This proposed research furthers NICHD’s mandate of improving child health by investigating and preventing harmful social and environmental causes, including adverse childhood events.