THE WAY TO A MAN`S HEART
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During interview training and supervision, we emphasised that interviewers needed to pay attention to verbal and non-verbal cues suggesting that the interviewee found the question confusing or unclear and to paraphrase questions when needed. For both quantitative and qualitative data collection, all field staff were trained in accordance with the WHO ethical guidelines for conducting research on IPV [ 23 ].
Given participant concerns about signing written documents and literacy challenges, we relied on verbal consent for the qualitative data collection. Before giving consent, interviewees were given a simply worded information sheet and time to read it before deciding whether to take part in the study. To account for potential illiteracy, interviewers were instructed also to read the information sheet aloud and to make sure that participants understood all of its elements. No incentives were offered to participants to join the study.
Data collection, storage and analysis were designed to maintain participant confidentiality. Enumerators and interviewers provided all women, regardless of abuse status, with de-identified contact information for local IPV support services. Women reporting ongoing abuse were offered the option to contact these support services.
Interviews were conducted by both male and female enumerators in the quantitative survey, and by female interviewers only in the qualitative part of the study. In order to protect interviewers from potential psychological distress, the field supervisor debriefed each interviewer at the end of the day and held wider team meetings once a week to discuss issues arising in the fieldwork and emotions associated with the content of the interviews.
A workshop was held in Quito, Ecuador with members of the WFP and local authorities in order to disseminate the study results to key stakeholders. Integration of the quantitative and qualitative data occurred through triangulation of the data in which the two databases were used for analysis and comparison [ 20 ].
Is the way to a man's heart really his stomach?
Thematic findings and analysis of the qualitative data guided the choice of variables and secondary quantitative analysis. A report and a presentation on the qualitative findings were prepared and presented. Quantitative indicators that related to the thematic findings from the qualitative report were then chosen.
For each thematic area, quantitative and qualitative data were analysed and findings from both reported and compared. To estimate programme impacts on a series of possible mechanisms identified in the qualitative analysis, we conducted intent-to-treat ITT estimates using analysis of covariance ANCOVA modelling, controlling for province and the baseline value of our outcome variable. All analysis was conducted using Stata As randomisation was successful in balancing baseline characteristics across treatment and control arms, we present unadjusted regression results.
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However, sensitivity analysis confirmed that results were unchanged with a set of standard demographic controls of the individual woman, her partner and household not presented. Given that we found no differential impact by treatment modality on IPV in the RCT, we conducted the analysis of mechanisms using a pooled treatment indicator that included all three arms cash, food and food voucher [ 18 ].
Outcomes chosen for analysis were based on qualitative evidence of pathways of impact. The quantitative survey is somewhat limited in terms of questions on mechanisms, and thus for each theme we explored all relevant outcomes not previously analysed in companion papers. Outcomes were constructed and grouped as follows:. Impact of pooled treatment cash, food or voucher on disputes and disagreements in the last six months. Health and nutrition knowledge: Women were asked to respond to a module measuring the basic health and nutrition knowledge discussed in the nutrition training sessions.
Impact of pooled treatment cash, food or voucher on health and nutritional knowledge.
Impact of pooled treatment cash, food or voucher on group participation in the last six months. Analysis followed a thematic approach using a constant comparative method. The initial coding was guided by the themes in the topic guide sections but we also allowed for new themes to emerge from the data. To ensure inter-rater reliability, initially five IDIs and two FGD transcripts were coded by two researchers and codes compared. Where necessary, the coding framework was modified to reflect the process of reconciliation. Furthermore, the triangulation of the qualitative and quantitative data conferred validity to our results.
The choice of quotes to present in the results was based on their ability to reflect common views among participants. When quotes represent an exception or deviant case, we have noted this in the text [ 29 ]. When comparing the results by IPV experience status i. Overall, our combined results suggest that the programme, in the form of transfers and nutrition workshops, had an impact through three sometimes overlapping protective pathways operating at the couple, household and individual level. In the first pathway, financial stability and food security combined to decrease marital conflict resulting from the daily negotiation of money to meet daily food needs.
A summary of these findings is depicted in Fig. We also examined potential risk mechanisms mentioned in the literature through which transfers have the potential to increase violence. Usually, when women confronted their partner about infidelity, the men accused the woman of being the one who was having an affair or retaliated with violence. One of the main triggers of conflict in the household was the lack of financial means to fulfil basic needs such as food. The qualitative data suggest considerable support for this mechanism.
Interviewer: During the time of the transfers, was there any physical violence? Respondent: No, because I did not ask for it [money for food] anymore… I did not insist anymore, because the arguments happened mostly when I asked for money for food, and he usually did not have any money. IDI 42, Female, Tulcan. Sometimes problems arise because I am in need [of money] for one or the other thing and there is no money and that is when problems start, the fights […] and it [transfers] helped us a lot, he [the partner] had money to buy other things for the house or pay debts.
Many men and women reported that the transfers brought a sense of well-being and happiness in the household. Consequently, overall satisfaction increased, improving family relationships and well-being:. In my household it was like happiness, we all got along, with my children, with my husband […] in my house we were happy […] because before we did not have enough money for those things [food].
FGD 4, Female, Tulcan. The increased food security had a direct impact on children, who, according to their parents, felt freer to request foods that they liked such as yoghurt, a source of calcium encouraged in the nutrition training workshops. Thus, improved happiness and satisfaction may have been a particularly relevant way in which transfers affected IPV in the poorer households Fig.
Impact of pooled treatment cash, food or voucher on locus of control and happiness by food security quartiles. The third pathway through which transfers may have decreased IPV is by empowering female beneficiaries, and in particular by increasing their ability to make decisions, their self-confidence and their freedom of movement.
The interviews, however, also revealed that once the transfers ended, their increased decision-making ability diminished and they again depended on their husbands. In contrast to the qualitative findings, quantitative findings did not clearly demonstrate that the transfers had an impact on the proportion of women with either a sole or joint decision-making role on any of the discrete decision domains or on any composite index of decision making [ 30 ]. This could be because the questions were not specific enough or sufficiently nuanced to reflect the type of enhanced influence that women expressed as deriving from the transfers.
The qualitative component offered an alternative explanation for this discrepancy. These ambiguities suggest that there is room for improvement in methodologies for measuring individual intra-household economic empowerment. As I was telling you, the woman knows about her food and in my case, my wife is very good at seasoning, and you fall more in love depending on how the woman cooks… nutritiously and all. FGD 1, Male, Tulcan. Women had high baseline knowledge on these latter indicators, which may partially explain why there was little improvement or ability to detect significant increases.
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Qualitatively, women reported that they enjoyed the monthly training workshops because they gave them an opportunity to interact with other women and the trainers. For some women, the training was an opportunity to be less shy and to participate in the public domain:. I always spend my time at home, I do not go out much, I do not know how to relate with people very well and there [in the workshops], you slowly lose the shyness […] I used to be very shy, now I am only a bit shy […] I did not use to go to talks, I had never had talks before.
In addition, attending the training sessions and picking up the food transfers or vouchers presented women with an opportunity to go to an activity on their own without having to face the jealousy of their partners:. Interviewer: And during the time of the transfers when you had to go downtown to receive the food, did he also accuse you of being with a lover?
Respondent: No, because I used to go with more people [who also received the transfers] and I used to come back with them, sometimes in a car and he did not use to say anything. Some women, however, mentioned that men took them to the workshops and waited outside or went with them to pick up the transfers. The quantitative data support the qualitative findings on community involvement and freedom of movement.
Is the way to a man's heart really his stomach? - Pulse Nigeria
In particular, the transfer programme significantly decreased the probability of a partner accusing a woman of being unfaithful and attempting to limit her contact with her family. Although there is the potential for transfers, particularly cash, to be extracted forcefully from women, there were no qualitative reports of male partners attempting to do so or wanting to use the transfer for something other than food. Interviewer: Was he, like, jealous because you received the transfers?
Respondent: Not really, never, because it [the transfer] was for the sake of the household and the family. IDI 37, Female, Tulcan. FGD 2, Male, Tulcan. Most of the time it was men who worked outside the home and they would not be available to receive the transfer or shop for food.
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Qualitatively, none of the interviewees mentioned increased alcohol consumption as a by-product of the transfers. Using qualitative and quantitative triangulated methods, we explored the potential mechanisms that might explain the reduction in IPV found in the original RCT. We found that IPV is a common problem in the study setting. Reducing conflicts over money and financial stress appeared to be one of the main ways in which the transfers helped reduce IPV.
The transfers also had an impact at the household level by increasing overall well-being and happiness, a result that seemed particularly relevant for the poorest households. These theories would predict that transfers should decrease the average likelihood of IPV. It is important to note that a portion of women who received transfers still experienced IPV within the recall period; this is because of the high level of violence existing within the context of the intervention.
However, none of the interviewees reporting violence after the transfers linked this escalation of violence to the transfer. The RCT results [ 18 ] indicating a reduction in IPV were measured only over the six-month period of the transfer programme. The nutrition training, however, seemed to yield lasting benefits.
During the qualitative interviews, women reported still remembering the knowledge gained in the training workshops; many said that this was the most helpful part of the programme and that it was still applicable, even if they were in financially difficult circumstances.
Significantly, both the characteristics of the setting and the framing of the programme itself may have shaped its impact on IPV.