Effects of Government-Implemented Cash Plus Model on Violence Experiences and Perpetration Among Adolescents in Tanzania, 2018‒2019

Tia Palermo, Leah Prencipe, Lusajo Kajula, Tanzania Cash Plus Evaluation Team

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)


Objectives. To examine the impacts of a government-implemented cash plus program on violence experiences and perpetration among Tanzanian adolescents. Methods. We used data from a cluster randomized controlled trial (n = 130 communities) conducted in the Mbeya and Iringa regions of Tanzania to isolate impacts of the "plus" components of the cash plus intervention. The panel sample comprised 904 adolescents aged 14 to 19 years living in households receiving a government cash transfer. We estimated intent-to-treat impacts on violence experiences, violence perpetration, and pathways of impact. Results. The plus intervention reduced female participants' experiences of sexual violence by 5 percentage points and male participants' perpetration of physical violence by 6 percentage points. There were no intervention impacts on emotional violence, physical violence, or help seeking. Examining pathways, we found positive impacts on self-esteem and participation in livestock tending and, among female participants, a positive impact on sexual debut delays and a negative effect on school attendance. Conclusions. By addressing poverty and multidimensional vulnerability, integrated social protection can reduce violence. Public Health Implications. There is high potential for scale-up and sustainability, and this program reaches some of the most vulnerable and marginalized adolescents. (Am J Public Health. 2021;111(12):2227-2238. https://doi.org/10.2105/AJPH.2021.306509).

Original languageEnglish
Pages (from-to)2227-2238
Number of pages12
JournalAmerican Journal of Public Health
Issue number12
Publication statusPublished - 1 Dec 2021

Bibliographical note

Funding Information:
Preliminary findings from this study were presented at the Population Association of America Annual Meeting virtually in May 2021 and at the AIDS 2020 23rd International AIDS Conference virtually in July 2020. The authors would like to acknowledge the support of the Tanzania Social Action Fund (TASAF) and Tanzania Commission for AIDS (TACAIDS)—in particular, Ladislaus Mwamanga (TASAF), Amadeus Kamagenge (TASAF), and Fariji Mishael (TASAF) for the implementation of this evaluation. In addition, the UNICEF personnel instrumental to the initial planning stages of this pilot and study included Alison Jenkins, Beatrice Targa, Patricia Lim Ah Ken, Victoria Chuwa, Naomi Neijhoft, and Tulanoga Matwimbi. We would also like to acknowledge the hard-working field teams of EDI Global, who conducted the data collection for this study to the highest professional standards.

Funding Information:
Funding for this pilot and evaluation has been provided by Oak Foundation (OCAY-16-73) and UNICEF. Additional funding for the evaluation (2017–2019) was provided by the United Kingdom’s Department of International Development (DFID 203529-102) and the Swedish Development Cooperation Agency (Sida G41102), both through a grant to UNICEF Office of Research–Innocenti supporting the Transfer Project. Additional funding for program implementation activities (2018–2020) was provided by Irish Aid (IA-TAN/ 2019/064).

Publisher Copyright:
© 2021 American Public Health Association Inc.. All rights reserved.


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