Prevention of violence against women and girls: A cost-effectiveness study across 6 low- and middle-income countries
Outcomes: Child, Early, and Forced Marriage, Gender‑Based Violence
View SourceKey Social Norms Take-aways This study shows that community-based interventions designed to change harmful gender norms and social norms around violence are among the most cost-effective strategies for preventing violence against women and girls in low- and middle-income countries. The findings highlight that investing in proven social norms interventions can improve population health, although additional refinement is needed before some intervention models can be effectively scaled.
Objectives To assess the cost-effectiveness, health impact, and broader societal benefits of six violence prevention interventions implemented in Ghana, Kenya, Pakistan, Rwanda, South Africa, and Zambia.
Methods The study conducted a trial-based cost-effectiveness analysis using data from five randomized controlled trials in sub-Saharan Africa and one randomized controlled trial in South Asia. Interventions included school-, workshop-, community-, and combined community-based programs. Costs were estimated using micro-costing, while health impacts were measured as disability-adjusted life years averted. Social norms were incorporated through gender-transformative interventions that explicitly addressed harmful gender norms and community norms around violence, with several studies also measuring gender attitudes or beliefs about gender norms.
Intervention Details Six established interventions were evaluated: community mobilization addressing harmful gender norms (Ghana), school-based empowerment and self-defense (Kenya), a play-based school intervention (Pakistan), a gender-transformative community and savings group intervention (Rwanda), a livelihoods and gender-transformative program (South Africa), and a psychotherapeutic couples intervention (Zambia).
Results Community- and school-based interventions were generally the most cost-effective. The Ghana community intervention that targeted harmful gender attitudes and social norms had the lowest cost per disability-adjusted life year averted, while the South African livelihoods intervention had the highest. Overall, interventions were more successful at reducing women’s experience of violence than men’s perpetration, and livelihood-focused programs generated additional economic benefits that improved their societal value.
Conclusions Community-based interventions that transform harmful gender norms offer good value for money and should be prioritized for scale-up. Future evaluations should capture broader social, economic, and health outcomes to fully demonstrate the benefits of social norms interventions for preventing violence against women and girls.
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