The study, Men Engagement in Women Empowerment (MEWE), will test the usefulness of cash transfer and life-skill building initiatives among beneficiaries of the Benazir Income Support Programme (BISP), a nationwide means-tested welfare programme run by the federal government. 

Previous studies by AKU researchers in Hyderabad and Karachi have found that restrictions imposed by husbands on a woman’s financial autonomy or her ability to work, were a prominent cause of emotional distress. 

Such economic constraints make women fearful about their children’s health and the consequent feeling of powerlessness also impacts their mental health, says Professor Rozina Karamaliani, one of the co-lead investigators of the MEWE project. However, Professor Karamaliani adds that initiatives to economically empower women alone aren’t enough to address women’s mental health challenges or their vulnerability to violence. 

“Economic empowerment can give women the ability to achieve equality but money alone isn’t the answer. Men need to be a part of the solution and that’s why MEWE aims to break new ground by evaluating approaches aimed at both men and women,” she adds. 

One of the intervention arms of MEWE will see men and women jointly receive eight weeks of life-skill training sessions conducted by community health workers. 

These sessions will teach couples financial management techniques to help them improve management of family resources, problem-solving skills to improve harmony in the household, and emotional management methods to promote cooperation over conflict. Decision-making skills will also be taught to show husbands how to include spouses in key matters related to family health. 

The results of the joint life-skills training will be compared against other intervention arms where only women receive life-skill training and where women only receive cash transfers from the BISP.  

Speaking about the goals of the study, Professor Karamaliani added: “Domestic violence is often perceived as a private household issue. In reality, it is an important public health issue since the effects of violence causes depression which harm a mother’s ability to take care of her family’s health, nutrition and education. 

“Breaking the cycle of violence requires an approach that tackles the influence of broader issues such as poverty and patriarchal gender norms that can cause aggressive behaviour,” she added. 

The study will take place in districts of Sindh, Balochistan, Punjab and Khyber Pakhtunkhwa. The objectives of the study are in line with global efforts to achieve targets under goal 3 and goal 5 of the Sustainable Development Goals. Goal 3: ensure healthy lives and promote well-being for all at all ages, calls for special efforts to promote mental health and wellbeing. 

Similarly, the aims of goal 5: achieve gender equality and empower all women and girls, require countries to take measures to end all forms of violence against women in the public and private sphere.

Faculty from the School of Nursing and Midwifery (SONAM), the department of psychiatry at AKU and the department of Community Health Sciences (CHS) will jointly conduct the study which is part of the Umeed-e-Nau initiative managed by the Division of Women and Child Health.

Funded by the Bill & Melinda Gates Foundation, Umeed-e-Nau is a five-year project that will see AKU work with public sector programmes and primary care providers such as lady health workers and community health midwives to deliver proven interventions and to improve the quality of care at health facilities in 14 mainly rural districts in Balochistan, Southern Punjab and Sindh, as well as urban slums in Karachi.

Dr Tazeen S Ali, associate professor at SONAM and the CHS, and assistant dean of research and graduate studies at SONAM, is a co-lead investigator on the project. Dr Judith McFarlane from Texas Woman’s University and AKU’s Dr Nargis Asad, Dr Saima Hirani, Ms Shireen Shehzad and Ms Kausar Khan are co-investigators on the project.