Microcredit and domestic violence in Bangladesh: an exploration of selection bias influences

The Effects of Husbands' Alcohol Consumption and Women's Empowerment on Intimate Partner Violence in India

The influence of husband's alcohol consumption and that of women's empowerment has been largely studied separately in relation to the intimate partner violence (IPV) faced by women, which has hindered a nuanced understanding of gender-based violence in India. This study aimed to understand how husbands' alcohol consumption shapes the relationship between women's empowerment and violence among Indian couples. Data from the 2015-16 National Family Health Survey (NFHS) were used in this study. A composite women's empowerment index was constructed and its association with husbands' drunkenness and odds of facing emotional, physical, severe, and sexual violence was examined. This study found that compared to women whose husbands were never drunk, those whose husbands were sometimes or often drunk had significantly higher odds of experiencing physical, emotional, and sexual violence. For all the types of IPV, an increase in the empowerment index was associated with a significant reduction in the odds of experiencing violence. However, increasing frequency of husband's drunkenness in combination with increasing scores on the empowerment index was associated with a significant increase in the odds of IPV, except sexual violence. Our findings highlight the nuances of IPV, situating the experiences of women in the social, cultural, and economic realities of Indian society.

Trick or Treat: Does a Microfinance Loan Induce or Reduce the Chances of Spousal Violence against Women? Answers from India

It is a common belief that microfinance plays a dual role of poverty alleviation and socioeconomic upliftment of its women participants. However, there are enough researches that negates the positive impact of microfinance loans on spousal violence. Recognized as one of the most predominant social evils, violence against women is not only a violation of their human rights but also an act of exploitation and denial of freedom. In the present study, we have tried to investigate if microfinance loan takers experience more spousal violence as compared to their counterparts by analyzing the National Family Health Survey IV, 2015-16. Our results indicate that 40.8% of women microfinance participants experience spousal violence. Additionally, the likelihood of microfinance participants to experience spousal violence is much higher than the non-microfinance participants (odds ratio = 1.35, p value = .000). Microfinance programs are designed to increase the individual agencies of women participants, which, in turn, reduce the chances of them becoming victims of spousal violence. However, if the credit program participation induces the woman to be a victim of spousal violence together with becoming financially autonomous, then such hidden costs need to be taken into account while evaluating the effectiveness of the gendered policy design.

The Gender System and Class Mobility: How Wealth and Community Veiling Shape Women's Autonomy in India

It is often assumed that improvements in household wealth are associated with greater gender equality, including greater women's autonomy and decision-making power inside the home. Yet, evidence often shows the opposite: greater household wealth often curtails women's autonomy. Research has yet to reveal the driving forces behind this surprising finding. This paper focuses on one important social force, the community gender system, to show how it shapes the relationship between changing household wealth and women's autonomy. Drawing on a nationally representative panel of rural women in India and fixed effects models, I find that the prevalence of women's veiling at the village level, a notable marker of an exclusionary gender system, moderates the effects of increasing household wealth on women's autonomy. In villages with less veiling, increases in wealth have the perverse effect of suppressing women's autonomy. The study suggests that in these places, households curtail women's mobility because such behavior signals rising social status. In contrast, in villages with more veiling increasing household wealth does not reduce women's autonomy because most households across the class spectrum are already conforming to the norms of seclusion. The findings demonstrate how new wealth interacts with a community gender system which is anchored in gendered notions of family honor to reproduce structures of gender inequality.

Women's participation in microfinance: Effects on Women's agency, exposure to partner violence, and mental health

OBJECTIVES

The health and social effects of women's microfinance participation remain debated.

METHODS

Using propensity-score methods, we assessed effects of microfinance participation on novel measures of agency; intimate partner violence (IPV) exposure; and depressive symptoms in 930 wives in Matlab, Bangladesh interviewed 11/2018-01/2019.

RESULTS

Participants, versus non-participants, were married younger (16.7 vs. 17.4 years), more often Muslim (90.7% vs. 86.2%), less schooled (5.4 vs. 6.8 grades), and more often had husbands (27.0% vs. 19.6%) and mothers (63.2% vs. 50.5%) without schooling. Participants and non-participants had similar unadjusted mean scores for prior-week depressive symptoms, prior-year IPV, and intrinsic attitudinal agency (gender-equitable attitudes; non-justification of wife beating). Participants had higher unadjusted mean scores for intrinsic voice/mobility; instrumental agency (using financial services, voice with husband, voice/mobility outside home); and collective agency. Average adjusted treatment effects were non-significant for depressive symptoms, IPV, and attitudinal intrinsic agency, and significantly favorable for other agency outcomes.

CONCLUSIONS

Microfinance participation had no adverse health effects and favorable empowerment effects in Bangladeshi wives.

POLICY IMPLICATIONS

Microfinance can empower women without adverse health effects. Social-norms programming with men and women may be needed to change gendered expectations about the distribution of unpaid labor and the rights of women.

Prevalence, associated factors, and disclosure of intimate partner violence among mothers in rural Bangladesh

BACKGROUND

The purpose of this study is to assess the prevalence and associated factors of physical and sexual intimate partner violence (IPV) among married women of reproductive age in a rural population in northeast Bangladesh. In addition, we examined women's sharing and disclosure of violence experience with others.

METHODS

This cross-sectional study uses data from a household survey of 3966 women conducted in 2014 in the Sylhet District of Bangladesh. Interviews were completed in respondent's homes by trained local female interviewers.

RESULTS

Twenty-nine percent (28.8%, 95% CI 27.4-30.3%) of the women reported ever experiencing physical or sexual IPV by their spouse; 13.2% (95% CI 12.1-14.3%) reported physical or sexual IPV in the past year. Of the 13.2%, 10.1% (95% CI 9.2-11.1%) reported experiencing physical IPV and 4.6% (95% CI 4.0-5.3%) reported sexual IPV. In a combined model, the adjusted odds of having experienced physical or sexual IPV in the past year were higher for women who were raised in households with history of IPV (AOR = 4.35, 95% CI 3.26-5.80); women with no formal education (AOR = 1.76, 95% CI 1.30-2.37); women whose husbands had no formal education (AOR = 1.63, 95% CI 1.22-2.17); Muslim (AOR = 1.63, 95% CI 1.03-2.57); women younger than age 30 (AOR = 1.53, 95% CI 1.11-2.12); and women who were members of an NGO or microcredit financial organization (AOR = 1.38, 95% CI 1.04-1.82). Wealth, parity, number of household members, and pregnancy status (pregnant, postpartum, neither pregnant nor postpartum) were not associated with physical or sexual IPV after adjusting for other factors. Data on disclosure was available for women who reported experiencing physical violence in the last year; only 31.8% of victims told someone about the violence they had experienced and 1% reported to police, clerics, health workers, or a counselor altogether.

CONCLUSIONS

In rural northeast Bangladesh, a high proportion of women of reproductive age experience physical or sexual IPV. Women do not often speak of these experiences, especially to anyone outside of family. Interventions aimed at preventing future IPV and addressing current IPV should focus on women who witnessed IPV in childhood, as well as younger women and less educated couples.

TRIAL REGISTRATION

This study was registered as a Clinical Trial (Identifier: NCT01702402). https://clinicaltrials.gov/ct2/show/NCT01702402.

Coping with domestic violence: women's voices in Bangladesh

Purpose

This paper aims offer a benchmark by providing an account of women's experiences with domestic violence in Bangladesh and develops illustrations on coping with abuse.

Design/methodology/approach

A case study design was adopted, applying an emic perspective in employing a qualitative research approach to explore and describe women's experiences with and perceptions about domestic violence and their ways of coping in Sherpur District, Bangladesh. In total 25 recently married women participants were purposively sampled by snowballing. In-depth interview data facilitated a latent thematic content analysis.

Findings

The findings indicate that women adopt a range of responses to domestic violence. Two key aspects of coping surfaced in the narratives: (1) emotion-driven and (2) problem-driven approaches to abusive situations. Findings point to a range of research issues that require further study such as domestic violence and taboo; somatization; structural gender inequalities; male perpetrators; family dynamics and the intersections of these issues and contexts.

Originality/value

A more proactive way of coping resulted in resilience amidst an abusive environment, whereas passive ways of coping led to a life in distress. It is important however, to understand ways of coping as a continuum rather than a dichotomy.

Missed Opportunities for Addressing Intimate Partner Violence Through Microcredit: Qualitative Findings From Bangladesh

Microcredit has shown mixed results when used to reduce intimate partner violence (IPV). This study explored microcredit and IPV in Bangladesh by conducting 12 focus groups with married men and women. Participants described challenges to microcredit participation highlighting "missed opportunities" for reducing IPV, including needs to (a) prevent violence sparked by loan disputes, (b) incorporate skill development to improve women's agency as a means of reducing IPV, and (c) mindfully engage men in the loan process to help address men's unequal gender ideologies. These modifications to microcredit programs are proposed to maximize positive change on gender and IPV.

Age Moderates the Association Between Microfinance Membership and Physical Abuse, Relationship Power, and Transactional Sex in Haitian Women

Microfinance interventions may have differential effects on relationship dynamics among subpopulations of women. We estimated the association between microfinance participation duration and physical abuse, relationship power, and transactional sex in a sample of Haitian women (n = 304). Furthermore, we tested for moderation by age. In older women, microfinance tended to be associated with reduced risk of violence, low relationship power, and transactional sex. These associations were not observed for younger women. Thus, older Haitian women may benefit from microfinance in ways that younger women do not. Future studies should examine whether additional training and resources could improve outcomes in younger women.

Sustainable Empowerment Initiatives among Rural Women through Microcredit Borrowings in Bangladesh

Microcredit is an effective instrument that has been recognized to alleviate poverty, especially in developing countries such as Bangladesh. This study seeks to use microcredit as an instrument to bridge the gap between the accessibility of microcredit among poor rural women and sustainable socio-economic development, providing novelty to the concept of “sustainability of empowerment”. In addition, this study employed poor rural women to estimate the empowerment performance of microcredit borrowers compared to non-borrowers in the same socio-economic environment as it relates to microcredit in rural Bangladesh. A regression analysis was used to accomplish these objectives. This study also used propensity score matching techniques to find an easy way to access microcredit. The empirical results not only involve participation in microcredit accessibility but also the particular qualitative attributes of women empowerment. The results also suggest that sustainability is accompanied by affluence among microcredit borrowers, as indicated by women empowerment. The outcome of the empirical analysis shows that there is a significant impact of microcredit on increasing participation in the overall decision-making process, in legal awareness, independent movements, and mobility, as well as enhancing living standards to encourage sustainable women empowerment. This study recommends future investigations for microcredit providers to explore how to build an integrated, holistic approach to women empowerment in Bangladesh.

Microfinance and violence prevention: A review of the evidence and adaptations for implementation in the U.S

Microfinance programs provide access to small amounts of capital in the form of credit, savings, or financial incentives. There is evidence that microfinance reduces financial strain and reduces violence making it a promising public health approach. However, most of this evidence was generated internationally in low-resource countries; thus, it is likely that adaptations are necessary for microfinance to be effective at preventing violence in the U.S. This article reviews the evidence base for microfinance interventions on violence outcomes; outlines the potential of microfinance to prevent violence in the U.S.; and offers some possible adaptations in order to increase the likelihood that microfinance will prevent violence in the U.S. Programs might consider providing matched savings instead of small loans to individuals and providing job skills training. Furthermore, it is important for U.S. microfinance programs to engage multiple sectors and to consider additional content, such as a gender equity component and safety planning to protect those who might be in violent relationships. It is also important that these adaptations be rigorously evaluated for impacts on multiple forms of violence.

Does lower fertility empower women? Evidence from rural Bangladesh

Theoretically, lower fertility should enhance female autonomy. However, the impact of reduced fertility on female empowerment could be heterogeneous and differ by regions. In this paper, using a Family Planning Program in Bangladesh as an instrument for fertility, I find that lower fertility gives women access to economic resources and control over their practice of clothing and greater physical mobility. I also find that there is a trade-off in female autonomy resulting from reduced fertility. In developing countries, where the women's position in the marriage is weak, lower fertility reduces the decision making power of the women and curtails their property rights.

Women economic empowerment via cash transfer and microcredit programs is enough to decrease intimate partner violence? Evidence from a systematic review

Intimate partner violence (IPV) is a worldwide public health problem. Many proposals aiming to eliminate its occurrence include the empowerment of women through their socio-economic development. In this context, some studies suggested that microcredit programs (MP) and cash transfer programs (CTP) are initiatives that can also reduce the risk of IPV. Others pointed to an opposite effect. The objective of this study was to investigate the influence of women's economic empowerment in MP and CTP on the risk of physical, psychological and sexual violence through a systematic review. Papers/documents selection was conducted by two researchers according to the following criteria: published in English, Portuguese or Spanish; primary data; assessing the effect of MP or CTP on IPV; in heterosexual couples; on women beneficiaries of the intervention; using a comparator group eligible for an MP or CTP; and focusing on risk IPV as the outcomes. Our results showed that the impact of MP are mixed when it comes to physical and physical/sexual violence. Even so, the review suggests that the effect of MP on sexual violence is trivial or nonexistent. Regarding the impact of CTPs, the present study showed that the effects on physical, physical/sexual, psychological, and sexual violence were also heterogeneous. Women more empowered and with some autonomy could be at risk. Despite that, participation in the empowerment program should be encouraged for poor women and families. However, parallel interventions to lead with IPV should be addressed to the main actions to reduce the risk of increasing IPV prevalence in certain scenarios.

Women's income and risk of intimate partner violence: secondary findings from the MAISHA cluster randomised trial in North-Western Tanzania

BACKGROUND

Intimate partner violence (IPV) is pervasive throughout the world, with profound consequences for women's health. While women's 'economic empowerment' is touted as a potential means to reduce IPV, evidence is mixed as to the role of different economic factors in determining women's risk. This paper explores associations and potential pathways between women's income and experience of IPV, in Mwanza city, Tanzania.

METHODS

We use data from married/cohabiting women (N = 740) enrolled in the MAISHA study, a cluster randomised trial of an IPV prevention intervention. Women were interviewed at baseline and 29-months later. We use logistic regression to model cross-sectional (baseline) and longitudinal associations between: a woman's monthly income (quartiles) and her past year risk of physical IPV, sexual IPV and economic abuse; and a woman's relative financial contribution to the household (same/less than partner; more than partner) and past year physical IPV and sexual IPV.

RESULTS

At baseline, 96% of respondents reported earning an income and 28% contributed more financially to the household than their partner did. Higher income was associated with lower past-year physical IPV risk at baseline and longitudinally, and lower sexual IPV at baseline only. No clear associations were seen between income and economic abuse. Higher relative financial contribution was associated with increased physical IPV and sexual IPV among all women at baseline, though only among control women longitudinally. Higher income was associated with several potential pathways to reduced IPV, including reduced household hardship, fewer arguments over the partner's inability to provide for the family, improved relationship dynamics, and increased relationship dissolution. Those contributing more than their partner tended to come from more disadvantaged households, argue more over their partner's inability to provide, and have worse relationship dynamics.

CONCLUSIONS

While women's income was protective against IPV, women who contributed more financially than their partners had greater IPV risk. Poverty and tensions over men's inability to provide emerge as potentially important drivers of this association. Interventions to empower women should not only broaden women's access to economic resources and opportunities, but also work with women and men to address men's livelihoods, male gender roles and masculinity norms.

TRIAL REGISTRATION

ClinicalTrials.gov #NCT02592252 , registered retrospectively (13/08/2015).

Is microfinance associated with changes in women's well-being and children's nutrition? A systematic review and meta-analysis

BACKGROUND

Microfinance is the provision of savings and small loans services, with no physical collateral. Most recipients are disadvantaged women. The social and health impacts of microfinance have not been comprehensively evaluated.

OBJECTIVE

To explore the impact of microfinance on contraceptive use, female empowerment and children's nutrition in South Asia, Sub-Saharan Africa and Latin America and the Caribbean.

DESIGN

We conducted a systematic search of published and grey literature (1990-2018), with no language restrictions. We conducted meta-analysis, where possible, to calculate pooled ORs. Where studies could not be combined, we described these qualitatively.

DATA SOURCES

EMBASE, MEDLINE, LILACS, CENTRAL and ECONLIT were searched (1990-June 2018).

ELIGIBILITY CRITERIA

We included controlled trials, observational studies and panel data analyses investigating microfinance involving women and children.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers extracted data and assessed risk of bias. The methodological quality of included studies was assessed using the Cochrane risk-of-bias tool for controlled trials and quasi-experimental studies and a modified Newcastle Ottawa Scale for cross-sectional surveys and analyses of panel data. Meta-analyses were conducted using STATA V.15 (StataCorp).

RESULTS

We included 27 studies. Microfinance was associated with a 64% increase in the number of women using contraceptives (OR 1.64, 95% CI 1.45 to 1.86). We found mixed results for the association between microfinance and intimate partner violence. Some positive changes were noted in female empowerment. Improvements in children's nutrition were noted in three studies.

CONCLUSION

Microfinance has the potential to generate changes in contraceptive use, female empowerment and children's nutrition. It was not possible to compare microfinance models due to the small numbers of studies. More rigorous evidence is needed to evaluate the association between microfinance and social and health outcomes.

PROSPERO REGISTRATION NUMBER

CRD42015026018.

The effect of training problem-solving skills for pregnant women experiencing intimate partner violence: a randomized control trial

Introduction

Intimate partner violence (IPV) in pregnancy is considered as an additional threat to the maternal/fetal health. The present study was aimed to investigate the effectiveness of training problem-solving skills on IPV against pregnant women.

Methods

The present randomized clinical trial was conducted on 125 and 132 women visiting the health centers of Tehran as the intervention and the control groups, respectively; samples were selected using random stratified cluster sampling. The intervention group underwent four problem-solving training sessions. Three months later, both groups completed the revised Conflict Tactics Scale questionnaire. Data were analyzed using SPSS v.16.

Results

The mean (SD) ages of the participants were 27.51 (4.26) and 27.02 (4.26) years, respectively, in the control and the intervention groups. The rates of the physical and psychological violence were significantly reduced after the intervention in the intervention group. Risk differences of the physical, psychological and sexual violence before and after the intervention were 3% (95% CI: -8.23 to14.13, P = 0.6), 1.5% (95% CI: -4.93 to 8.03, P = 0.6) and 4.8% (95% CI: -7.11 to 16.52, P = 0.4) in the control group and 8.8% (95% CI: -3.47 to 20.71, P = 0.1), 25.4% (95% CI: 15.77 to 34.66, P < 0.001) and 4.9% (95% CI: -7.38 to16.97, P = 0.4) in the intervention group, respectively.

Conclusion

It seems that training this skill as a part of the routine prenatal care could be effective in reducing intimate partner violence.

Does Intimate Partner Violence Decline as Women's Empowerment becomes Normative? Perspectives of Bangladeshi Women

Studies addressing the relationship between women's empowerment and intimate partner violence (IPV) have yielded conflicting findings. Some suggest that women's economic and social empowerment is associated with an increased risk of intimate partner violence (IPV), arguably because men use often IPV to enforce their dominance and reassert inegalitarian gender norms when patriarchal norms are challenged; other studies suggest the converse. It is important to understand why these findings are contradictory to create a more sound basis for designing both women's empowerment interventions and anti-violence interventions. The aim of this study is to clarify the relationship between women's empowerment and IPV in a setting where gender roles are rapidly changing and IPV rates are high. We examine some of the ways in which the nature of women's empowerment evolved in six villages in rural Bangladesh during a 12-year period in which surveys have documented a decline of 11 points in the percentage of married women experiencing IPV in the prior year. The paper is based on data from 74 life history narratives elicited from 2011 to 2013 with recently married Bangladeshi women from the six villages, whom other community residents identified as empowered. Our findings suggest that women's empowerment has evolved in several ways that may be contributing to reductions in IPV: in its magnitude (for example, many women are earning more income than they previously did), in women's perceived exit options from abusive marriages, in the propensity of community members to intervene when IPV occurs, and in the normative status of empowerment (it is less likely to be seen as transgressive of gender norms). The finding that community-level perceptions of empowered women can evolve over time may go a long way in explaining the discrepant results in the literature.

A global comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours

BACKGROUND

Intimate partner violence (IPV) and HIV are co-occurring global epidemics, with similar root causes of gender and economic inequalities. Economic interventions have become a central approach to preventing IPV and HIV.

OBJECTIVE/METHODS

We undertook a comprehensive scoping review of published evaluations of economic interventions that sought to prevent IPV and/or HIV risk behaviours.

RESULTS

Forty-five separate analyses of interventions met our criteria. Broadly, unconditional cash transfer interventions showed either flat or positive outcomes; economic strengthening interventions had mixed outcomes, with some negative, flat and positive results reported; interventions combining economic strengthening and gender transformative interventions tended to have positive outcomes.

CONCLUSIONS

The review highlighted a number of gaps. Specifically, there were limited studies evaluating the impact of economic interventions on female sex workers, young women, and men. In addition, there were missed opportunities, with many evaluations only reporting either IPV- or HIV-related outcomes, rather than both, despite overlaps.

Men's response to their wives' participation in microfinance: perpetration and justification of intimate partner violence in Bangladesh

OBJECTIVE

The present study adds to extant literature on the association between microfinance participation and intimate partner violence (IPV) by assessing a national sample of men married to microfinance participants. The key objective was to assess whether there was a positive association between wives' microfinance participation and men's perpetration and justification of IPV in urban areas of Bangladesh.

STUDY DESIGN

This study is based on a population-based secondary data analysis.

METHODS

In this cross-sectional study, data from a national sample of men from the 2007 Bangladesh Demographic and Health Survey were analysed using logistic regression analyses. IPV perpetration was measured using a modified Conflict Tactics Scale and justification of IPV was measured based on 'justification of wife beating' statements with which men agreed or disagreed.

RESULTS

Men married to microfinance participants were not significantly different from men married to non-participants of microfinance in terms of IPV perpetration in both urban and rural areas. However, the interaction effect of wives' microfinance participation and urban living on men's justification of IPV revealed a significant and positive beta coefficient. Specifically, wives' participation in microfinance was positively associated with men's justification of IPV in urban areas (β = 0.51, P < 0.05).

CONCLUSION

Microfinance organizations in urban areas should bundle microfinancial services with IPV screening and intervention geared toward men and women.

Group-based microfinance for collective empowerment: a systematic review of health impacts

Objective

To assess the impact on health-related outcomes, of group microfinance schemes based on collective empowerment.

Methods

We searched the databases Social Sciences Citation Index, Embase, MEDLINE, MEDLINE In-Process, PsycINFO, Social Policy & Practice and Conference Proceedings Citation Index for articles published between 1 January 1980 and 29 February 2016. Articles reporting on health impacts associated with group-based microfinance were included in a narrative synthesis.

Findings

We identified one cluster-randomized control trial and 22 quasi-experimental studies. All of the included interventions targeted poor women living in low- or middle-income countries. Some included a health-promotion component. The results of the higher quality studies indicated an association between membership of a microfinance scheme and improvements in the health of women and their children. The observed improvements included reduced maternal and infant mortality, better sexual health and, in some cases, lower levels of interpersonal violence. According to the results of the few studies in which changes in empowerment were measured, membership of the relatively large and well-established microfinance schemes generally led to increased empowerment but this did not necessarily translate into improved health outcomes. Qualitative evidence suggested that increased empowerment may have contributed to observed improvements in contraceptive use and mental well-being and reductions in the risk of violence from an intimate partner.

Conclusion

Membership of the larger, well-established group-based microfinance schemes is associated with improvements in some health outcomes. Future studies need to be designed to cope better with bias and to assess negative as well as positive social and health impacts.

Microfinance Participation and Domestic Violence in Bangladesh: Results From a Nationally Representative Survey

This article examines domestic violence among women who participate in microfinance in Bangladesh. Secondary analysis of survey data from nationally representative Bangladesh Demographic and Health Survey was used to investigate the association between microfinance participation and domestic violence of 4,163 ever-married women between the ages of 18 and 49 years. Outcome measure is experience of domestic violence as measured by a modified Conflict Tactics Scale (CTS) and predictor variables include microfinance, binary indicator of relatively better economic status, autonomy, decision-making power, and demographic variables. The likelihood of experiencing domestic violence was not found to vary with microfinance participation. However, the interaction effect of microfinance and better economic status was found to be significantly associated with domestic violence (9% increased probability). Experience of domestic violence was negatively associated with older age, higher education of the husband, and autonomy. In Bangladesh, microfinance participation may be associated with a higher probability of experiencing domestic violence for women with relatively better economic status, but not for the poorest of the poor.

A systematic review of microfinance and women's health literature: Directions for future research

While growing evidence suggests that microfinance is an effective approach for improved women's health, a significant gap remains in our understanding. The objective of this review is to synthesise the findings from published literature focused on microfinance and health issues particularly affecting women, including HIV/AIDS, reproductive health, mental health, and violence. Forty-one articles that examine the impact of microfinance participation on women's health were identified through a systematic search of electronic databases, coded using a structured abstraction form, and synthesised. Review results indicate that the impact of microfinance on women's health is an area in great need of research and publication attention. Varied quality and reporting in the identified articles restricted the ability to draw concrete conclusions regarding the relationship between microfinance participation and women's health, but led to the identification of current gaps in existing published research. Future research should work to address the recommendations provided in order to offer additional evidence to better understand the use of microfinance programming as a structural intervention to improve women's health.

Microcredit participation and women's health: results from a cross-sectional study in Peru

INTRODUCTION

Social and economic conditions are powerful determinants of women's health status. Microcredit, which involves the provision of small loans to low-income women in the hopes of improving their living conditions, is an increasingly popular intervention to improve women's socioeconomic status. Studies examining the health effects of microcredit programs have had mixed results.

METHODS

We conduct a cross-sectional study among female clients of a non-profit microcredit program in Peru (N = 1,593). The predictor variable is length of microcredit participation. We conduct bivariate and multivariate linear regressions to examine the associations between length of microcredit participation and a variety of measures of women's health. We control for participants' sociodemographic characteristics.

RESULTS

We find that longer participation is associated with decreased depressive symptoms, increased social support, and increased perceived control, but these differences are attenuated with the inclusion of covariates. We find no association between length of participation and contraception use, cancer screening, or self-reported days sick.

CONCLUSIONS

These results demonstrate a positive association between length of microcredit participation and measures of women's psychological health, but not physical health. These findings contribute to the discussion on the potential of microcredit programs to address the socioeconomic determinants of health, and suggest that addressing socioeconomic status may be a key way to improve women's health worldwide.