期刊论文详细信息
International Journal for Equity in Health
Microcredit participation and women’s health: results from a cross-sectional study in Peru
Lia C. H. Fernald1  Rita Hamad2 
[1] School of Public Health, University of California Berkeley, 50 University Hall, Berkeley 94720, CA, USA;Division of General Medical Disciplines, Stanford University, 1070 Arastradero Road, Palo Alto 94304, CA, USA
关键词: Peru;    Latin America;    Socioeconomic determinants of health;    Women’s health;    Poverty alleviation;    Microcredit;   
Others  :  1222800
DOI  :  10.1186/s12939-015-0194-7
 received in 2015-02-05, accepted in 2015-07-21,  发布年份 2015
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【 摘 要 】

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.

【 授权许可】

   
2015 Hamad and Fernald.

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【 参考文献 】
  • [1]Ahmed S, Creanga AA, Gillespie DG, Tsui AO. Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PLoS One. 2010; 5:e11190.
  • [2]Nene B, Jayant K, Arrossi S, Shastri S, Budukh A, Hingmire S, et al. Determinants of women's participation in cervical cancer screening trial, Maharashtra, India. Bull World Health Organ. 2007;85:264–72.
  • [3]Marmot M, Friel S, Bell R, Houweling TAJ, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet. 2008; 372:1661-1669.
  • [4]Leatherman S, Metcalfe M, Geissler K, Dunford C. Integrating microfinance and health strategies: examining the evidence to inform policy and practice. Health Policy Plan. 2012; 27:85-101.
  • [5]Reed L. State of the Microcredit Summit Campaign Report. Microcredit Summit Campaign, Washington; 2011.
  • [6]Mayoux L. Women's Empowerment and Micro-Finance Programmes: Strategies for Increasing Impact. Development in Practice. 1998; 8:235-241.
  • [7]Hennink M, McFarland DA. A delicate web: Household changes in health behaviour enabled by microcredit in Burkina Faso. Global Public Health. 2013; 8:144-158.
  • [8]Mohindra KS, Haddad S. Women's interlaced freedoms: a framework linking microcredit participation and health. Journal of Human Development. 2005; 6:353-374.
  • [9]Littlefield E, Morduch J, Hashemi S. Is microfinance an effective strategy to reach the Millennium Development Goals? CGAP Focus Note 24. 2003.
  • [10]Rahman A. Micro-credit initiatives for equitable and sustainable development: who pays? World Development. 1999; 27:67-82.
  • [11]Brett J. “We sacrifice and eat less”: the structural complexities of microfinance participation. Hum Organ. 2006; 65:8-19.
  • [12]Arber S. Class, paid employment and family roles: Making sense of structural disadvantage, gender and health status. Social Science & Medicine. 1991; 32:425-436.
  • [13]Duvendack M, Palmer-Jones R, Copestake JG, Hooper L, Loke Y, Rao N. What is the evidence of the impact of microfinance on the well-being of poor people?. EPPI-Centre, Social Science Research Unit, Institute of Education, University of London, London; 2011.
  • [14]van Rooyen C, Stewart R, de Wet T. The Impact of Microfinance in Sub-Saharan Africa: A Systematic Review of the Evidence. World Development. 2012; 40:2249-2262.
  • [15]Desai J, Johnson K, Tarozzi A. On the impact of microcredit: Evidence from a randomized intervention in rural Ethiopia. Barcelona GSE Working Paper 741. 2013.
  • [16]Banerjee A, Duflo E, Glennerster R, Kinnan C. The miracle of microfinance? Evidence from a randomized evaluation. Working Paper 18950. Cambridge, Massachusetts: National Bureau of Economic Research. 2013.
  • [17]Pronyk PM, Harpham T, Busza J, Phetla G, Morison LA, Hargreaves JR, et al. Can social capital be intentionally generated? A randomized trial from rural South Africa. Social Science and Medicine. 2008;67:1559–70.
  • [18]Crépon B, Devoto F, Duflo E, Parienté W. Impact of microcredit in rural areas of Morocco: Evidence from a Randomized Evaluation. Cambridge, Massachusetts: Massachusetts Institute of Technology Working Paper, 2011.
  • [19]Doocy S, Teferra S, Norell D, Burnham G. Credit program outcomes: coping capacity and nutritional status in the food insecure context of Ethiopia. Social Science and Medicine. 2005; 60:2371-2382.
  • [20]Hamad R, Fernald LC. Microcredit participation and nutrition outcomes among women in Peru. J Epidemiol Community Health. 2012; 66:e1.
  • [21]MkNelly B, Dunford C. Impact of Credit with Education on Mothers and Their Young Children's Nutrition: CRECER Credit with Education Program in Bolivia. Davis, California: Freedom From Hunger; 1999.
  • [22]Goetz AM, Gupta RS. Who takes the credit? Gender, power, and control over loan use in rural credit programs in Bangladesh. World Development. 1996; 24:45-63.
  • [23]Hashemi S, Schuler SR, Riley AP. Rural Credit Programs and Women’s Empowerment in Bangladesh. World Development. 1996; 24:635-653.
  • [24]Norwood C. Women, microcredit and family planning practices: A case study from rural Ghana. Journal of Asian and African studies. 2011; 46:169-183.
  • [25]Pitt MM, Khandker SR, McKernan S-M, Latif MA. Credit programs for the poor and reproductive behavior in low-income countries: are the reported causal relationships the results of heterogeneity bias? Demography. 1999; 36:1-21.
  • [26]Schuler SR, Hashemi SM. Credit programs, women's empowerment, and contraceptive use in rural Bangladesh. Studies in Family Planning. 1994; 25:65-76.
  • [27]Ahmed S, Chowdhury M, Bhuiya A. Micro-credit and emotional well-being: experience of poor rural women from Matlab, Bangladesh. World Development. 2001; 29:1957-1966.
  • [28]Fernald LC, Hamad R, Karlan D, Ozer EJ, Zinman J. Small individual loans and mental health: a randomized controlled trial among South African adults. BMC Public Health. 2008; 8:409. BioMed Central Full Text
  • [29]Bajracharya A, Amin S. Microcredit and Domestic Violence in Bangladesh: An Exploration of Selection Bias Influences. Demography. 2013; 50:1819-1843.
  • [30]Kevane M, Wydick B. Microenterprise lending to female entrepreneurs: sacrificing economic growth for poverty alleviation? World Development. 2001; 29:1225-1236.
  • [31]Easton T. The hidden wealth of the poor: a survey of microfinance. The Economist. 2005;377.
  • [32]Yunus M. Toward eliminating poverty from the world: Grameen Bank experience. In: Anderson CL, Looney JW, editors. Making Progress: Essays in Progress and Public Policy. Lanham, Maryland: Lexington Books; 2002. p. 371–8.
  • [33]Mohindra KS, Haddad S, Narayana D. Can microcredit help improve the health of poor women? Some findings from a cross-sectional study in Kerala, India. International Journal for Equity in Health. 2008; 7:2. BioMed Central Full Text
  • [34]Moseson H, Hamad R, Fernald L. Microcredit participation and child health: results from a cross-sectional study in Peru. J Epidemiol Community Health. 2014; 68(12):1175-1181.
  • [35]Mosley P. The use of control groups in impact assessments for microfinance. Working Paper No. 19. Geneva, Switzerland: ILO, Enterprise and Cooperative Development Department, Social Finance Unit. 1997.
  • [36]Dohn AL, Chávez A, Dohn MN, Saturria L, Pimentel C. Changes in health indicators related to health promotion and microcredit programs in the Dominican Republic. Revista Panamericana de Salud Pública. 2004; 15:185-193.
  • [37]Smith SC. Village banking and maternal and child health: evidence from Ecuador and Honduras. World Development. 2002; 30:707-723.
  • [38]González V, Stewart A, Ritter P, Lorig K. Translation and validation of arthritis outcome measures into Spanish. Arthritis Rheum. 1995; 38:1429-1446.
  • [39]Salgado de Snyder V, Maldonado M. Psychosocial functioning of wives of Mexican immigrants to the United States. Revista Latinoamericana de Psicologia. 1993; 25:167-180.
  • [40]Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977; 1:385-401.
  • [41]Snyder N, Maldonado M. Características psicométricas de la escala de depresión en el Centro de Estudios Epidemiológicos en mujeres mexicanas adultas de áreas rurales. Salud Publica Mexico. 1994;36:200–9.
  • [42]Ghazali SR, Elklit A, Vincent Balang R, Sultan MA, Yong Chen Y. Determining The Cut-Off Score For A Malay Language Version Of The Centre For Epidemiologic Studies Depression Scale (CESD). ASEAN Journal of Psychiatry. 2014; 15:146-152.
  • [43]Broadhead WE, Gehlbach SH, de Gruy FV, Kaplan BH. The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients. Med Care. 1988; 26:709-723.
  • [44]Bellón SJ, Delgado SA, Luna dCJ, Lardelli CP. Validity and reliability of the Duke-UNC-11 questionnaire of functional social support. Atención Primaria/Sociedad Española De Medicina De Familia y Comunitaria. 1996;18:153–63.
  • [45]Bobak M, Pikhart H, Rose R, Hertzman C, Marmot M. Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries. Soc Sci Med. 2000; 51:1343-1350.
  • [46]Thompson SC, Sobolew-Shubin A, Galbraith ME, Schwankovsky L, Cruzen D. Maintaining perceptions of control: Finding perceived control in low-control circumstances. J Pers Soc Psychol. 1993; 64:293-304.
  • [47]Rodin J. Aging and health: Effects of the sense of control. Science. 1986; 233:1271-1276.
  • [48]Demographic and Health Surveys. http://www. dhsprogram.com. Accessed 4 February, 2015. webcite
  • [49]Filmer D, Pritchett L. Estimating Wealth Effects without Expenditure Data--or Tears: An Application to Educational Enrollments in States of India. Policy Research Working Papers No. 1994. Washington, D.C: World Bank; 1998.
  • [50]Zeller M, Houssou N, Alcaraz GV, Schwarze S, Johannsen J. Developing Poverty Assessment Tools based on Principal Component Analysis: Results from Bangladesh, Kazakhstan, Uganda, and Peru. International Association of Agricultural Economists 2006 Annual Meeting, No. 25396. Queensland, Australia.
  • [51]Kim JC, Watts CH, Hargreaves JR, Ndhlovu LX, Phetla G, Morison LA, et al. Understanding the impact of a microfinance-based intervention on women's empowerment and the reduction of intimate partner violence in South Africa. American Journal of Public Health. 2007;97:1794-1802.
  • [52]Jaillard AS, Mazetti P, Kala E. Prevalence of Migraine and Headache in a High-Altitude Town of Peru: A Population-Based Study. Headache: The Journal of Head and Face Pain. 1997; 37:95-101.
  • [53]Wu DY, Munoz M, Espiritu B, Zeladita J, Sanchez E, Callacna M, et al. Burden of Depression Among Impoverished HIV-Positive Women in Peru. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2008;48:500–4.
  • [54]Samandari G, Speizer IS, O'Connell K. The Role of Social Support and Parity On Contraceptive Use in Cambodia. Int Perspect Sex Reprod Health. 2010; 36(3):122-131.
  • [55]Valente TW, Watkins SC, Jato MN, Van Der Straten A, Tsitsol L-PM. Social network associations with contraceptive use among Cameroonian women in voluntary associations. Soc Sci Med. 1997; 45:677-687.
  • [56]Al Riyami A, Afifi M, Mabry RM. Women's autonomy, education and employment in Oman and their influence on contraceptive use. Reproductive Health Matters. 2004; 12:144-154.
  • [57]Saleem S, Bobak M. Women's autonomy, education and contraception use in Pakistan: a national study. Reproductive Health. 2005; 2:1-8. BioMed Central Full Text
  • [58]Ali MM, Cleland J, Shah IH. Trends in reproductive behavior among young single women in Colombia and Peru: 1985–1999. Demography. 2003; 40:659-673.
  • [59]Lachman ME, Weaver SL. Sociodemographic variations in the sense of control by domain: Findings from the MacArthur studies of midlife. Psychol Aging. 1998; 13:553-562.
  • [60]Bayer AM, Nussbaum L, Cabrera L, Paz-Soldan VA. Missed Opportunities for Health Education on Pap Smears in Peru. Health Education & Behavior. 2011; 38:198-209.
  • [61]Arrossi S, Ramos S, Paolino M, Sankaranarayanan R. Social inequality in Pap smear coverage: identifying under-users of cervical cancer screening in Argentina. Reproductive Health Matters. 2008; 16:50-58.
  • [62]Williams-Brennan L, Gastaldo D, Cole D, Paszat L. Social determinants of health associated with cervical cancer screening among women living in developing countries: a scoping review. Arch Gynecol Obstet. 2012; 286:1487-1505.
  • [63]Lee M, Park E-C, Chang H-S, Kwon JA, Yoo KB, Kim TH. Socioeconomic disparity in cervical cancer screening among Korean women: 1998–2010. BMC Public Health. 2013; 13:553. BioMed Central Full Text
  • [64]INEI/DHS. Encuesta Demográfica y de Salud Familiar 2004. Lima, Peru: 2005
  • [65]Brau JC, Woller G. Microfinance: a comprehensive review of the existing literature. Journal of Entrepreneurial Finance & Business Ventures. 2004; 9:1-26.
  • [66]Shaw J. Microenterprise occupation and poverty reduction in microfinance programs: evidence from Sri Lanka. World Development. 2004; 32:1247-1264.
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