title: Effect of combining a health program with a microfinance-based self-help group on health behaviors and outcomes.
abstract: OBJECTIVE
  Women's participation in microfinance-based self-help groups (SHGs) and the resultant social capital may provide a basis to address the gap in health attainment for poor women and their children. We investigated the effect of combining a health program designed to improve health behaviours and outcomes with a microfinance-based SHG program.
  
  
  METHODS
  A mixed method study was conducted among 34 villages selected from three blocks or district subdivisions of India; one in Gujarat, two in Karnataka.
  
  
  METHODS
  A set of 17 villages representing new health program areas were pair-matched with 17 comparison villages. Two rounds of surveys were conducted with a total of 472 respondents, followed by 17 key informant interviews and 17 focus group discussions.
  
  
  RESULTS
  Compared to a matched comparison group, women in SHGs that received the health program had higher odds of delivering their babies in an institution (OR: 5.08, 95% CI 1.21-21.35), feeding colostrum to their newborn (OR: 2.83, 95% CI 1.02-5.57), and having a toilet at home (OR: 1.53, 95% CI 0.76-3.09). However, while the change was in the expected direction, there was no statistically significant reduction in diarrhoea among children in the intervention community (OR: 0.86, 95% CI 0.42-1.76), and the hypothesis that the health program would result in decreased out-pocket expenditures on treatment was not supported.
  
  
  CONCLUSIONS
  Our study found evidence that health programs implemented with microfinance-based SHGs is associated with improved health behaviours. With broad population coverage of SHGs and the social capital produced by their activities, microfinance-based SHGs may provide an avenue for addressing the health needs of poor women.
authors: Nossal Institute for Global Health, University of Melbourne, Australia; Indian Institute of Public Health Gandhinagar, Gujarat, India. Electronic address: ssaha@iiphg.org.
authors: S
authors: S
authors: Saha
authors: Nossal Institute for Global Health, University of Melbourne, Australia.
authors: M
authors: M
authors: Kermode
authors: Nossal Institute for Global Health, University of Melbourne, Australia.
authors: P L
authors: PL
authors: Annear
mesh_terms: D005260:Female; D005378:Financial Support; D005500:Follow-Up Studies; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007194:India; D011203:Poverty; D015397:Program Evaluation; D012657:Self-Help Groups / Q000191:economics*
keywords: Difference-in-difference; Health behaviours; India; Microfinance; Self-help group