title: Credit with Health Education in Benin: A Cluster Randomized Trial Examining Impacts on Knowledge and Behavior.
abstract: We evaluate whether health education integrated into microcredit lending groups reduces health risks by improving health knowledge and self-reported behaviors among urban and rural borrowers in eastern Benin. In 2007, we randomly assigned 138 villages in the Plateau region of Benin to one of four variations of a group liability credit product, varying lending groups' gender composition and/or inclusion of health education using a 2 × 2 design. Women in villages receiving health education, regardless of gender composition of the groups, showed improved knowledge of malaria and of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), but not of childhood illness danger signs. No significant changes in health behavior were observed except an increase in HIV/AIDS prevention behavior, a result predominantly driven by an increase in respondents' self-reported ability to procure a condom, likely an indicator of increased perceived access rather than improved preventative behavior. Women in villages assigned to mixed-gender groups had significantly lower levels of social capital, compared with villages assigned to female-only groups. This suggests there may be an important trade-off to consider for interventions seeking improved health outcomes and social capital through provision of services to mixed-gender groups. Although bundling health education with microcredit can expand health education coverage and lower service-delivery costs, the approach may not be sufficient to improve health behaviors.
authors.affiliation: Department of Economics, Yale University, New Haven, Connecticut. dean.karlan@yale.edu.|Innovations for Poverty Action, New Haven, Connecticut.|M.I.T. Jameel Poverty Action Lab, Cambridge, Massachusetts.
authors.forename: Dean
authors.initials: D
authors.lastname: Karlan
authors.affiliation: Department of Economics, Yale University, New Haven, Connecticut.|Innovations for Poverty Action, New Haven, Connecticut.
authors.forename: Bram
authors.initials: B
authors.lastname: Thuysbaert
authors.affiliation: Freedom from Hunger, Davis, California.
authors.forename: Bobbi
authors.initials: B
authors.lastname: Gray
mesh_terms: D000328:Adult; D001541:Benin; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult