Abstract
Economic constraints may lead to poor health among people from the developing world. Microfinance has proven to be useful in improving health outcomes elsewhere, but it still remains a neglected issue in Nepal. This study aims to assess perceived usefulness of the microfinance on health awareness and practices among different ethnic groups of Nepal. A community-based cross-sectional study was conducted in four districts of western Nepal. A total of 500 microfinance clients representing different ethnic groups (upper caste, aadibasi and janajati, and dalit) were selected by using systemic random sampling. Health awareness and practices among different ethnic groups were compared by logistic regression after adjustment for age, level of education, sex of household heads, occupation, and place of residence. Since participants were asked about their health awareness and practices, before and after microfinance intervention, during a single interview, there was a strong possibility of recall bias with respect to their preintervention awareness and other measures. Microfinance intervention positively influenced self-reported health awareness and practices among different ethnic groups in Nepal, which was highest among the upper caste group (77-92%, rate ratios around 1.7-2.6), followed by the aadibasi/janajati (60-76%, rate ratios around 1.4-1.8) and dalit group (33-52%, reference group). Self-reported awareness about environment and sanitation, family planning methods, and available health services at local level improved from 11.2 to 69.2, 9.2 to 65.0, and 3.8 to 59.8%, respectively, among the clients after microfinance intervention (p < 0.001). Similarly, the practices of eating nutritious food/balanced diet, drinking safe water, using toilet, immunizing the children, and regularly visiting the healthcare facility were improved from 4.2 to 63.8, 12.6 to 66.8, 15.2 to 70.4, 15.8 to 73.8, and 3.6 to 61.4%, respectively (p < 0.001). Despite lack of control group and potential recall bias, this study reports positive effect of microfinance on self-reported health awareness and practices among different ethnic groups of Nepal. This finding supports further implementation and evaluation of equity-based microfinance to improve health and economic conditions of Nepalese people.
Highlights
Every year, 25 million households are pushed into poverty due to recurrent illnesses and expensive healthcare
Our current study indicates that microfinance intervention might improve the components of awareness and practices related to health except for the use of traditional healers
The study suggests that the incorporation of microfinance strategy to health strategy could possibly be effective in developing countries like Nepal
Summary
25 million households (more than 100 million people) are pushed into poverty due to recurrent illnesses and expensive healthcare. Access to the good health services and health protection are key components for fighting against poverty [1, 2]. As health and poverty are interrelated to each other [5], improving health of the poor necessitates poverty reduction and an increased access to healthcare. Microfinance organizations can implement health programs that increase knowledge, change health-related behaviors, and improve access to health services [6]. Microfinance has been shown to have a positive impact on many health issues, such as malaria and tuberculosis control [7, 8], maternal [9], and child health [10]. Microfinance has proven to be useful in improving health outcomes elsewhere, but it still remains a neglected issue in Nepal.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
