Abstract

Financial inclusion is presently one of the most widely recognised areas of activity in international development. Financial inclusion initiatives have built upon donors’ experience with microfinance, but have displaced and superseded microfinance interventions in recent years with a more encompassing agenda of financial services for poverty alleviation and development (Mader 2016). With financial inclusion, policymakers and donors hope that access to financial services (including credit, savings, insurance and money transfers) provided by a variety of financial service providers (FSPs), of which microfinance institutions are a subset, will allow poor and low-income households in low- and middle income countries to enhance their welfare, grasp opportunities, mitigate shocks, and consequently escape poverty, as well as advance macroeconomic development which is also expected to benefit poor/low-income households. More recently, some donors have suggested behavioural changes (such as household spending decisions) to also be desired outcomes of access to financial services. Unlike most previous systematic reviews, which focused on microfinance interventions (or sub-sets thereof), we explicitly adopt a broader scope to review any available systematic review or meta-analysis evidence on financial inclusion as a whole field. Systematic reviews, meta-analyses and research syntheses (in short: meta-studies) have sought to clarify the impacts from financial inclusion on poor people in low- and middle-income countries, based on an array of different underlying studies which include quantitative and qualitative work based on long-term and short-term data. The bulk of these meta-studies have been focused on microfinance, and many specifically on microcredit. The very different quality and approaches of these meta-studies, and of the studies underlying them, however, pose a major challenge for policymakers, programme managers and practitioners in assessing the benefits and drawbacks of finance-based approaches to poverty alleviation. Increasingly there is confusion about the impacts, and a risk of “cherry picking” among different findings. Further, many meta-studies are not taking into account what is missing from their primary studies, which would affect understanding of the evidence, for example by not analysing or reporting gendered impacts. More recently, primary studies1 have also sought to understand the impacts of financial inclusion initiatives more broadly (Cull, Ehrbeck and Holle 2014; Demirgüc-Kunt and Klapper 2013), but the systematic review evidence has not yet progressed as far as for microfinance. The field of financial inclusion in low- and middle-income countries is diverse and complex, encompassing microfinance as the best-known intervention in this space, but increasingly extending beyond it. Microfinance refers to the provision of financial services including loans, savings accounts, insurance (e.g. health, crop, life, credit life or default insurance), and money transfer services, specifically to poor and low-income people in low- and middle income countries around the world who are not usually served by the regular banking sector, by dedicated providers who collectively identify as micro-finance institutions (MFIs); these providers may range in size and type from small, local non-profit NGOs to large commercial microfinance companies. Financial inclusion encompasses this set of services, while acknowledging a wider possible range of service providers, including community finance organisations, government programmes, commercial banks, fintech enterprises, and mobile network operators. It also highlights the connection of financial access with other services, for instance digital technologies, access to government welfare provision, mhealth services, or agricultural innovations. In short: microfinance is focused on specific financial services provided by a particular set of providers; financial inclusion more broadly aims to address poor and low-income people's ability to access and use financial services for broader ends, and is agnostic about who provides them. The most commonly-provided services within financial inclusion still are microcredit loans, made to about 211 million families worldwide (Microcredit Summit Campaign 2015), with durations of around 12 months, which are repaid in weekly (and sometimes bi-weekly or monthly) instalments, and are often guaranteed by group membership, small collateral, or personal guarantors. Savings and insurance services are usually offered only in conjunction with loans, but also sometimes independently. Money transfers and mobile payments services (i.e. financial technologies, or fintech, that have the potential to disrupt established business models of the inclusive financial space by delivering financial services via digital platforms) are a relatively new area of activity, which is still under development in many countries, but has achieved scale in parts of East Africa and South Asia; reviews of mhealth interventions will also be included to understand the role of mobile technologies in potentially shaping the provision of inclusive financial services. The space of financial inclusion is changing rapidly, and the purpose of this systematic review of reviews4 is to assess evidence for the broader range of inclusive financial services increasingly being offered, including but going beyond (micro)credit. The policy rationale behind financial inclusion activities is that the usage of financial services is expected to improve the lives of poor and low-income people in low- or middle-income countries (i.e. generate a positive impact) through one or more of three possible channels: (1) personal/household financial improvements, in the form of increased incomes, lower costs, building assets, sustainably consuming more goods and services, or managing the impacts of shocks better; (2) empowerment gains, primarily an increase in well-being and health, and enhanced women's freedom, status, and recognition; (3) and macroeconomic development, when broader financial access drives inclusive growth or generates reductions in inequality. These channels and their most important impact pathways are shown schematically in the figure below. Pathways to financial inclusion impacts Channel 1 refers to the (presumed) ability of individuals to translate financial services usage into financial improvements for themselves or their families. These improvements may result, to simplify, through two pathways: firstly, investments by the “economically active poor” (Ledgerwood 1999: 1) in revenue-generating assets, primarily microenterprise (Grosh and Somolekae 1996), but also in human capital; secondly, through improved money-management capability (ability to move money over space and time, from where/when it is earned to where/when it is needed) to enable smoothing consumption, saving, hedging against risk, and access to liquidity (Collins et al. 2007). Included in these channel is the potential of particular modes of financial service provision leading to changed attitudes and behaviours, wherein people reprioritise expenditures in ways that are more conducive poverty-alleviation (e.g. less spending on “temptation goods”, more on asset accumulation), suggestions of which have grown more prominent in recent years (Banerjee et al. 2015; World Bank 2015). Channel 2 refers to the (presumed) translation of financial services into the (subjectively-experienced and/or objectively observable) empowerment of individuals who use them. The literature generally articulates two forms of empowerment: improved subjective well-being and physical health regardless of gender, and empowerment for women. Physical outcomes may result from financial options which allow control of risk (e.g. insurance) or better spending on health (Dercon et al. 2012). Mental health/well-being outcomes may result from improved life satisfaction, sense of self-worth, feeling of being included and having more choices thanks to gaining access to financial services (Angelucci et al. 2014). Women's empowerment may result from access to financial services increasing women's status, freedom, and recognition (both within and outside the household), for instance when women are enabled to be more active in the public sphere, or increase their intra-household economic decision-making power, or gain greater autonomy (Kabeer 2005; Suri and Jack 2016). Channel 3 refers to the potential for inclusive financial sectors to be conducive to macroeconomic development in low- or middle-income countries, from which poor and low-income people in turn benefit (Cull, Demirgüç-Kunt, and Morduch 2013; World Bank 2014). The economic literature sees inclusive financial sector development as driving economic growth by mobilising savings and investments in the productive sector, and reducing information, contracting and transaction costs across the economy, leading to efficiency gains (Banerjee and Newman 1993; Galor and Zeira 1993; King and Levine 1993); poverty alleviation will result if poor people benefit from subsequent economic growth. Inclusive financial sector development is also seen as potentially reducing economic inequality, either indirectly (through growth leading to lower inequality) or through enabling lower-income individuals to invest in their own human capital (Jalilian and Kirkpatrick 2005; Beck et al. 2007). Notably, these channels of potential (that is: widely-discussed, but not yet clearly demonstrated) impact of financial services usage on poverty (as well as their respective pathways) are interdependent, as indicated by some of the cross-connections in the figure. But most existing reviews have focussed on individual channels or only certain pathways within them. A higher level of review systematisation will enable us to better understand the interconnections and contingencies between the different impact channels and pathways. In each impact channel, furthermore, the possibility of adverse impacts (on average, or for parts of the population) must be considered, as there is no reason to assume the impacts will be positive. Among the adverse impacts that have been discussed at length in the literature so far are worsened impoverishment (Mosley 2001), financial and emotional stress (Ashta et al. 2015), debt traps and permanent indebtedness (Schicks 2010; Guérin et al. 2014), gender-based violence and women's disempowerment (Rahman 1999), undermined economic development and social greater inequality (Bateman 2010; Sandberg 2012). While a large number of methodologically robust studies have systematically synthesised evidence on microfinance, the same cannot yet be said for financial inclusion more broadly. Some donor agencies, especially the World Bank, have carried out primary studies on financial inclusion of various types including microfinance facility to justify why financial inclusion policy matters, how it matters, and what it means to policymaking (cf. Cull, Ehrbeck and Holle 2014; Demirgüc-Kunt and Klapper 2013; Demirgüc-Kunt, Klapper and Singer 2017; World Bank 2014). But the existing research syntheses on financial inclusion (beyond microfinance) have been unsystematic in their approach. Finally, it is worth noting that systematic reviews of reviews also have a role to play in translating knowledge into policy impact. In the context of financial inclusion, without robust evidence that financial services generate significant and meaningful – ideally: transformative – impacts in poor people's lives, financial inclusion efforts would lack a clear justification in developmental or social policy terms. This can be said without pre-judging the evidence. However, the existing systematic reviews and meta-analyses which we are presently aware of (and which have focused on microfinance rather than financial inclusion broadly-defined) have generated few strong or unambiguous results, suggesting that the improvements in poor people's lives that accrue from financial inclusion are relatively small or manifest mainly as intermediary impacts – changes in behaviours and spending patterns, rather than changes in incomes or well-being –, at least in the shorter term. Presently, too little is known across different meta-studies with different approaches, and we expect a systematic review of reviews will generate a clearer picture. Existing systematic reviews and meta-analyses have reviewed primary studies of many different types of financial services. As indicated in the table below, a substantial number of systematic reviews, meta-analyses and research syntheses on financial inclusion and closely-connected topics exist. However, the focus of the bulk of studies (in keeping with the activity focus of the financial inclusion sector) has been on credit and credit-type (e.g. leasing) services, particularly those provided by MFIs. The evidence base on other services is smaller but growing rapidly, particularly in the area of mobile service provision and fintech for development. The existing systematic reviews and meta-analyses have followed diverse approaches. Some of the systematic reviews are fairly broad, aiming to cover the whole microfinance spectrum (e.g. Duvendack et al. 2011). Others cover specific interventions, such as microcredit (e.g. Vaessen et al. 2014), formal banking services (Pande et al. 2012), microenterprise (e.g. Grimm and Paffhausen 2015), microsavings and microleasing (Stewart et al. 2012), and microinsurance (Cole et al. 2012). Some systematic reviews focus on particular populations, such as Sub-Saharan African recipients (e.g. Stewart et al. 2010), particular methods of providing financial services, such as self-help groups (e.g. Brody et al. 2016) or particular outcomes, such as health (e.g. Leatherman et al. 2012) or empowerment (Vaessen et al. 2014; Brody et al. 2016). The systematic reviews also differ by focus, many covering effectiveness evidence, but others incorporating participant views (e.g. Brody et al. 2016) and barriers or enablers of uptake and effectiveness (e.g. Panda et al. 2016) including innovations in information and communications technology (e.g. Gurman et al. 2012, Jennings and Gagliardi 2013, Sondaal et al. 2015, Lee et al. 2016). The systematic reviews and meta-analyses use a range of methodologies to synthesise the evidence, including theory-based approaches, narrative syntheses and statistical meta-analyses. Many of them have not been conducted to standards that would support a ‘high confidence’ rating5; not all meta-studies that have impacted policy discussions have used a systematic methodology (Odell 2010; Bauchet et al. 2011; Beck 2015). In addition, the majority of systematic reviews and meta-analyses are available in technical reports where there is no transparent decision rule for determining implications of the findings, including critical appraisal and strength of evidence tools like GRADE assessment (Guyatt et al. 2013) and user-friendly presentation of results (e.g. translating standardised effect sizes into metrics commonly used by decision makers). In addition, there is no overall synthesis of the implications for policy, programming, practice and research for the sector from this body of synthesised evidence. Below is a chronological overview of many known systematic reviews, meta-analyses and research syntheses of financial inclusion interventions: A clear mapping of knowledge gaps will allow policy-related research funders to better direct research funds towards addressing the gaps, and the systematic reviewing of known impacts will allow policymakers to focus their efforts on those interventions that are known to work best, on where they work best, or otherwise to eschew or improve them. Our stakeholder engagement strategy will include a policy brief, a collection of blogs, and dissemination events, as well as working with our advisory board to disseminate the findings. The objective of this systematic review of reviews is to systematically collect and appraise the existing systematic reviews and meta-analyses of financial inclusion impacts, analyse the strength of the methods used, synthesise the findings from those systematic reviews and meta-analyses, and report implications for policy, programming, practice and further research. Systematic reviews of reviews are undertaken in other sectors for which evidence is widely available, especially health (Becker and Oxman 2008) and recently education (Polanin et al. 2017), but they are non-existent in international development, and thus this study will address a notable gap.6 It provides the opportunity to develop and pilot an evidence synthesis approach in a sector where there is a large body of evidence of variable quality, but a systematic appraisal and synthesis of the body of systematic reviews and meta-analyses is lacking. Polanin et al (2017) provide useful guidance on how best to conduct such systematic reviews of reviews; they point towards methodological challenges of such reviews and suggest ways forward to improving them. “A systematic review summarizes the best available evidence on a specific question using transparent procedures to locate, evaluate, and integrate the findings of relevant research” (The Campbell Collaboration 2014, p.6). “A systematic review attempts to collate all empirical evidence that fits pre-specified eligibility criteria in order to answer a specific research question. It uses explicit, systematic methods that are selected with a view to minimizing bias, thus providing more reliable findings from which conclusions can be drawn and decisions made” (Section 1.2 in Higgins and Green 2011). “Meta-analysis [is] the statistical combination of results from two or more separate studies” to produce an overall statistic with the aim to provide a precise estimate of the effects of an intervention (Section 9.1.2 in Higgins and Green 2011). It should be noted that not every systematic review automatically contains a meta-analysis, e.g. if primary studies are too heterogeneous in terms of study designs, conceptual framings and or outcomes, then a meta-analysis may not be appropriate. Furthermore, occasionally meta-analyses are published separately without drawing on the broader systematic review they may have been originated from. We exclude any evidence that did not meet the definitions we outlined above. The scope of the systematic reviews and meta-analyses we will include may be diverse (different questions are often addressed; a range of linked interventions are examined such as credit, savings, insurance, leasing, money transfers etc.) but there is considerable overlap in terms of their population of interest. Almost all systematic reviews and meta-analyses focus on the impacts of financial inclusion on poor households based in low- or middle-income countries (using the World Bank definition9). In other words, our population is the population of participants in inclusive finance activities that are conducted in low- and middle-income countries. Where systematic reviews and meta-analyses include evidence from high-income countries, we will only consider the findings that are presented for low- and middle-income countries; we will also consider systematic reviews and meta-analyses covering particular regions within low- and middle income countries, e.g. Sub-Saharan Africa or fragile and conflict-affected areas. At the primary study level, our population of interest would be participants taking part in inclusive finance activities in low- and middle-income countries. In this systematic review of reviews, we will include all systematic reviews and meta-analyses that address at least one or more types of intervention for financial inclusion, as described above. In the majority, we expect the interventions will be one or more sub-categories of microfinance: microcredit, micro-savings, micro-insurance, micro-leasing, and/or money transfers. However, our search strategy explicitly targets the broader range of inclusive finance activities, such as mobile monies, index insurance, or savings promotion. For our purposes, to warrant inclusion of the systematic review or meta-analysis, the reviewed intervention must have at least one financial service as an essential element of the intervention – for instance, not all systematic reviews of mhealth interventions would qualify for inclusion, but systematic reviews of mhealth interventions that require participants to purchase an insurance service would. The key is that the intervention is fundamentally a financial service directed at poor and low-income people. At the primary study level, our intervention of interest would be interventions that address at least one or more types of financial inclusion interventions. Existing systematic reviews and meta-analyses of financial inclusion typically examine a wide range of poverty indicators (including income, assets, expenditure, personal networks, gender/empowerment, well-being, health, etc.). In this systematic review of reviews, we will include all systematic reviews and meta-analyses that address at least one or more of these domains. We will group the indicators in three categories of impacts: social, economic, or behavioural. We will not distinguish between primary or secondary outcomes but consider all outcome measures. Our systematic review of reviews will also assess the evidence for outcomes further back along the causal chain; most importantly rates of uptake, and then investment in productive activity, human capital accumulation, improved money management, savings accumulation, risk/shock management, health and nutrition spending, and women's economic activity. These might be enablers of improvements on poverty indicators (over a longer term) even if, importantly, should not in themselves be taken as evidence of impact in terms of poverty alleviation. At the primary study level, our outcomes of interest would be outcomes that address at least one or more of the poverty domains described above. The first systematic reviews engaging with financial inclusion issues (Stewart et al 2010, Duvendack et al 2011) indicated that no systematic reviews existed prior to their reviews. The primary studies these two systematic reviews included date back to the late 1990s reporting on data that was collected in the early 1990s – this coincides with rigorous impact evaluations of financial inclusion becoming more mainstream, hence our searches will be limited to 2010 onwards. No restriction was placed on language of papers. We do not expect to make any changes to the eligibility criteria set out in this section but should we need to make any adjustments we will justify and documents these carefully and any changes will be in line with the objectives of this systematic review of reviews (relates to MECIR checklist, item 13). Evidence will be included irrespective of its publication status (relates to MECIR checklist, item 12). We will adopt a multi-pronged search strategy which was informed by Kugley et al (2016) and that explores bibliographic databases to identify published literature, institutional websites for published and unpublished literature, and back-referencing from recent systematic reviews (see Table 1 above) to ensure additional sources are identified. Authors Details Geographical focus Funder Odell, 2010 Research synthesis Worldwide Grameen Foundation Stewart et al, 2010 SR; quantitative evidence only Sub-Saharan Africa DFID Duvendack et al, 2011 SR; quantitative evidence only Worldwide DFID Bauchet, et al, 2011 RCT evidence only – not a SR Worldwide CGAP Leatherman et al, 2012 SR; microfinance and health Worldwide University of North Carolina Pande et al, 2012 SR; formal banking services Worldwide DFID Stewart et al, 2012 SR; includes micro-leasing, quantitative evidence only Worldwide DFID Grimm and Paffhausen, 2015 SR; micro-entrepreneurs Worldwide KfW Group Maitrot and Niño-Zarazúa, 2013 SR; quantitative evidence only Worldwide Unclear Cole et al, 2012 SR; micro-insurance focus, quantitative only Worldwide DFID Gurman et al, 2012 SR; mhealth Worldwide Unclear Yang and Stanley, 2013 Meta-analysis only, focus on income Worldwide Self-funded Jennings and Gagliardi, 2013 SR; mhealth and gender focus South Asia, Sub-Saharan Africa Unclear Vaessen et al, 2014 SR including meta-analysis; empowerment focus Worldwide 3ie Awaworyi, 2014 Meta-analysis only Worldwide Self-funded Arrivillaga and Salcedo, 2014 SR; focus on HIV/AIDS prevention Worldwide Unclear Aranda-Jan et al, 2014 SR; mhealth Africa Unclear Madhani, Tompkins, Jack and Fisher, 2015 Modified SR; focus on women's mental health Worldwide Unclear Beck, 2015 Research synthesis Worldwide World Bank Sondaal et al, 2015 SR; mhealth Worldwide Authors received no specific funding Devi et al, 2015 Updated SR; mhealth Sub-Saharan Africa Unclear Watterson et al, 2015 SR; mhealth South Asia, Sub-Saharan Africa Unclear Agarwal et al, 2015 SR; mhealth South Asia, Sub-Saharan Africa, Latin America & Carribean mPowering Frontline Health Workers – USAID & Johns Hopkins University Brody et al, 2016 SR; SHGs/women's empowerment Worldwide 3ie Gopalaswamy et al, 2016 SR; quantitative evidence only South Asia DFID Panda et al, 2016 SR, health financing, insurance Worldwide 3ie Lee et al, 2016 SR and meta-analysis, mhealth Worldwide WHO White et al, 2016 SR; mhealth South Asia National Institutes of Health Amoakoh-Coleman et al, 2016 SR; mhealth Middle East & North Africa, Sub-Saharan Africa Netherlands Organization for Scientific Research (NWO) Steinert et al, forthcoming SR; micro-savings Sub-Saharan Africa Unclear The following institutional websites will be searched: After completing the screening process, we will also run citation searches on included systematic reviews and meta-analyses in Google Scholar, Scopus and Web of Science to identify more recent systematic reviews or meta-analyses not retrieved in database searches. We piloted our key search terms (see Appendix 1 for full search strategies) and ran preliminary searches in Econlit (Ebsco) (510 hits), Scopus (1035 hits), Repec (Ebsco) (238 hits), Academic Search Complete (Ebsco) (366 hits), and Web of Science (2014 hits). Search strategies were constructed using both textwords (title/abstracts) and where available index terms. Each strategy consisted of 3 parts – Intervention (financial inclusion, microfinance and other relevant terms), Study design (adapted from 3ie's search filter for its systematic review database), and LMICs (adapted from the Cochrane EPOC Group's LMICs filter based on World Bank definition of LMICs). We adjusted our search strategy for each database and web source. No restriction was placed on language of papers but all searches were limited to 2010 onwards (rationale provided above) and only English language papers were identified. We will adopt a snowballing, also called reference harvesting, approach to ensure we have not missed any key systematic reviews or meta-analyses. We will also consult our advisory board to get their views on the sample of included studies. We will update our searches for all relevant databases within 12 months before publication of our study and screen all new systematic reviews and meta-analyses using the eligibility criteria outlined above. One review author (MD) will screen all titles and abstracts of the systematic reviews and meta-analyses identified by the search. The second review author (PM) will independently review each systematic review and meta-analysis for inclusion to confirm the inclusion decision of the first review author (MD). Full texts will be obtained and screened when a decision cannot not be made based on title and abstract screening. Disagreements will be resolved by discussion or by involving a third party (e.g. a member of the advisory board) if a consensus cannot be reached. A PRISMA flow diagram will be used to summarise the study selection process and a table with the characteristics of excluded studies will be included in the appendix. The systematic reviews and meta-analyses we will include will have included primary studies that employed quantitative, qualitative and mixed methods approaches. Hence, many of the systematic reviews and meta-analyses in our study sample will have adopted a narrative synthesis approach to deal with the methodological diversity found in the included primary studies (e.g. Stewart et al 2010 and 2012, Duvendack et al 2011). In some cases, however, meta-analysis is feasible and the preferred synthesis approach (e.g. Yang and Stanley 2013, Awaworyi 2014, Lee et al 2016). In very few cases, a combination of qualitative and quantitative synthesis approaches can be found (e.g. Vaessen et al 2014). Some of the systematic reviews and meta-analyses in our study sample will have been published in multiple places, e.g. they may have been published as a Campbell systematic review but also as a peer-reviewed journal article (e.g. Vaessen et al 2014). Or they may have been published on DFID's R4D website as well as a peer-reviewed journal article (e.g. Stewart et al 2012). Where this is the case, we will treat them as duplicate reviews with data extracted from the most comprehensive review. Should we identify multiple versions of the same systematic review or meta-analysis, we will only include the latest updated version. An issue that remains after removing duplicate systematic reviews and meta-analyses is that of overlap. In our sample of included systematic reviews, we may find reviews that included some of the same primary studies. One way to address overlap is to present a matrix (see Polanin et al 2017) that includes all primary studies captured in the systematic reviews with a high and medium conference rating, this would allow us to understand the extent of overlap, i.e. which primary studies were included in which one of the

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