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Impact of Malaria Education on the Health of Microfinance Clients

Location: Benin
Sample: 3,000-5,000 microfinance clients in semi-rural Benin
Timeline:
2007
Target Group: 
Rural population
Women and girls
Outcome of Interest: 
Communicable diseases
Gender attitudes and norms
Malaria
Self-esteem/self-efficacy
Sexual and reproductive health
Women’s/girls’ decision-making
Intervention Type: 
Credit
Preventive health
Training
AEA RCT Registration Number: 
Partners:

When microfinance borrowers experience illness, they may face unforeseen expenses or be unable to work, which may cause them to default on loan payments. Researchers are conducting a randomized evaluation to measure the impact of offering individuals in villages in Benin access to health education in addition to credit.

Policy Issue 

Just as illness can keep a person from working or going to school, it can also cause microfinance recipients to fall back or default on loan payments. In some cases loan defaults are linked to illness, which consumes available cash and makes the victim unable to work. Community organizations and policy makers have therefore proposed including health education alongside microfinance services. As a complement to microfinance services, health education could potentially increase repayment rates for the microfinance institution (MFI), while also improving the lives of clients. Health education increases costs for MFIs, who must direct resources towards training loan officers as educators, and increase the time that loan officers spend at each village banking meeting where training is given. There is potential for benefit on measures of both health and microfinance outcomes, but if the additional trainings are ineffective, they could be drawing away an MFI’s resources away from its core activities.

Context of the Evaluation 

Located in West Africa, Benin’s economy is based primarily on agriculture and regional trade. The rural population in Benin suffers from very poor health. Although insecticide treated bed nets – a proven defense against malaria contraction - are provided free of of charge, 22 percent of deaths in children under 5 are nonetheless attributed to malaria.1

PADME (Association pour la Promotion et l’Appui au Developpment de Microenterprises) is a private MFI based in Cotonou, Benin. There are a number of MFIs in Benin, and PADME represents a significant share of the market, serving approximately 49,700 borrowers2 out of an estimated 85,300 in the entire country.3

A man and woman assemble a bed net to provide malaria protection.

A man and woman assemble a bed net to provide malaria protection.

Details of the Intervention 

In 2006, Freedom from Hunger launched the Microfinance and Health Protection (MAHP) initiative in rural Benin to help local MFI partners create and sustain key health services that complement their credit offering. This evaluation seeks to test the impact of providing credit with education on health and microfinance indicators, as well as the impact of combining education with the provision of health care products, and the specific aspects of the solidarity lending design.

Researchers are working with PADME to introduce the health education intervention to half of the villages they serve. PADME typically markets their services by reaching out both to community leaders and individuals who may be interested in taking out loans, which vary in size with an average amount of US$758. In the villages randomly assigned to receive the intervention, clients will be offered access to credit as well as health education. In the comparison villages, potential clients will only be offered access to credit. The health education will consist of three modules: malaria education, integrated management of childhood diseases, and HIV/AIDS planning. An additional component of the study seeks to better understand the role of gender in microfinance. In addition to the random assignment of health education services, researchers will also designate villages according to the gender composition of new borrowing groups. In a random subset of villages, microfinance groups will be mixed-gender, while others will be female only.

Results and Policy Lessons 

Results forthcoming.

Karlan, Dean, Bram Thuysbaert, and Bobbi Gray. "Credit with Health Education in Benin: A Cluster Randomized Trial Examining Impacts on Knowledge and Behavior." The American Journal of Tropical medicine and Hygiene. doi: 10.4269/ajtmh.16-0126

 1 World Health Organization (WHO). Benin: Health Profile. Last update: 4 April 2011.

 2 Microfinance Information Exchange (MIX) Market. PADME. http://www.mixmarket.org/mfi/padme

 3 Microfinance Information Exchange (MIX) Market. Country Profile: Benin. http://www.mixmarket.org/mfi/country/Benin