Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.3
,
No
.2
,
Jun
e
2
014
, pp
. 10
7
~
11
6
I
S
SN
: 225
2-8
8
0
6
1
07
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
The Case for Microcredit: Does
I
t
Improve M
a
t
e
rnal and Child
Health and Wellbeing?
Madhurim
a S
a
rk
ar
1
, Mu
hiuddin Haider
2
1
The
Rese
arch
I
n
stitute
, Na
tion
w
ide Chi
l
dren’s
Hospital,
USA
2
Department of
Public Health
, U
n
iversity
of Mar
y
land, USA
Article Info
A
B
STRAC
T
Article histo
r
y:
Received
March 28, 2014
Rev
i
sed
May
6, 201
4
Accepte
d
J
u
ne 2, 2014
It is
pos
s
i
ble to achi
e
ve th
e abo
v
e de
velopment
goals, if disposable income,
especially
of th
e poor,
is incr
eas
ed. A
joint research pro
j
ect in
Banglad
esh
was initi
at
ed b
y
BRAC
and I
C
DDR,B to ev
alua
te
the
exte
nt to whi
c
h
socioeconomic development
en
gineer
ed
throug
h microcredit might enhan
c
e
maternal and
ch
ild health
progr
ams a
nd to de
t
e
rm
ine th
e im
pact of
rura
l
community
development programs on co
mmunit
y
well-being
. We conducted
a s
y
s
t
em
atic r
e
view on BRAC-ICDDR,B J
o
int Res
earch
P
r
oje
c
t W
o
rking
Paper Series. Th
e series contain
e
d 32
working pa
pers out of which we only
s
e
lec
t
ed pap
e
rs
that exam
ined or
had referen
ces
t
o
m
a
ternal and c
h
ild hea
lth
(n=13). We d
e
veloped
a ch
ecklist based
on
the Tr
ansparen
t Report of
Evalu
a
tions with Nonrandomized De
signs (TREND) criteria.
The BRAC
papers show prom
ising positive li
nkag
e
s be
tween im
plem
e
n
tation of
m
i
crocredi
t program
s
in rural areas
and (1) incr
eas
e in incom
e
, (2) increa
s
e
in health
status
and (3) improvement
in wom
e
n’s
heal
th.
The
assum
p
tion tha
t
increasing women’s empowerment thr
ough income and education leads to
improvements health and surviv
al is re
fe
rred a n
u
m
b
er of tim
es
in the BRAC
studies, howev
er, this
assumption has not
b
e
e
n
tested
in we
l
l
contro
lled
interv
ention stu
d
ies and fur
t
her
independ
ent r
e
search
needs
to b
e
conducted
in order
to test the h
y
pothes
e
s set out b
y
th
e B
R
AC papers.
Th
e data from
BRAC is a uniq
u
e opportunity
to examin
e pre and post interven
tion of the
im
pact of
m
i
cro
c
redi
t and
s
u
ch
data
sets can pr
ovides research
ers with the
prospect of
cond
ucting
continuou
s rigorous resear
ch in
th
e coun
tr
y.
Keyword:
M
i
crocre
di
t
Em
powerm
e
nt
BRAC
Poverty
Wom
e
n’s healt
h
status
Copyright ©
201
4 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
M
a
dh
uri
m
a Sarka
r
,
Center
for
Innovation i
n
Pe
di
atric Practice,
Natio
nwid
e Child
ren’s
Ho
sp
it
al,
7
0
0
C
h
ild
r
e
n’
s D
r
i
v
e, Co
lu
m
b
u
s
,
O
H
,
4
3205
.
Em
a
il: mad
h
u
ri
m
a
.sark
a
r@natio
n
w
i
d
ech
il
d
r
en
s.o
r
g
1.
INTRODUCTION
Th
ere are about th
ree b
illio
n
p
e
op
le,
h
a
lf of
th
e wo
rld’s
p
o
p
u
l
ation
,
liv
ing o
n
the in
co
m
e
o
f
less th
an
two dollars a
day. Am
ong t
h
ese poor com
m
unities, one child
in five
does not live to see his or he
r fifth
b
i
rthd
ay.Th
e
ratio
of th
e in
co
m
e
b
e
tween th
e
5
%
rich
est
an
d 5%
p
oor
est o
f
th
e pop
ulatio
n
is
7
4
to 1 as
co
m
p
ared
to
t
h
e ratio
of 30
to
1
2
i
n
19
60
[1
]. To
enh
a
n
c
e in
tern
ation
a
l
d
e
v
e
l
o
p
m
en
t, th
e Un
ited
Natio
n
s
Or
ga
ni
zat
i
on (
U
N
O
) a
n
no
u
n
c
e
d t
h
e m
i
ll
enni
um
devel
opm
ent
g
o
al
s, ai
m
e
d
t
o
eradi
cat
e p
ove
rt
y
by
2
0
1
5
[
2]
.
I
t
i
s
possi
bl
e t
o
a
c
hi
eve t
h
e ab
o
v
e de
vel
o
pm
ent
goal
s
, i
f
di
spo
s
ab
le in
co
m
e
(esp
ecially
of the poor) is increased
[3]
.
One
o
f
t
h
e
m
a
i
n
aven
ues
of i
n
creasi
ng
d
i
sposa
b
l
e
i
n
c
o
m
e
of t
h
e
p
o
o
r
i
n
de
vel
o
pi
n
g
nat
i
o
n
s
i
s
t
h
r
o
ug
h t
h
e
use
of m
i
crofinance a
n
d m
i
crocredit [4].
Ban
g
l
ad
esh is
o
f
ten
v
i
ewed in
m
o
st
m
i
cro
c
red
it and
health literatu
re as a
‘test case fo
r dev
e
lop
m
en
t’
[5
].
Sev
e
ral do
zen NGOs an
d in
tern
ational o
r
g
a
n
i
za
tio
n
s
o
p
e
rate in th
e co
un
try
in
clu
d
i
n
g
IC
DDR,B
(I
nt
er
nat
i
onal
C
e
nt
er f
o
r Di
arr
h
eal
Dis
ease Researc
h
, Banglades
h
) and BRAC
(Banglade
s
h Rural
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S
V
o
l
.
3,
No
. 2,
Ju
ne
2
0
1
4
:
10
7 – 1
1
6
10
8
Ad
va
ncem
ent C
o
m
m
i
t
t
ee)
w
h
i
c
h
ha
ve
bee
n
c
o
l
l
a
b
o
rat
i
n
g
f
o
r al
m
o
st
25 y
ear
s. IC
D
D
R
,
B
ope
rat
e
s
d
e
m
o
g
r
ap
h
i
c su
rv
eillan
ce syste
m
an
d
MCH-FP (m
atern
a
l ch
ild
h
ealth-famil
y
p
l
an
n
i
ng
) p
r
ogram
s
in
v
a
riou
s
di
st
ri
ct
s. B
R
A
C
i
s
an i
n
di
g
e
no
us
n
o
n
-
go
ver
n
m
e
nt
al
or
gani
zat
i
o
n i
n
v
o
l
v
e
d
i
n
p
r
o
m
oti
ng
wel
f
ar
e a
n
d
d
e
v
e
l
o
p
m
en
t in
respon
se to
th
e m
a
ss
m
i
g
r
atio
n
an
d re
settle
m
e
n
t
o
f
refu
g
e
es in
no
rt
heastern
Bang
lad
e
sh
fo
llowing
th
e
civ
il war
[6
].Th
e NGO
h
a
s been
fo
cu
sed
on th
e fu
nd
am
en
tal g
o
a
l
o
f
po
verty allev
i
atio
n sin
c
e
its in
cep
tion
in 19
72
and
BR
AC’s R
D
P
(rural d
e
v
e
l
o
p
m
ent p
r
o
g
ram
)
is an
in
teg
r
ated
, m
u
lti-secto
r
al i
n
itiativ
e
in
vo
lv
ing
in
sti
t
u
tio
n
b
u
ild
i
n
g, fun
c
tion
a
l edu
catio
n, sa
v
i
ng
and
gr
oup
tru
s
t f
und
s, cr
edit d
i
sb
ur
sem
e
n
t
, an
d
training in inc
o
m
e
and em
ploym
e
nt genera
tion activitie
s, legal literacy
and
non-
form
al prim
ary schooling.
The R
D
P
or
ga
ni
zed t
h
e
ru
ral
po
o
r
i
n
t
o
gr
ou
ps w
h
o w
o
r
k
a
s
i
n
st
rum
e
nt
s f
o
r
devel
opm
ent
of h
u
m
a
n resou
r
ce
s
an
d o
c
cup
a
tio
nal sk
ills. Group
m
e
m
b
ers are en
co
uraged
t
o
tak
e
o
n
i
n
co
me g
e
n
e
rating
activ
ities facilitat
e
d
b
y
BRAC’s cred
it
prog
ram
[7
].
A jo
i
n
t research
p
r
o
j
ect B
R
AC and
IC
DDR,B
was i
n
itiated
b
y
research
ers
fro
m
BRACto
(1
)
eval
uat
e
t
h
e ex
t
e
nt
t
o
whi
c
h soci
oec
o
n
o
m
i
c
devel
opm
ent
engi
neere
d
t
h
ro
ug
h m
i
crocredi
t
m
i
ght
en
hanc
e t
h
e
MCH-FP pro
g
ram
effectiv
eness and
(2
)
draw
o
n
IC
DDR
,B’s
d
e
m
o
g
r
aph
i
c su
rv
eillan
c
e syste
m
to
d
e
t
e
rm
in
e
t
h
e im
pact
of
R
D
P o
n
com
m
uni
t
y
wel
l
-
bei
ng [
8
]
.
U
n
d
e
rl
y
i
ng s
o
ci
oe
con
o
m
i
c devel
opm
ent
pol
i
c
i
e
s and
pr
o
g
ram
s
are assum
p
t
i
on ab
o
u
t
t
h
ei
r p
r
esu
m
ed bene
fi
t
s
for rai
s
i
ng
heal
t
h
st
at
us an
d h
u
m
a
n wel
l
-
bei
ng
[8]
.
M
a
rke
d
g
r
adi
e
nt
s i
n
soci
oec
o
n
o
m
i
c di
ffere
nt
i
a
l
s
have be
en n
o
t
e
d i
n
l
i
f
e expect
a
n
cy
by
i
n
com
e
, educat
i
o
n
,
occu
pat
i
o
nal
cl
ass fo
r m
a
ny di
ffe
rent
di
seases an
d i
n
di
verse
p
o
p
u
l
a
t
i
ons
[9]
.
Ho
we
ver
,
t
h
e m
a
jor
i
t
y
of
st
udi
es i
nve
st
i
g
at
i
n
g
t
h
e
rel
a
t
i
ons
hi
p
bet
w
een
soci
oec
o
n
o
m
i
c devel
opm
ent
an
d
h
eal
t
h
are ei
t
h
er cr
oss
sect
i
onal
or
c
o
n
d
u
ct
ed a
s
t
r
en
d a
n
al
y
s
i
s
m
a
ki
ng i
t
d
i
fficu
lt to
ex
p
l
ore th
e in
terv
en
ing
p
a
thways an
d
mechanism
s
that link s
o
cioeconom
i
c
devel
opm
ent
,
hea
l
t
h
and
wel
l
-
b
e
i
ng.
Som
e
research s
u
gge
st
s t
h
at
i
n
com
e
t
e
nds t
o
be
rel
a
t
e
d t
o
heal
t
h
t
h
ro
u
gh
a di
rect
effect
on t
h
e m
a
t
e
ri
al con
d
i
t
i
ons
nec
e
ssary
f
o
r
bi
ol
ogi
cal
survival and through an effe
ct on so
cial p
a
rticip
atio
n
an
o
ppo
rt
u
n
ity to
co
n
t
ro
l life ci
rcu
m
stan
ces [1
0
]
.
A
twen
ty fiv
e
year fo
ll
o
w
u
p
fro
m
th
e Wh
iteh
a
ll stu
d
i
es [1
1
]
fo
und
th
at
wh
ile th
ere i
s
n
o
ev
id
en
ce o
f
a
thres
hol
d, the
r
e see
m
s to be
a clear gradie
nt in
m
o
rta
lit
y fo
r th
e
g
e
n
e
ral p
opu
latio
n
th
at
ru
ns fro
m
th
e
least
t
h
e
m
o
st
depri
v
ed
. A fram
e
wor
k
de
vel
o
pe
d by
UN
IC
EF i
d
ent
i
f
i
e
s po
ve
rt
y
as a key
el
em
ent
t
o
a decreasi
n
g
q
u
a
lity of life
[2
].
Ad
d
ition
a
lly, p
a
thways
between
i
n
cr
easin
g
econ
o
m
ic d
e
v
e
l
o
p
m
en
t an
d h
ealth status h
a
v
e
b
een
h
ypo
th
esi
s
b
y
a n
u
m
b
e
r o
f
research
ers. Sen
’
s cap
ab
ility ap
p
r
o
a
ch
[1
2
]
, Gro
ssm
an
’s h
ealth
pro
d
u
c
tion
t
h
eo
ry
[1
3]
,a
n
d
M
o
hi
n
d
ra a
nd
Ha
dda
d’
s
conce
p
t
u
al
fra
m
e
wor
k
al
l
expl
ore t
h
e l
i
n
kage
s t
h
r
o
ug
h
whi
c
h
increase
d
econom
i
c and
m
i
crocre
dit ac
tiv
iti
es i
m
p
act h
ealth
ou
tco
m
es, esp
ecially fo
r
wo
m
e
n
in
d
e
v
e
l
o
p
i
n
g
co
un
tries [1
4
]
.
Thi
s
bac
k
gr
o
u
nd
pa
per i
s
a
rapi
d sy
nt
he
si
s of s
o
m
e
cur
r
ent
e
v
i
d
e
n
ce on
l
i
nka
ge
s bet
w
ee
n
m
i
crocredi
t
a
n
d
wom
e
n’s
hea
l
t
h
wi
t
h
a ce
nt
r
a
l
i
zed f
o
cu
s
on
re
vi
ewi
n
g t
h
e
B
R
A
C
w
o
r
k
i
n
g
pape
r se
ri
es
fr
om
Ban
g
l
ad
esh.It
will first rev
i
ew th
e link
a
g
e
s b
e
tween
h
ouseho
l
d
in
co
m
e
an
d
m
i
cro
c
red
it, th
en
syn
t
hesize
ex
istin
g
literatu
re in
clud
i
n
g
literatu
re fro
m
BRAC b
e
tween
in
co
m
e
an
d
h
ealth
with
a fo
cus o
n
wo
m
e
n
and
fin
a
lly lo
ok
at
th
e ways th
at
micro
c
red
it m
i
g
h
t
h
a
v
e
a
posi
tive effect on
health ou
t
c
om
es f
o
r
w
o
m
e
n. T
a
bl
e 1
pr
o
v
i
d
es a
sy
n
t
hesi
s o
f
s
e
l
ect
ed
pape
rs
f
r
o
m
BR
AC
an
d
assesses t
h
ei
r
m
e
t
hod
ol
o
g
y
a
n
d
res
u
l
t
s
.T
he
pape
r
s
ex
p
l
o
r
e a
nu
mb
er
o
f
th
em
es
cro
s
scu
tting
the g
a
m
u
t o
f
research
on
m
i
cr
o
c
red
it and
exa
m
in
e
collection
of
d
a
ta/b
aselin
e in
fo
rm
atio
n
o
n
th
e d
e
m
o
g
r
ap
h
i
c su
rv
eillan
ce syste
m
(DSS) v
a
riab
les, g
a
in
i
n
g
in
si
g
h
t
s in
co
n
c
ep
ts
o
f
illn
ess an
d
t
h
eir
cau
ses
fro
m
wo
m
e
n
’
s p
e
rsp
e
ctiv
e an
d
corresp
ond
ing
so
cial an
d
fam
i
ly at
titu
d
e
,
id
en
tificatio
n
of factors/inp
u
t
s (su
c
h
as m
i
cro
c
red
it) and
institu
tio
n
s
res
pon
sib
l
e fo
r creat
in
g
h
ealth
/women
’s
heal
t
h
out
c
o
m
e
s an
d t
e
st
i
ng
of
hy
p
o
t
h
esi
s
on
bet
t
e
r
heal
t
h
st
at
us
of m
e
m
b
ers of R
D
P
pr
o
g
ram
s
whi
c
h ca
n
j
u
stify conti
nuity of the
BRAC
initiatives. These
multifaceted obj
ectives would
e
n
a
b
le
investigat
ors/
researche
r
s t
o
t
a
ke a
ho
listic view on
t
h
e im
p
o
r
tan
ce/ju
stificatio
n
o
f
th
e con
tin
u
a
tion
of B
R
AC-
IC
D
D
R
,
B
l
i
n
k
a
ges a
nd a
sses
s
i
ng t
h
e i
m
pact
of ec
on
om
ic devel
o
pm
ent pr
o
g
ram
s
suc
h
as m
i
crocre
di
t
o
n
in
co
m
e
an
d
h
e
alth
ou
tco
m
es.
2.
R
E
SEARC
H M
ETHOD
We co
n
ducte
d
a sy
stem
atic
revie
w
o
n
BRAC-IC
DDR,B
Joint Researc
h
Project
W
o
rking Pape
r
Seri
es. T
h
e se
r
i
es cont
ai
n
e
d
32
w
o
r
k
i
n
g
pa
pers
o
u
t
o
f
wh
i
c
h we
o
n
l
y
sel
ect
ed pa
pe
rs
that exam
ined
or
ha
d
referen
ces t
o
matern
al an
d
ch
ild
h
ealth
(n
=1
3). T Crite
ria
for e
v
aluatin
g
the studies
we
re determ
ined bef
o
r
e
revi
e
w
i
n
g t
h
e
art
i
c
l
e
s. W
e
devel
ope
d a checkl
i
s
t
base
d o
n
th
e Tran
sp
aren
t Rep
o
rt
o
f
Ev
aluatio
ns with
No
nr
an
d
o
m
i
zed Desig
n
s (T
REND
) crite
ria [15]. In contract to the CO
N
S
ORT g
u
i
d
elines f
o
r re
po
rtin
g
ran
d
o
m
i
zed t
r
ial
s
, TR
EN
D
g
u
i
d
el
i
n
es em
phasi
ze m
o
re d
e
t
a
i
l
e
d rep
o
rt
i
ng
o
f
t
h
e
o
ri
es
use,
desc
ri
pt
i
ons
o
f
i
n
t
e
rve
n
t
i
o
ns and
pos
si
bl
e co
m
p
ari
s
on co
nd
i
t
i
ons. R
e
vi
ewers com
p
leted a TREND che
c
klist for eac
h article
and the a
n
alysis for
selected T
R
EN
D
cri
t
e
ri
a
are
pr
ovi
ded
i
n
Tabl
e
1.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S
I
S
SN
:
225
2-8
8
0
6
The
C
a
se
f
o
r Mi
crocre
di
t
-
D
o
es It
I
m
prove
Mat
e
rn
al
an
d C
h
i
l
d
Heal
t
h
..
..
(
M
a
d
huri
m
a Sar
kar)
10
9
3.
R
E
SU
LTS AN
D ANA
LY
SIS
3.1 Linkages
between mi
cr
ocredit and income
Ever since
the
inception
of
Gram
een
ba
n
k
,
m
i
crofi
n
ance
pr
o
g
ram
s
hav
e
bee
n
used
t
o
t
a
r
g
et
a
n
d
i
n
crease
di
sp
os
abl
e
i
n
com
e
s am
ong t
h
e p
o
o
r.
In t
h
e
past
dec
a
de, m
i
crocred
i
t
has been a
d
e
vel
o
pm
ent
st
al
war
t
i
n
un
der
s
er
ved
co
u
n
t
r
i
e
s. I
n
gene
ral
,
m
i
crocred
it is a term
u
s
ed
to d
e
scrib
e
prog
ram
s
th
at
o
f
fer access to
sm
a
l
l
lo
an
s, fi
n
a
n
c
ial literacy, an
d
so
cial su
ppo
rt. Th
e con
cep
t of microcred
it h
a
s evo
l
v
e
d, and
term
s
lik
e
microfina
n
ce,
microenterpris
e, and m
i
cro lendi
ng, all re
pre
s
ent s
o
m
e
level of acce
ss to
fi
nancial a
nd/
or
social
resources. Ane
c
dotal evi
d
enc
e
exists to
suggest that
m
i
crofina
n
ce can m
a
ke
a differe
n
ce
in the lives of
thos
e
serv
ed
,
however, rigo
rou
s
q
u
an
titativ
e
ev
iden
ce o
n
th
e n
a
tu
re and
m
a
g
n
itu
d
e
of m
i
cro
f
in
an
ce is still lack
i
ng
[1
6]
.
A sy
st
em
at
i
c
revi
ew
by
D
uve
n
d
ack
et
.al
fo
u
nd t
h
at a vast m
a
jority of st
udies
on m
i
crofina
n
ce are
meth
o
d
o
l
og
ically weak
and
h
a
v
e
in
su
fficien
t
d
a
ta
[17
]
an
d
Stewart et.al furth
e
r fo
un
d
little ev
id
en
ce to
suggest that m
i
crofina
n
ce
has
a large im
pact of
pove
rty [18]
. Both t
h
es
e rev
i
ew
fo
cu
sed
on
stud
ies th
at
relied
heavi
l
y
o
n
R
C
T
(ra
nd
om
i
zed cont
r
o
l
l
e
d t
r
i
a
l
)
desi
g
n
. It
ca
n be ar
g
u
ed
, h
o
we
ve
r, t
h
at
R
C
T
s
m
a
y
not
be t
h
e
best
ap
p
r
oac
h
t
o
det
e
rm
i
n
e com
p
l
e
x rel
a
t
i
o
nshi
ps i
n
an i
n
t
e
rc
on
nect
ed
sy
st
em
and f
o
r a b
r
oade
r
pi
ct
ure;
researc
h
er
s ne
ed t
o
em
brace
ot
he
r m
e
t
hod
ol
o
g
i
e
s [
1
9]
.
Eco
nom
i
s
t
s
have l
o
n
g
p
o
si
t
e
d t
h
at
part
i
c
i
p
at
i
on i
n
m
i
crocredi
t
pr
og
ram
s
im
pro
v
es ec
o
nom
i
c
wel
l
b
ei
n
g
(o
f
t
h
e p
o
o
r
)
by
i
n
creasi
n
g
i
n
c
o
m
e
, bui
l
d
i
n
g a
sset
s
,
decreasi
ng ec
onom
ic inequalities and enha
ncing ca
pacity
for success
but
these va
riables
m
i
ght not ha
ve bee
n
measured in t
h
e RCTs.
The
TR
EN
D
r
e
vi
ews
f
r
om
Tabl
e
1
dem
ons
t
r
at
e st
ro
n
g
c
o
rrel
a
t
i
o
n
s
bet
w
een m
i
crocre
di
t
pr
o
g
ram
s
and
a ge
ne
ral
i
n
crease
i
n
di
sp
osa
b
l
e
i
n
c
o
m
e
an
d sa
vi
n
g
s, e
s
peci
al
l
y
am
on
g
wom
e
n [
5
,
8
,
20]
.
The
w
o
m
e
n i
n
t
h
e B
R
A
C
pr
og
ram
oft
e
n s
a
ve m
oney
i
n
t
h
e t
r
adi
t
i
ona
l
way
and ‘
k
n
o
w t
h
e val
u
e
of sa
vi
n
g
s’
[2
1]
. I
n
ad
d
ition
,
accord
i
ng
to fem
a
l
e
BRAC m
e
mb
ers, RDP
savin
g
s
, cred
it and
train
i
ng
prog
ram
s
p
r
o
v
i
d
e
d
th
e
mean
s to
en
gag
e
an
d
d
i
v
e
rsify rem
u
n
e
rat
i
v
e
activ
ities an
d supp
ort th
eir
h
u
sb
and
s
’ in
co
m
e
g
e
neratin
g
activ
ities [22
]
. Mo
st
wo
m
e
n
also
p
e
rcei
v
e
d
related
in
creases in
t
h
eir i
n
fl
u
e
n
c
e ov
er
h
o
u
s
eho
l
d
d
e
cisio
n
m
a
ki
ng.
In ad
di
t
i
on,
gr
o
up i
n
t
e
r
v
i
e
ws am
ong
part
i
c
i
p
at
i
n
g m
e
n eli
c
i
t
t
h
at
m
e
n are oft
e
n h
u
m
i
l
i
a
t
e
d
at
t
h
e
pr
os
pect
o
f
bo
rr
owi
n
g
m
oney
fr
om
fri
ends
, nei
g
h
b
o
rs
o
r
t
h
e l
o
cal
M
a
haj
an
s
(m
oney
l
e
nde
rs
). B
e
c
o
m
i
ng
B
R
A
C
m
e
m
b
ers
not
onl
y
sa
ves t
h
em
fr
om
ap
pr
oachi
n
g
ot
he
rs,
b
u
t
m
a
ny
t
i
m
e
s t
h
e wi
ves
b
o
r
r
o
w
m
oney
fr
om
t
h
e pr
o
g
r
a
m
and t
h
e m
e
n al
t
o
get
h
e
r
do
n
o
t
ha
ve t
o
a
p
pr
oac
h
a
n
y
o
n
e
[2
1]
.
3.2 Linkages
between inc
o
me and health outc
omes
The TR
E
ND
anal
y
s
i
s
of t
h
e B
R
A
C
wo
r
k
i
n
g pa
per
s
fr
om
Tabl
e 1 furt
her f
o
un
d i
n
st
ances
o
f
rel
a
t
i
ons
hi
ps
b
e
t
w
een ec
on
o
m
i
c
heal
t
h
and
heal
t
h
o
u
t
c
om
es.Eco
n
o
m
i
c h
eal
t
h
i
s
one
of
t
h
e m
a
ny
i
nput
s t
h
at
det
e
rm
i
n
e heal
t
h
o
u
t
p
ut
an
d s
t
at
us (ot
h
ers i
n
cl
ude
bi
ol
o
g
i
c
a
l
, psy
c
h
o
l
o
gi
ca
l
,
cul
t
u
ral
a
nd
soci
al
) an
d
has
t
o
be
m
odel
e
d wi
t
h
ot
he
r i
n
put
s t
o
have a si
gni
fi
cant
effect
on
h
eal
t
h
[2
3]
.Ot
h
e
r
s su
g
g
est
t
h
at
whi
l
e
som
e
l
i
nkage
s
bet
w
ee
n i
n
c
o
m
e
and
p
ove
r
t
y
al
l
e
vi
at
i
on fr
om
an ec
onom
i
c perspective, t
h
e all-enc
o
m
p
assing
nat
u
re
of
po
ve
rt
y
dem
a
nds t
h
at
we
u
n
d
e
rst
a
n
d
h
o
w
i
m
provem
e
nt
s in al
so i
m
pro
v
e
s
t
h
e l
e
sser m
e
asure
d
or
qua
n
t
i
f
i
a
bl
e
p
s
ycho
so
cial relatio
n
s
h
i
p
s
such
as h
ealth st
atu
s
, so
ci
al inferio
r
ity, iso
l
atio
n,
p
o
werlessness,
h
u
m
iliat
i
o
n
an
d
accepting low
status work [7]. Othe
r
s
u
gge
sted m
e
diators
betwee
n inc
o
me
and health we
re (a)
func
tional
ed
u
cation
,
(b) h
ealth
literacy, (c) in
creasi
n
g
ch
ild
edu
cation
,
and
(d
) estab
lish
i
ng
prim
a
r
y h
ealth
care prog
ram
[5]
.
3.3 Linkages
between micr
ocredit, in
c
o
m
e
and wom
e
n’s heal
th
outc
omes
Wh
ile m
i
cro
c
red
it in
terv
en
tio
n
s
are
n
o
t
ex
p
licitly d
e
sign
ed
t
o
h
a
v
e
an
im
p
act o
n
h
ealth
,
few
practical m
i
cr
ocre
dit/m
i
crofinance
m
odels
such as the Gram
een bank
m
o
d
e
l o
f
mi
crofin
an
ce, posit th
at
econ
o
m
i
c and
soci
al
p
o
v
ert
y
(w
hi
ch i
n
cl
u
d
e
s
p
ove
rt
y
o
f
he
al
t
h
)
go
ha
n
d
i
n
han
d
a
n
d s
h
oul
d t
h
us
be t
a
ckl
e
d
si
m
u
ltan
e
o
u
s
ly
[1
4
]
. Th
e relatio
n
s
h
i
p
b
e
t
w
een
po
v
e
rty an
d
ill h
ealth
h
a
s b
een
ch
aract
erized
as syn
e
rg
istic
an
d
b
i
d
i
rection
a
l-
p
o
v
e
rty co
nfin
es th
e
cap
acity to
produ
ce h
ealth an
d ill h
ealth
lead
s t
o
fu
rt
h
e
r
im
pove
rishm
e
nt that dim
i
nishing the
pote
ntial of i
ndi
viduals a
n
d households t
o
im
prove their ec
onom
ic
st
at
us an
d t
h
e
r
e i
s
a gr
owi
ng
reco
g
n
i
t
i
on t
h
a
t
po
or
heal
t
h
i
s
a di
m
e
nsi
on o
f
p
o
v
ert
y
;
t
h
er
efo
r
e,
one
p
o
t
e
nt
i
a
l
resu
lt of pov
erty red
u
c
tion
is p
r
o
g
ress in
t
h
e h
ealth
of
th
e p
o
o
r
.An
in
crease in
micro
c
red
it activ
ity h
a
s b
een
l
i
nked t
o
i
m
provem
e
nt
s i
n
so
ci
oeco
nom
i
c
stat
us,
po
vert
y
a
l
l
e
vi
at
i
on an
d i
n
crease
d
em
po
werm
ent
fo
r w
o
m
e
n
t
h
r
o
u
g
h
an i
n
c
r
ease i
n
i
n
di
vi
dual
i
n
c
o
m
e
l
e
vel
s
[
5
]
.
Pre
v
i
ous em
pi
ri
cal
evi
d
e
n
ce f
r
om
devel
ope
d c
o
unt
ri
es
ex
ists to
sug
g
e
st th
at wo
m
e
n
ten
d
t
o
allo
cat
e a larg
er sh
are of t
h
eir i
n
come to
m
eet
th
e h
ealth
an
d nu
t
r
itio
n
a
l
need
s of h
o
u
s
e
hol
d
m
e
m
b
ers,
es
pecially childre
n
[24, 25].
N
e
v
e
r
t
h
e
less, t
h
er
e seem
s to
b
e
a con
cep
t
u
al ‘
b
lack
b
o
x
’
[
2
3
]
su
rr
oun
din
g
t
h
e
p
a
thways th
ro
ugh
whic
h inc
r
ease
s
in i
n
com
e
produces
health
change a
n
d
re
searche
r
s
nee
d
t
o
c
ont
i
nue
t
o
‘
u
n
p
ac
k’ t
h
e
bl
ack
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S
V
o
l
.
3,
No
. 2,
Ju
ne
2
0
1
4
:
10
7 – 1
1
6
11
0
bo
x s
u
r
r
o
u
ndi
ng t
h
e pat
h
wa
y
s
t
h
ro
u
gh
w
h
i
c
h an i
m
pro
v
e
m
e
nt
i
n
SES
l
eads t
o
an i
m
pr
o
v
em
ent
i
n
heal
t
h
st
at
us
?
T
h
i
s
i
s
an especi
al
l
y
im
port
a
nt
q
u
es
t
i
on i
n
de
vel
o
pi
n
g
co
unt
ri
es
where m
i
crocredi
t
pr
o
g
ram
s
have
been fl
ou
ri
shi
n
g
.
M
a
hb
u
b
,
M
a
y
eed and
Roy
prese
n
t
e
d
som
e
sel
f-rep
o
rt
e
d
evi
d
e
n
ce
t
h
at
suggest
s
st
ron
g
l
i
nkage
s bet
w
e
e
n i
n
cr
eases i
n
i
n
com
e
vi
a
m
i
croc
redi
t
act
i
v
i
t
i
e
s for
wom
e
n [2
6]
. The
key
que
st
i
on i
s
wh
et
her
th
e wo
m
e
n
are u
s
i
n
g th
e ex
tra d
i
sp
o
s
ab
le i
n
co
m
e
to
au
gmen
t th
eirs and
th
ei
r ch
ild
ren
’
s’
h
ealth
stat
u
s
’.
If
stron
g
p
a
thways an
d
p
o
s
itiv
e relatio
n
s
h
i
p
s
ex
ist b
e
tween
increasing
m
i
cro
c
red
it lend
ing
an
d
h
ealth
statu
s
, the
m
i
crocredi
t
m
odel
m
a
y
be use
d
t
o
dec
r
ease
h
eal
t
h
eq
ui
t
y
be
gi
n
n
i
n
g
wi
t
h
m
a
t
e
rnal
a
n
d
chi
l
d heal
t
h
e
qui
t
y
.
Th
e
1
995
study co
nd
u
c
ted
by Sco
tt, Ev
an
s an
d Cash
[
23] to
stu
d
y
th
e
i
m
p
act o
f
BR
A
C
’
s
so
cio-
eco
no
m
i
c in
terv
en
tion
s
in
clud
ing
m
i
cro
f
in
an
ce activ
ities
o
n
th
e wellb
ei
n
g
of t
h
e
ru
ral
po
or
un
co
v
e
red
t
h
at
alth
o
ugh
a
wide v
a
riety of scales an
d
m
easu
r
es ex
ist
in
th
e
BRAC in
terv
en
tio
ns th
at m
e
a
s
u
r
e
‘ill-h
ealth’ su
ch
as
m
o
rb
i
d
ity an
d
m
o
rtality t
h
ere are no
ind
i
cato
r
s
t
h
at measu
r
e ‘h
ealth
’
o
u
t
p
u
t
s.Chowdhu
ry and
B
h
u
i
ya
h
ypo
th
esized
sev
e
ral
p
a
thways lin
k
i
ng
t
h
e
v
a
ri
o
u
s
BRAC
rural
d
e
v
e
l
o
pmen
t p
r
og
ram
s
to
im
p
r
ov
em
e
n
ts in
health status
[8].Specifically, they h
ypo
th
esized
th
at in
creases in
hou
seho
ld
cred
it would
lead
to
an
i
n
co
m
e
in
crease and
a secu
re hou
seh
o
l
d
liv
eliho
o
d
with d
e
cr
eased
v
u
l
n
e
rab
ility, eq
u
itab
l
e i
n
tra
h
o
u
s
eho
l
d food
di
st
ri
b
u
t
i
o
n
an
d
great
er
co
pi
ng
capaci
t
y
.
A sec
o
n
d
pat
h
way
l
i
n
ke
d
credi
t
pr
og
ra
m
s
and ot
he
r
i
n
com
e
g
e
n
e
rating
act
iv
ities to
an
o
v
e
rall im
p
r
o
v
e
m
e
n
t
in
hou
seh
o
l
d
so
cioeco
no
m
i
c stat
u
s
.
Greater av
ailab
l
e
h
o
u
s
eho
l
d
i
n
co
m
e
m
a
y co
n
t
ribu
te to
b
e
tter env
i
ron
m
en
t
a
l co
nd
itio
ns
with
in
t
h
e
h
ouseho
l
d
,
p
e
rm
i
t
g
r
eater
sp
en
d
i
n
g
o
n
curativ
e illn
ess ep
isod
es and
prev
en
tiv
e
h
ea
lth, i
m
p
r
ov
e food su
pp
ly an
d
nutritio
n
,
and
in
crease
access
to
a
nd use of good quality
h
ealth care services
provided
by BRAC
and ot
her a
g
e
n
cies. These incom
e
effects m
a
y
en
ab
le earlier illn
ess d
e
tectio
n
an
d
m
a
n
a
g
e
m
e
n
t
, ti
mely
referral to
h
ealth
care facilities, i
m
p
r
o
v
e
d
n
u
t
ritio
n
a
l statu
s
and
h
i
g
h
e
r
co
v
e
rag
e
of p
r
ev
en
tiv
e
h
ea
lth care serv
ices. In
ad
d
ition
to
p
h
y
sical h
ealth, th
ere
might be pa
thways linki
ng succes
sful m
i
crocredit
activities to m
e
ntal heal
th [8]. Bhui
ya and
Ch
owdhu
ry
furth
e
r h
y
p
o
t
h
e
si
ze th
at p
a
rticip
atio
n
i
n
RDP will b
e
n
e
fit h
o
u
s
eho
l
d
s
b
y
in
creasing
wo
m
e
n
’
s
ab
ility to
resp
on
d
t
o
illn
ess episo
d
e
s and
m
a
n
a
g
e
m
e
n
t
o
f
sev
e
re illn
ess
with
in
th
e
fam
i
l
y
an
d
sug
g
e
st that th
is
p
r
o
cess
will b
e
m
e
d
i
ated
th
rou
g
h
a red
u
c
tion
in g
e
nd
er d
i
sp
arity,
im
p
r
o
v
ed
h
u
s
b
a
n
d
-wife
co
mm
u
n
i
catio
n
and
great
er fem
a
l
e
part
i
c
i
p
at
i
o
n i
n
h
ouse
h
ol
d d
eci
si
on m
a
ki
ng pr
ocesse
s [5]
.
Som
e
anecd
ot
al
evi
d
e
n
ce fr
om
t
h
e
B
R
A
C
wo
rki
n
g pa
pers s
u
gg
est
t
h
an i
n
B
a
ngl
a
d
es
h, i
n
cr
ease i
n
m
i
crocredi
t
l
e
ndi
ng i
n
r
u
ral
sect
or
s
of t
h
e
co
un
try
h
a
s led to
an
in
crease
in
so
cial cap
ital a
m
o
n
g
wo
m
e
n
[22
,
27
].
One
of t
h
e co
n
f
o
u
ndi
ng fact
o
r
s i
n
det
e
rm
i
n
i
ng t
h
e
ass
o
ciation bet
w
een increas
e in
microcred
it lo
an
s
am
ong
wom
e
n and positive
health outcom
e is the role a
nd
dept
h of enga
gem
e
nt in
public
participation.
Sub
s
tan
tial research ex
ists
to
show th
at
p
a
rticip
a
tion
i
n
th
e
pu
b
lic
sp
here, with
o
r
witho
u
t
access to
micro
c
red
it, may i
m
p
r
ov
e
quality o
f
life
for
wo
m
e
n
.
Some ex
am
p
l
es o
f
th
e
po
sitiv
e ou
tco
m
es asso
ciated
with participat
ion for wom
e
n
in
de
velopi
ng
countrie
s i
n
clude inc
r
eas
ed levels
of c
ont
raceptive
use and
kn
o
w
l
e
d
g
e o
f
fam
i
l
y
pl
anni
n
g
ba
sed
o
n
s
u
r
v
ey
dat
a
from three
devel
o
pment agen
cies
in rural Banglades
h
[2
8]
;
an i
n
crea
se i
n
wom
e
n’s
feel
i
n
gs
of e
m
powerm
e
nt
b
a
sed
on
ei
g
h
t
i
ndi
cat
o
r
s
rel
a
t
e
d t
o
w
o
m
e
n’s
rol
e
s
an
d
statu
s
within
th
e fam
ily a
n
d
co
mm
u
n
ity
u
s
ing
a m
u
lti-
clu
s
ter d
e
sign
in fou
r
l
o
catio
ns
in
Bang
lad
e
sh
with
wom
e
n pa
rt
i
c
i
p
at
i
n
g
i
n
t
w
o
de
vel
o
pm
ent
agenci
es
[
29]
;
a re
duct
i
on i
n
dom
est
i
c
vi
ol
ence
su
g
g
est
i
v
e o
f
in
creased
pub
lic v
i
sib
ility an
d
so
cial supp
ort in
Ban
g
l
ad
esh
[3
0
]
; and
im
p
r
o
v
e
d
h
ealth
literacy related
t
o
med
i
a ex
po
su
re and
ed
u
cati
o
n, an
d
a po
sitiv
e i
m
p
act
o
n
th
e nu
tritio
nal statu
s
of
particip
an
ts an
d th
ei
r
fam
i
lies [3
1
]
.
Ho
we
ver
,
sum
m
a
ry
dat
a
fro
m
all
BR
AC
studi
ess
u
gge
st
whi
l
e
bei
ng a fe
m
a
l
e
l
eads t
o
a 24% ri
se i
n
od
ds
of
bec
o
m
i
ng a B
R
A
C
m
e
m
b
er,
wom
e
n i
n
ge
neral
,
b
o
r
r
o
w m
u
ch l
e
s
s
t
h
an m
e
n an
d are
n
o
t
en
ga
ged a
s
act
i
v
el
y
as t
h
ei
r m
a
l
e
count
e
r
pa
rt
s [
7
]
.
The
r
ef
ore
,
t
h
e i
n
c
o
m
e
t
h
at
wom
e
n ge
ne
rat
e
m
a
y
not
be e
n
o
u
g
h
t
o
invest in
healthcare
,
especial
ly
p
r
ev
en
tiv
e
h
ealth
care. Add
itio
n
a
lly, Ad
a
m
s et. alalso discovere
d
through
part
i
c
i
p
at
o
r
y
r
e
search
, t
h
at
u
n
l
i
k
e m
o
st
count
ri
es, i
n
B
a
n
g
l
adesh
,
me
n
ten
d
to
b
e
primarily resp
on
si
ble fo
r
m
a
jor
heal
t
h
d
eci
si
on m
a
ki
ng
i
n
t
h
e
h
o
u
se
h
o
l
d
[
22]
.
Wom
e
n’s
i
n
vol
vem
e
nt
i
n
heal
t
h
d
eci
si
on m
a
ki
ng
t
e
n
d
s
to
b
e
restricted to
min
o
r
illn
esses, or tim
es
wh
en
th
ei
r m
a
le co
un
terp
art
is ab
sen
t
.
Furt
h
e
r
u
n
d
e
rstandin
g
o
f
wo
m
e
n
’
s
h
ealt
h
statu
s
in Bang
lad
e
sh
also
need
s t
o
tak
e
in
t
o
acco
u
n
t
women
’
s
p
e
rcep
tio
n
s
o
f
illn
ess fo
r th
em
an
d th
eir ch
ild
ren
.
An
ex
p
l
o
r
at
o
r
y stud
y
o
f
wo
m
e
n
’
s percep
tion
s
of
illn
ess foun
d th
at wo
m
e
n
d
e
scribe
t
h
em
sel
v
es as i
l
l
when t
h
ey
can no l
o
n
g
e
r
wo
r
k
an
d w
e
re be
d ri
d
d
e
d
[3
2]
. Thi
s
pe
rcept
i
o
n m
i
ght
pose
su
bstan
tial issu
es i
n
p
r
ev
en
tiv
e
h
ealth
ed
ucatio
n
.
Al
o
ng with stru
ctural and
institu
tio
n
a
l av
ailab
ility o
f
medical servic
es these fact
ors serve as m
a
jor
barriers
t
o
i
m
provi
n
g
wo
m
e
n and c
h
i
l
d
ren
’
s
heal
t
h
. E
v
en i
f
wom
e
n’s i
n
come increases a
s
a re
su
l
t
of
m
i
crocredi
t
i
n
t
e
rve
n
t
i
o
ns,
she
m
i
ght
not
use
t
h
e i
n
com
e
f
o
r
an
y
pre
v
e
n
tive
healthcare a
n
d the
r
ef
o
r
e,
he
r
heal
t
h
st
at
us
m
i
ght
rem
a
i
n
as bef
o
re [
3
2]
.
Table
1.
Sam
p
le of the
analysi
s
of selected BRA
C
w
o
r
k
i
n
g
pape
rs t
a
rget
i
n
g
wom
e
n’s em
po
we
rm
ent
,
econom
i
cs and health
Au
th
o
r(s), Y
ear
(1
)
Bhuiy
a
&
C
howdhu
r
y
(
1995)
(2
)
Scott,
E
v
ans,
Cash
(
1995)
(3
)
Chowdhur
y
&
Bhuiy
a
, 1995
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S
I
S
SN
:
225
2-8
8
0
6
The
C
a
se
f
o
r Mi
crocre
di
t
-
D
o
es It
I
m
prove
Mat
e
rn
al
an
d C
h
i
l
d
Heal
t
h
..
..
(
M
a
d
huri
m
a Sar
kar)
11
1
Au
th
o
r(s), Y
ear
(1
)
Bhuiy
a
&
C
howdhu
r
y
(
1995)
(2
)
Scott,
E
v
ans,
Cash
(
1995)
(3
)
Chowdhur
y
&
Bhuiy
a
, 1995
Paper
design
Conceptual
Conceptual
Conceptual study
pr
oposal
Sam
p
le size,
description of
sa
m
p
l
e
T
a
r
g
et population-
people who do not
own
m
o
r
e
than 0.
5
acr
e of land inclu
d
ing
ho
m
e
stead
and who ear
n their
livelih
ood
by
selling
m
a
nual labor
N/A
N/A
Resear
ch ai
m
s
(
1
)
Conduct baseline sur
v
ey
befor
e
star
ing r
u
r
a
l develop
m
ent pr
oject.
(2) Link BRAC int
e
rventions with
de
m
ographic surve
illance syste
m
of
ICDDR, B
to
m
oni
tor fertility,
m
o
rtal
ity,
nuptuality
and
m
i
gration.
(3)Establish database with inform
ati
on
on var
i
ables that are linked with DSS
sy
ste
m
.
(4) Establish s
m
all
s
cale in-depth vill
age
level continuous d
a
ta collection sy
stem
for
under
s
tandin
g
the pathway
s
of
influence o
f
the RDP on health and
socioeconom
ic status.
An individual expe
r
i
ences
innu
m
e
r
a
ble health inputs
(econo
m
i
c f
actors
like
m
i
cr
ocr
e
dit being one of them
).
T
h
e balance between
pr
edisposin
g and r
e
spondi
ng
inputs can r
e
sult in a change of
state where
the individual
interprets the alte
red state
through a sociocult
u
ral filter.
The resultant state
of
health/illness is fo
und on a
spectru
m
of
ever c
h
anging
health outco
m
e
s.
RDP
m
e
m
b
ers
and their
dependents ha
ve lower
m
o
r
b
idity
than non-m
e
m
b
er
s.
RDP
m
e
m
b
er
have gr
eater
access to
m
odern h
ealthcare.
R
D
P
me
mb
e
r
s
a
n
d
t
h
e
i
r
dependents have b
e
tter
nutr
itional status than non-
me
mb
e
r
s
.
Descr
i
ption of r
e
sear
ch
T
h
e paper
descr
i
bes how the study
aim
s
will be acco
m
p
lished.
Pr
ogr
am
p
r
ocess develop
m
ent begins
with identify
i
ng ho
useholds o
f
the tar
g
et
gr
oup.
Pr
ogr
am
organizer
(
P
O)
discu
ssed
proble
m
s
and initiates form
ation of
village organizations.
M
e
m
b
er
s begin a s
a
vings pr
ogr
am
.
Gradually
m
e
m
b
er
s are encourages to
take on inco
m
e
ge
nerating activities
facilitated by BRA
C's credit progra
m
.
Elect
m
a
nage
m
e
nt
co
mm
itt
ee
f
r
o
m
the
village.
(1) Review heal
th
definitions.
(2) Crea
te a
health
status
m
odel
of health wher
e production o
f
health/illness is considered to
be based on sim
p
lified health
inputs givi
ng r
i
se to health
output.
(
3
)
E
xplor
es
m
e
th
od of
exam
ining m
echan
is
m
thr
ough
which health interventions
pr
oduce health out
co
m
e
s.
(
4
)
Pr
oposes fur
t
her
r
e
sear
ch to
under
s
tand m
echanis
m
s
by
which health interventions
pr
oduce health out
co
m
e
s.
T
h
e pr
oposal has a nu
m
b
er
of
hy
potheses r
e
lated
to health,
healthcare ac
cess a
nd
wo
m
e
n’s health.
T
h
e
r
e
sear
cher
s pr
opose a nu
m
b
er
of s
m
all
scale stud
ies that will
be conducted to ge
t in-
d
epth
inform
ation to explain
m
e
chanis
m
s
of
the
i
m
pact of
RDP on wo
m
e
n’
s
lives.
T
h
eor
i
es/m
ethodology
and
fr
am
ewor
ks used
N/A
N/A
N/A
Target variables/ac
tivities
(1) Functional education
(2) Facilit
ated gro
up
m
eetings
(
3
)
Savings and gr
oup tr
ust fu
nd
(
4
)
Tr
aining
(
5
)
Pr
oviding cr
edit
(
6
)
Childr
e
n's education
(7) Legal
literacy
(
8
)
Pr
i
m
ar
y health
car
e pr
ogr
a
m
Health inputs/outp
u
ts
1.
Biological
2.
Psy
c
hological
3.
E
nvir
o
n
m
ental
4. Cultural
5. Social
6. Health sector
7. NGO/govern
m
e
nt
Hy
pothesized pathway
s
:
(1
) Th
e f
i
rst p
a
th
way lin
k
s
decreased m
o
rb
idity
and
m
o
rtalit
y with
a
n
increased
utilization of effective
healthcar
e ser
v
ices pr
ovided
by
BRAC’
s pr
ogr
am
s
.
(
2
)
Second pathway
links
cr
edit pr
ogr
a
m
s
and other
inco
m
e
to a
n
overall
im
p
r
ovem
e
nt in hou
sehold
socioeconom
ic status.
(3
) It is f
u
rth
e
r h
y
p
o
t
h
e
sized
that participation in RDP will
benefit ho
useh
olds by
increasing wo
m
e
n
’
s ability to
r
e
spond to ill
ness and
m
a
nage
m
e
nt of illness within
the f
a
m
ily
m
e
diated by
r
e
duced gender
dispar
ity
,
im
p
r
oved husb
a
nd wife
co
m
m
unication and gr
eat
fe
m
a
le particip
ation in
decision m
a
king.
Results/obser
vatio
ns
N/A-
T
h
is paper
is
only
descr
i
bing how
the study ai
m
s
will
be acco
m
p
lished.
The
study
(
w
e
assu
m
e
) has been conducted
elsewhere.
M
a
ny
inputs fr
o
m
the BRAC
approach are
m
u
lt
i
f
aceted and
do not lend them
selves to
direct quantitative
analysis.
The challenge is to
derive
interm
ediate input var
i
ables
N/A-
is
a pr
oposal
but no
study
has been conducted
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S
V
o
l
.
3,
No
. 2,
Ju
ne
2
0
1
4
:
10
7 – 1
1
6
11
2
Au
th
o
r(s), Y
ear
(1
)
Bhuiy
a
&
C
howdhu
r
y
(
1995)
(2
)
Scott,
E
v
ans,
Cash
(
1995)
(3
)
Chowdhur
y
&
Bhuiy
a
, 1995
that
are a
m
enable t
o
quantification.
Consider
health ou
tput
m
e
asures of
‘healt
h
’ in
addition to
m
easures of ill
health such as
m
o
rbidity/
m
o
r
talit
y. A
par
ticular
inter
v
ention has no
association with
m
o
rbidity/
m
o
r
talit
y but people
consider the
m
s
e
lves to be
healthier.
Health indicators need to add
self-
r
e
por
t based on
individ
u
al’
s
per
c
eption o
f
their
health status.
M
eas
ur
ing
m
o
rbidity and
m
o
rtality often
pr
ovide no specific
inform
ation
f
o
r assessing the eff
ectiveness
of interventions.
Co
mm
ent/qualities
There is
a ri
ch e
m
pirical data source
that
can be
m
i
ned fr
o
m
the DSS database
that
will help resea
r
che
r
s assess variables
that
m
e
diate and
m
oderate the linkage
between inco
m
e
a
n
d health
T
h
e paper
pr
ovides an
interesting conceptual
fr
am
ewor
k for
con
s
ider
ing
health inputs.
T
h
e m
oder
a
ting
var
i
able fr
o
m
pr
ed
isposing an
d
r
e
spondin
g
factor
s is
hy
pothesized as the
inter
p
r
e
tation of health outputs
according to an individual’s
socio cultural lens that
deter
m
ines where
t
h
e
individ
u
als falls on
the
spectru
m
of health and illness.
T
h
e paper
lay
s
out the
hy
pothesized
linkages
between m
i
cr
ocr
e
dit
and
health.
4.
CO
NCL
USI
O
N
AN
D I
M
PL
ICATI
O
N
S
F
O
R T
H
E F
U
TURE
Whi
l
e
t
h
ese a
n
d
ot
he
r m
odera
t
o
rs a
n
d m
e
di
at
ors
o
f
t
h
e
ass
o
ci
at
i
on
bet
w
ee
n i
n
com
e
and
heal
t
h
ha
ve
been
hy
p
o
t
h
e
s
i
zed, m
o
re st
u
d
i
es usi
n
g ri
g
o
r
ous m
e
t
hod
ol
o
g
y
nee
d
s t
o
be
con
d
u
ct
ed.
It
can be a
r
g
u
e
d
t
h
at
t
o
un
de
rst
a
n
d
t
h
e
rel
a
t
i
onshi
ps
bet
w
ee
n i
n
co
m
e
and heal
t
h
i
n
devel
o
pi
n
g
cou
n
t
r
i
e
s, we
need t
o
f
o
c
u
s
on t
h
e
si
m
u
ltan
e
ity a
s
well as th
e two
prong
ed relatio
n
s
h
i
p
bet
w
ee
n co
u
n
t
r
y
-
l
e
vel
i
n
c
o
m
e
gene
rat
i
on
pr
oces
s
(
t
h
r
ou
gh
pr
ogr
am
s
lik
e
m
i
cr
o
c
r
e
d
it)
especially o
f
th
e po
or and
their h
ealth statu
s
and
id
en
tify the
fact
or
s/
co
nt
rol
vari
a
b
l
e
s w
h
i
c
h
pr
om
ot
e or i
nhi
bi
t
t
h
e st
re
n
g
t
h
of
t
h
e t
w
o
st
eppe
d
rel
a
t
i
onshi
p.
Thes
e fi
ndi
ng
s
will h
e
lp
to
form
u
l
a
t
e p
o
licies an
d
ascertain
t
h
e ov
erall av
ai
lab
ility
o
f
m
a
t
e
rials an
d
so
ci
al reso
urces that can
en
ab
le th
e poor to
en
jo
y qu
ality h
ealth
care. Th
ese im
p
o
r
tan
t
fin
d
i
ng
s b
a
sed
on
rigo
rou
s
research
can
fu
rt
h
e
r
ex
tend
to
n
o
n
-
g
o
v
e
rn
m
e
n
t
al activ
ities su
ch as th
e in
trod
uctio
n
o
f
m
i
cro
c
red
it an
d m
i
c
r
ofin
an
ce
b
y
ou
tsid
e
o
r
g
a
n
i
zatio
n
s
in
ad
d
ition
t
o
B
R
AC.
A key elem
ent
in decrea
sing s
o
cial poverty a
nd ill
health a
m
ong the poor
is
to increase
m
a
ternal and
chi
l
d
heal
t
h
(
M
C
H
) out
c
o
m
e
s
wi
t
h
i
n
u
nde
rse
r
ve
d
c
o
unt
ri
es. One
of
t
h
e
l
a
r
g
est
di
f
f
ere
n
ces
i
n
heal
t
h
indicators am
ong
de
veloped a
nd
de
veloping
countries is the
i
r
m
a
ternal
m
o
rtality and m
o
rbidity rates where a
vast
m
a
jori
t
y
of
t
h
e 5
2
9
,
0
0
0
wom
e
n wh
o di
e
eac
h
y
ear
f
r
o
m
com
p
l
i
cat
i
ons o
f
chi
l
dbi
rt
h bel
o
n
g
t
o
d
e
v
e
l
o
p
i
n
g
cou
n
t
ries [2
]. Matern
al an
d
ch
il
d
h
ealth
h
a
v
e
re
m
a
in
ed
p
e
rv
asiv
e and
d
a
m
a
g
i
ng
to ov
erall
q
u
a
lity
of l
i
f
e i
m
prove
m
e
nt
s i
n
l
o
w and m
i
ddl
e-i
n
c
o
m
e
count
ri
es [
3
]
.
The h
eal
t
h
of m
o
t
h
ers an
d
chi
l
d
re
n i
s
cl
osel
y
related
to
th
e gen
e
ral h
ealth
of th
e co
mm
u
n
ity an
d
m
easu
r
es th
at b
r
ing
ab
ou
t i
m
p
r
ov
emen
t in
g
e
n
e
ral h
ealth
also
ten
d
t
o
pro
d
u
ce im
p
r
o
v
ed
m
a
tern
al an
d ch
ild
h
ealth
. In
add
itio
n, rap
i
d
in
creases in
p
opu
latio
n
stemmin
g
fr
om
earl
y
m
a
r
r
i
a
ge a
n
d
l
ack
of
fam
i
ly
pl
an
ni
n
g
ca
n f
u
rt
he
r ha
ve
ne
gat
i
v
e
effect
s
o
n
heal
t
h
an
d
dev
e
l
o
p
m
ent
;
h
o
wev
e
r, th
ey
can
b
e
m
itig
ated
b
y
spu
r
ri
n
g
econo
m
i
c
d
e
v
e
l
o
p
m
en
t,
esp
ecially a
m
o
n
g
wo
m
e
n
.
A
v
ital
com
pone
nt
i
n
defi
ni
n
g
w
o
m
e
n’s em
pow
erm
e
nt
has be
en t
h
e asses
s
wom
e
n’s i
n
fl
u
e
nce o
v
e
r
h
o
u
s
eh
ol
d
sp
en
d
i
n
g
on
f
a
mil
y
w
e
ll-
b
e
i
n
g
.
A 200
1 N
e
p
a
l Dem
o
g
r
aph
i
c an
d H
ealth Surv
ey
f
ound
that “[w
]
o
m
en
who
are em
pl
oy
ed
and e
a
r
n
cas
h
have m
o
re say
i
n
h
o
u
s
eh
ol
d
d
eci
si
on m
a
ki
ng
t
h
an
w
o
m
e
n wh
o
do
n
o
t
w
o
rk a
n
d
wom
e
n w
h
o w
o
r
k
but
d
o
not
earn c
a
sh
i
n
c
o
m
e” (p.
4
7
);
t
h
i
s
i
n
cl
u
d
ed
dec
i
si
ons a
b
out
t
h
ei
r o
w
n
heal
t
h
care
[3
3]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S
I
S
SN
:
225
2-8
8
0
6
The
C
a
se
f
o
r Mi
crocre
di
t
-
D
o
es It
I
m
prove
Mat
e
rn
al
an
d C
h
i
l
d
Heal
t
h
..
..
(
M
a
d
huri
m
a Sar
kar)
11
3
The a
ssum
p
tion that inc
r
easing m
a
ternal em
power
m
e
nt
t
h
r
o
ug
h i
n
com
e
an
d e
d
ucat
i
o
n
l
eads
t
o
i
m
p
r
ov
em
en
ts in
ch
ild
h
ealth
and
surv
i
v
al is wid
e
s
p
re
ad a
n
d has
been inc
o
rp
o
r
at
ed
in
t
o
m
a
n
y
po
licy
d
o
c
u
m
en
ts. Howev
e
r, t
h
is assu
m
p
tio
n
h
a
s
no
t b
e
en
tested
in
well con
t
ro
lled
in
terv
en
tion
stud
ies and
fu
rt
h
e
r
i
nde
pen
d
e
n
t
re
search
n
eeds
t
o
be c
o
nd
uct
e
d
i
n
or
de
r t
o
t
e
s
t
t
h
e
hy
p
o
t
h
ese
s
set
out
by
t
h
e B
R
A
C
pape
r
s
. It
i
s
also
co
n
cei
v
a
ble th
at BRAC
facilitated
so
ci
o
econo
m
i
c d
e
v
e
lop
m
en
t (esp
ecially
m
i
cro
c
red
it) m
a
y also
h
a
v
e
negat
i
v
e
ef
fect
s o
n
t
h
e
heal
t
h
st
at
us
of
y
o
u
n
g
c
h
i
l
d
re
n.
Wom
e
n’s
part
i
c
i
p
at
i
on i
n
em
pl
oy
m
e
nt
and
ot
he
r
activ
ities
m
a
y
in
vo
lv
e leav
i
n
g
th
e sup
e
rv
isi
o
n
o
f
sm
all ch
ild
ren
to
o
t
h
e
r caretak
ers less ab
le to
respon
d
to
their pa
rticular health
needs
,
s
u
ch
a
s
f
o
r b
r
ea
st
-fee
d
i
n
g
o
r
t
h
e
pre
p
ar
at
i
on o
f
ene
r
gy
de
nse weani
ng f
o
o
d
s [3
4,
3
5
]
. Th
erefore, in
terv
en
tion
s
tack
ling
wo
m
e
n
’
s em
p
o
werm
en
t al
so
n
e
ed
to
fo
cu
s on
‘collectiv
e
e
m
powe
r
m
e
nt’ and
not just indi
vidual em
powe
r
m
e
nt. This
can
be accom
p
lished through a
num
b
er of via
b
le
and l
o
w c
o
st
m
e
t
hods s
u
c
h
as an est
a
bl
i
s
hm
ent
of com
m
uni
t
y
cent
e
r or
pr
o
v
i
d
i
n
g
m
i
crocredi
t
l
o
ans t
o
wom
e
n
t
o
be
gi
n
l
o
w
c
o
st
day
care
f
o
r ot
her
wom
e
n.
Th
ere
h
a
s
b
e
en
fu
rt
h
e
r critiqu
e
abou
t th
e myo
p
i
c fo
cus on th
e p
o
s
itiv
e
ou
tco
m
es o
f
p
a
rticip
atio
n
in
m
i
crocredi
t
w
h
i
l
e
m
i
nim
i
zi
ng i
ssues such as
l
o
an co
nt
r
o
l
an
d m
i
suse by
m
a
l
e
m
e
m
b
ers of ho
use
h
ol
ds (
G
oet
z
& Gupta, 1996); concern about the
b
e
st in
terests of th
e p
a
rticip
an
ts, i
n
clud
ing
in
creased
wo
rk
lo
ads and
respon
sib
ilities an
d
fin
a
n
c
ial
su
stain
a
b
ility o
v
e
r tim
e
[36
]
; critic
is
m
th
at th
e p
r
o
g
ra
m
s
h
a
v
e
d
i
fficu
l
t
y
reachi
ng the most vul
nera
ble populations whethe
r related
to choice or exc
l
usion [37]
; appre
h
e
n
sion about the
g
e
nd
er an
d power relation
s
an
d th
e so
cial/
c
u
ltu
ral con
s
train
t
s p
l
aced
on
wo
m
e
n
in an
d ou
tsid
e th
e ho
m
e
,
whi
c
h ca
n l
ead
t
o
p
o
o
r
o
u
t
c
o
m
es [34]
;
ass
o
ci
at
i
on bet
w
ee
n he
al
t
h
decl
i
n
e an
d b
u
si
n
e
ss
fai
l
u
re
[
38]
;
c
once
r
n
abo
u
t
t
h
e o
v
er
use o
f
em
powe
r
m
e
nt
for wom
e
n rel
a
t
e
d t
o
p
a
rt
i
c
i
p
at
i
on [
3
9]
;
and a di
ffi
c
u
l
t
y
i
n
di
scerni
ng t
h
e
asp
ects
o
f
th
e
p
r
og
ram
s
th
at
lead
to po
sitive ou
tco
m
es [40
]
. Fu
rt
h
e
r in
t
e
rv
en
tion
s
n
e
ed
to
b
e
d
e
velop
e
d in a
way th
at ad
dresses th
ese leg
iti
m
a
te issu
es and
co
n
c
ern
s
.
In
ad
d
ition
,
quite ap
art fro
m
BRAC’s so
cioeco
no
m
i
c d
e
v
e
lo
p
m
en
t in
terven
tio
ns,
o
t
h
e
r
b
ackgroun
d
fact
or
s can al
s
o
i
n
fl
ue
nce t
h
e di
rect
i
o
n,
ve
l
o
ci
t
y
and nat
u
re
of
p
o
ssi
bl
e
pat
h
way
s
o
f
c
h
an
ges i
n
wel
l
-bei
ng
and t
h
ese c
o
nfounding varia
b
les nee
d
to be accounte
d
for whe
n
disc
us
sing t
h
e im
pacts of m
i
crocre
dit on
heal
t
h
an
d wel
l
bei
ng
of any
c
o
m
m
uni
t
y
, not
just
m
a
t
e
rnal
and c
h
i
l
d
heal
t
h
. F
o
r exam
pl
e, ur
bani
zat
i
o
n (
I
sl
am
19
9
0
)
,
m
oder
n
i
zat
i
on an
d t
h
e di
f
f
usi
o
n
o
f
new i
d
eas,
sec
t
oral
t
r
a
n
sf
orm
a
t
i
on [
4
1]
, an
d
i
n
creasi
ng
p
o
v
ert
y
[42] as
well a
s
re
gional di
fferences
are
ke
y varia
b
les
th
at can
affect
pop
u
l
ation
h
ealth. Fu
rt
h
e
r
stud
ies of
B
R
A
C
dat
a
need t
o
ri
g
o
r
o
usl
y
cont
r
o
l
f
o
r t
h
ese fact
o
r
s t
o
u
nde
rst
a
nd
whi
c
h pat
h
way
s
are t
h
e
m
o
st
si
gni
fi
ca
nt
.
Fu
rt
h
e
rm
o
r
e,
b
a
sed
on
t
h
e cu
rren
t literatu
re, m
i
cro
c
red
it/h
ealth
research
cou
l
d
u
tilize sev
e
ral
ex
istin
g
t
h
eories an
d
eng
a
ge ad
d
ition
a
l theo
ry dev
e
l
o
pmen
t. For ex
am
p
l
e, critica
l
so
cial th
eory,
wh
ich
ad
dr
esses
po
wer
and
pr
iv
ilege f
r
o
m
a
hi
st
ori
cal
and soci
al
pers
pect
i
v
e,
wo
ul
d s
u
pp
o
r
t
an u
p
st
ream
-t
h
i
nki
n
g
approach
to di
scover syste
m
s
and
beha
vi
ors that limit opport
unities a
n
d
create ba
rrie
r
s
for
wom
e
n to receive
and
use m
i
crocredi
t
[
43]
. C
h
a
o
s t
h
e
o
ry
,
whi
c
h p
o
si
t
s
t
h
at
s
m
al
l
changes d
u
ri
ng a se
q
u
en
ce of e
v
ent
s
ca
n al
t
e
r
out
c
o
m
e
s i
n
a sy
st
em
and t
h
a
t
or
der ca
n
be
fo
u
nd
wi
t
h
i
n
s
e
em
i
ngl
y
chao
t
i
c
pat
t
e
rns [
4
4]
, w
o
ul
d s
u
p
p
o
r
t
a
social ecol
ogi
cal approach t
o
i
d
entify
pat
h
ways
and
evalu
a
te ch
ang
e
s related to
h
e
alth
and
l
o
w i
n
co
m
e
wom
e
n. T
o
e
x
t
r
i
cat
e t
h
e i
n
fl
uence
s
of i
ndi
vi
d
u
al
pat
h
wa
ys in a m
echanism
as com
p
lex as
health
status is
a
d
a
un
ting
task
. Non
e
th
eless, a d
e
term
in
atio
n
of in
pu
ts
a
nd
varia
b
les that increase
health and
wellbeing,
esp
ecially
m
a
t
e
r
n
al
and
ch
il
d
h
ealth
an
d w
e
llb
eing
, shou
ld
b
e
un
d
e
r
t
ak
en. W
h
ile
B
R
A
C
h
a
s
under
t
ak
en
su
bstan
tiv
e research
on
m
i
cro
c
red
it, k
e
y
qu
estio
n
s
re
m
a
in
-
wh
at are th
e path
ways throug
h
wh
ich
m
i
cro
c
red
i
t
can infl
uenc
e health outcom
esso that
m
i
crocredit can
be used as an e
ffec
tiv
e in
stru
m
e
n
t
fo
r im
p
r
ov
ing h
ealth
status.
The f
o
l
l
o
wi
n
g
conce
p
t
m
a
y
be hel
p
f
u
l
i
n
l
ogi
cal
l
y
fo
rm
ul
at
e a ‘
m
odel
’
for
u
nde
rt
aki
ng
ri
g
o
r
o
us
pol
i
c
y
resea
r
c
h
.
A ‘
d
em
on
st
rat
i
v
e’ ec
on
om
et
ri
c fram
e
wo
rk
can e
s
t
a
bl
i
s
h t
h
e
rel
a
t
i
ons
hi
p
bet
w
ee
n
micro
c
red
it and
h
ealth
ou
tcomes an
d
assist
in
id
en
tification
of in
st
ru
m
e
n
t
s fo
r
stren
g
t
h
e
n
i
ng
th
e
relatio
n
s
h
i
p
.
There ca
n
be a
fo
ur st
e
ppe
d r
e
l
a
t
i
onshi
p bet
w
een m
i
crocre
di
t
and
w
o
m
a
n/
chi
l
d
heal
t
h
o
u
t
c
om
es. Thi
s
can be
co
n
c
ep
tu
alized b
y
th
e fo
llowin
g
system
o
f
fu
n
c
tion
a
l
forms.
(1) In
co
m
e
=
f (Micro
credit, ed
u
catio
n
an
d
sk
ill, h
eath
,
o
t
h
e
r relev
a
n
t
lo
cal v
a
riab
les), (2)
co
nsu
m
p
tio
n
of ‘h
ealth
‘go
o
d
s
and
serv
ices =f (In
co
m
e
,
Av
ailab
ility o
f
h
ealth
g
ood
s an
d
serv
ices/st
a
te o
f
heal
t
h
i
n
f
r
ast
r
uct
u
re, cost
o
f
heal
t
h
servi
c
e
s
), (
3
) C
o
ns
u
m
pti
on o
f
heal
t
h
go
o
d
s an
d
servi
ces
by
w
o
m
e
n
/
chi
l
d
re
n = f (
C
ons
um
pt
i
on (
t
ot
al
) of heal
t
h
go
ods a
nd ser
v
i
ces, ap
pr
o
p
ri
at
e vari
abl
e
s r
e
prese
n
t
i
n
g w
o
m
e
n’s
em
powe
r
m
e
nt
), an
d (
4
)
Ap
pr
op
ri
at
e st
at
us i
ndi
cat
o
r
o
f
w
o
m
e
n’s/
chi
l
d
ren
heal
t
h
=f (C
o
n
sum
p
t
i
on
of
heal
t
h
go
o
d
s an
d ser
v
i
ces by
w
o
m
e
n/
chi
l
d
ren
,
f
o
od c
o
n
s
um
pt
i
on/
nut
ri
t
i
on b
y
wom
e
n/
chi
l
d
re
n, sa
ni
t
a
t
i
on, t
i
m
e
spe
n
t
by
w
o
m
e
n
fo
r
wo
rk
kee
p
i
n
g t
h
em
awa
y
fr
om
chi
l
d
re
n)
.
There
are two
nota
b
le feature
s
in the a
b
ove
syste
m
. First, th
ere is sim
u
ltan
e
ity b
e
tween
h
ealth
an
d
i
n
com
e
(equat
i
ons
1 an
d 2
)
.
Furt
herm
ore, i
n
ad
di
t
i
on t
o
pri
m
ary
i
ndep
e
nde
nt
va
ri
abl
e
s (M
i
c
roc
r
edi
t
i
n
1,
Inc
o
m
e
i
n
2,
C
ons
um
pt
i
on(
t
o
t
a
l
)
o
f
he
al
t
h
g
o
o
d
s a
n
d ser
v
i
ces i
n
3 a
n
d
C
ons
um
pt
i
on
of
heat
h
g
o
ods
a
n
d
serv
ices b
y
wo
m
e
n
/
ch
ild
ren
in 4) t
h
ere are a nu
m
b
er
o
f
aux
iliary v
a
riab
les (ed
u
cation in
1,h
eal
t
h
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S
V
o
l
.
3,
No
. 2,
Ju
ne
2
0
1
4
:
10
7 – 1
1
6
11
4
in
frastru
ct
u
r
e an
d
co
st of
h
ealth
serv
ices in
2,wo
m
e
n
’
s em
p
o
werm
en
t in
3
,
n
u
t
ritio
n
,
tim
e s
p
en
t
b
y
wo
m
e
n
for
work
i
n
g
k
e
ep
in
g
t
h
em
away
fro
m
ch
ild
ren
)
.Th
e
aux
iliary v
a
riab
les m
o
d
i
fy(p
ositiv
ely o
r
n
e
g
a
tively) th
e
streng
th
of th
e relatio
n
s
h
i
p
o
r
t
h
e elasticity b
e
twee
n
he
al
t
h
o
f
w
o
m
e
n an
d c
h
i
l
d
re
n
and
p
r
i
m
ary
vari
abl
e
s
su
ch
as in
co
me o
r
m
i
cro
c
red
it. Th
ese elasticities, wh
en
esti
m
a
ted
in
a p
r
o
p
e
r
way, will g
i
v
e
v
e
ry u
s
efu
l
pol
i
c
y
gui
dan
ce i
f
m
i
crocr
e
di
t
i
s
t
o
be used as a p
o
t
e
nt
i
n
st
r
u
m
e
nt
fo
r im
pro
v
i
ng heal
t
h
st
a
t
us of
wom
e
n/
chi
l
d
re
n.
Th
e
d
a
ta fro
m
BRAC research
is a un
iqu
e
op
portun
ity to
ex
am
in
e p
r
e and
po
st in
terv
entio
n
of the
im
pact
of m
i
cr
ocre
di
t
an
d s
u
c
h
dat
a
set
s
ca
n
pr
o
v
i
d
es
resear
chers
wi
t
h
t
h
e
pr
os
pect
o
f
co
nd
uct
i
n
g c
ont
i
n
u
o
u
s
r
i
go
ro
us r
e
search
in th
e coun
tr
y.
REFERE
NC
ES
[1]
United Nations,
Millenium Dev
e
lopment Goals,
2007.
http://www.un.org/m
illen
niumgoals/pdf/mdg2007.pdf.
[2]
UNICEF, UNICEF annual report, 201
0
.
http://www.unicef.org/pub
licatio
ns/f
iles/UNICEF_Annual_Report_2010_EN_052711.pdf
.
[3]
WHO,
The m
illenn
ium
developm
ent
goals, 2011.
http://www.un.o
r
g/millenniumgo
als/pdf/(
2011_
E)
%20MDG%20R
eport%202011_
Book%20LR.pd
f.
[4]
UNESCAP, Ma
croeconomic po
licy
and d
e
velo
pment. http://www.unescap
.org
/our-work/macr
oeconomic-policy-
development.
[5]
Bhuiy
a
A., Chowdhur
y
M., “The im
pact of social and economic well deve
lopment programs on
health and well-
being: a BR
AC-ICDDR,B
collaborative p
r
oject
in Matlab”, BRAC working paper
series, 1995.
http:/
/rese
a
rch
.
br
ac.n
e
t/wor
kin
g
_
p
apers.php
?
s
cat=32.
[6]
Lovell C. H
., “
B
reaking
the
cycle o
f
pover
t
y
:
the BRA
C strateg
y
”, Kumarian
Press,
West Hartford, Conn
ecticut,
1992.
[7]
Zaman H., “Microcred
it programs: w
ho participates and to wh
at extent
?
”
,
BRAC working paper series,
1996
.
http:/
/rese
a
rch
.
br
ac.n
e
t/wor
kin
g
_
p
apers.php
?
s
cat=32.
[8]
Chowdhur
y
M., Bhuiy
a
A., “Effect
s of
socioeconomic dev
e
lo
pment on he
alth status and
hu
man well-being:
determining impact and exploring path
way
s
of change”,
BRAC
working paper series,
1995.
http:/
/rese
a
rch
.
br
ac.n
e
t/wor
kin
g
_
p
apers.php
?
s
cat=32.
[9]
Kannan K. P., Thankappan K. R
., Raman Kutty
V., Arav
indan K. P., “Health and deve
lopm
ent in rural Keral
a
:
a
stud
y
of the link
ages between so
cio-economic status and hea
lth Status”, Integrated
Rural Techno
lo
g
y
Centr
e
of the
Ke
ra
la,
Sa
stra
Sahity
a
P
a
r
isha
d, Kerala, India, 199
1.
[10]
Marmot M., “Th
e
influ
e
nce of
in
come
on health
:
views of an
epid
emiologist”,
He
alth A
ffairs
, vo
l/issue: 21(2), pp.
31-46, 2002
.
[11]
Marmot M. G.,
Davey
S.
G
., Stansfield S.,
et
al.,
"Health In
equali
ties among Br
itish civil servan
ts: the Whitehall
II
study
"
,
Lancet,
v
o
l/issue:
33
7
(87
54), pp
. 1387–1
393, 1991
.
[12]
Sen Am
art
y
a K., “Com
m
odities and Capab
ili
ties”, Oxford, Oxford
Universit
y
Press
,
1985
.
[13]
Grossman M., “The human capital model of
the
dema
nd for health.1999.Nation
a
l Bureau
of
Econ
omic Resear
ch”,
Working Pap
e
r
, 1999.
http://www.nber.org
/
papers/w7078.
[14]
Mohindra K. S., Haddad S., “Wo
men’s interlaced freedoms: a framework
link
i
ng microcred
it
participation an
d
heal
th”,
Journal
of Human Development
, vo
l/issu
e: 6(3)
, pp
. 364-
374, 2005
.
[15]
Des Jarlais D
.
C.,
Ly
les
C.,
C
r
epaz N., “Improving the repor
ting qua
lity
of nonrandomized evalu
a
tions
o
f
behavior
al
and p
ublic health
in
t
e
r
v
entions
:
the
TR
END s
t
atem
ent
”
,
Am
J
Publ
ic H
e
alth
, vol. 94
, pp
. 361-6, 2004.
[16]
Murdoch J., “Th
e
Microf
inan
ce
Promise”,
Journ
a
l of Economic
Literature,
vol.
XXXVII, pp. 15
69–1614, 1999
.
[17]
Duvendack M.,
Palmer-Jones R., C
opestak
e J.
G., Hooper L., Loke Y.,
R
a
o
N., “What is the evid
ence of
th
e
impact of
micro
f
inance on
the
well-being of
po
or peopl
e?
”, Lo
ndon: EPPI-Cen
tre, Soci
al Scien
ce R
e
sear
ch Unit,
Institute of
Education
,
Univ
ersit
y
of London
.
ISBN: 978-1-90734
5-19-7.
[18]
S
t
ew
art R., V
a
n
Roo
y
en C., K
o
rth M
., Chereni
A
.,
Rebelo D. S., “Do
micro-credit, micro-savings and micro-
leasing serve
as effective f
i
nancial in
clusion interventions enab
ling poor people,
and especially
w
o
men, to engage
in m
eaningful econom
ic opportunities in low-
an
d m
i
ddle-inco
m
e
countri
es. A s
y
stem
atic r
e
view
of the evid
ence”,
London:
EPPI-Centre, Social
Sci
e
nce Research
Unit, In
stitu
te
of E
ducat
ion,
Univer
sit
y
of London, 2012.
[19]
Cla
y
R
.
A.
, “
M
ore th
an on
e wa
y
to m
eas
ure
”
,
Am
erican Psycho
l
o
g
ical
Associatio
n,
vol/issue: 41(
8), pp
. 52
, 2010
.
[20]
Mahmud S., Hu
da S., “P
articip
ation in BRAC’s
rural development progr
am and the impact of gro
up d
y
namics on
individual ou
tco
m
es”,
BRAC wo
rking paper s
e
ries,
1998
. http://r
esearch
.brac.n
e
t/working_papers.php
?
s
cat=32.
[21]
Mannan M., Chowdhur
y
M., Bh
ui
y
a
A
., Rana
M., “Form
a
tion
of villag
e
or
gani
zat
ions: the first
three m
onths”,
BRAC
working p
aper series
, 199
5. http://research
.
brac.n
et/workin
g_papers.php
?
s
cat=32
.
[22]
Adams
A., Ro
y
R. D., Mahbub A.,
“Participator
y
methods to assess change
in health and women’s lives: an
explora
t
or
y stu
d
y
for
the BR
AC-ICDDR,B joint proj
ect
in
Matlab
”
,
BRAC working pap
er series,
1995
.
http:/
/rese
a
rch
.
br
ac.n
e
t/wor
kin
g
_
p
apers.php
?
s
cat=32.
[23]
Scott I
.,
Evans
T., Cash R
.
,
“Unpacking the black
box: stud
y
i
ng
the relations
hip between so
cioeconomic
development an
d health”,
BRAC
working pap
er s
e
ries,
1995
. h
ttp://research
.
brac.n
e
t/working_p
apers.php
?
s
cat=32.
[24]
Blumberg R. L., “Fair
y
tales
and facts:
ec
onomy
,
fa
mi
ly
fe
rt
i
l
ity
a
nd t
h
e
fe
ma
l
e
”,
In:
Women and World
deve
lopment
(ed
ited
b
y
Tinker
I., Bransen M
.
B
an
d Buvinic,
M.),
New York: Praeger, pp
. 12
-21, 1
976.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S
I
S
SN
:
225
2-8
8
0
6
The
C
a
se
f
o
r Mi
crocre
di
t
-
D
o
es It
I
m
prove
Mat
e
rn
al
an
d C
h
i
l
d
Heal
t
h
..
..
(
M
a
d
huri
m
a Sar
kar)
11
5
[25]
Gu
y
e
r J.
L., “Househol
d budgets
and women’s incomes”,
Workin
g Paper
, no. 28
, Brookline, MA, African Studies
Center
, Boston
University
, 1980
.
[26]
Mahbub A., May
e
ed M., Ro
y
R. D.,
“A qualitative explor
ation
o
f
some so
cioeco
nomic issues
in south Uddomdi,
Matlab
”
,
BRAC
working paper s
e
ries,
1995
. h
ttp://research
.
brac.n
e
t/working_p
apers.php
?
s
cat=32.
[27]
Chen M
.
,
M
a
h
m
ud S
., “
A
s
s
e
ss
ing chang
e
in
wom
e
n’s
lives
:
a con
cep
tual
fra
m
e
work”,
BRAC working pap
er
se
rie
s
,
1995
. ht
t
p
://res
earch
.brac.net
/
working_papers.php
?
s
cat=3
2
.
[28]
Amin R., Ahmed A. U., Chowdhur
y
J., Ahmed M., “Poor wo
men'
s particip
ati
on
in income-gen
er
ating projects and
their f
e
rti
lit
y r
e
g
u
lation
in rura
l
Banglad
esh: Evi
d
ence from
a r
e
c
e
nt surve
y
”
,
Wo
r
l
d Developmen
t
, vol/issue: 22
(4)
,
pp. 555-565
, 19
94.
[29]
Ha
she
m
i S.
M.
,
Sc
hule
r
S.
R.,
Riley
A.
P.,
“Rur
al cr
edit progr
ams and wo
men’s
empowerment in Bangladesh”,
World Development
, vol/issue: 24
(4), pp
. 635-653
, 1996.
[30]
S
c
huler S
.
R., H
a
s
h
em
i S
.
M
., Rile
y A
.
P
., A
k
hter
S., “Credit
programs, patriarch
y
and men’s violen
ce ag
ainst
women in rural
Banglad
esh”,
So
cial Science and
Medicine
, vo/issue: 43(12)
, pp
. 1
729-1742, 1996
.
[31]
D
ooc
y
S
.,
Tefer
r
a
S
., N
o
rell D
.
, Burnham
G
., “
C
redit
program outcomes: coping
capacit
y
and nutritional status in
the food
insecur
e
con
t
ext of
Et
h
i
opia”, vo
l. 60, p
p
. 2371-2382
, 2
005.
[32]
Mahbub A., Ah
m
e
d S. M., “Perspec
tiv
e of wo
m
e
n about
their
own illn
ess”,
BRAC work
ing pape
r se
rie
s
,
199
7.
http:/
/rese
a
rch
.
br
ac.n
e
t/wor
kin
g
_
p
apers.php
?
s
cat=32.
[33]
Ministr
y
of Health [Nep
al]
,
New ERA, and
O
RC Macro, “Nepal Demographi
c and Health Survey
2001
”,
Calver
ton, Mar
y
land, USA, Family
Health
Division, Ministr
y
of
Hea
lth
; New
ER
A; and ORC
Macro, 2002
.
[34]
Carloni A
.
S., “The impact of
ma
tern
al
emplo
y
m
e
nt and
in
come
on the nu
tritional status of
childr
en in rur
a
l areas
of develop
i
ng co
untries: what is
known, what is
not know
n, and
where the gaps are”, Rome: Food and Agricultur
e
Organization, 19
84.
[35]
Popkin B. M., Solon F. S., “Incom
e,
tim
e, th
e working m
o
ther and child nutr
itio
n”,
J Trop Pedia
t
r Environ Child
Health,
vol. 22
,
pp. 156-166
, 19
76.
[36]
May
oux L
., “Jobs, gender and sm
all enterp
rises : getting the policy
environm
ent right”,
ILO Working
Papers
346709, International Labor
Org
a
nization
,
2001
.
[37]
Amin S., Rai
A. S., Topa G.
, “Does microcredit reach
the poor an
d
vuln
e
rable?
Evid
ence from north
er
n
Banglad
esh”,
Jo
urnal of Develop
m
ent Economics
, vol/issue: 70(1)
, pp
. 59-82
, 200
3.
[38]
Zaman H., “Poverty
and BRAC’
s microc
redit pr
ogram: explorin
g some linkages”,
BRAC workin
g paper series
,
1997. http://research.br
ac.n
et/wo
r
king_papers.ph
p
?
scat=32
.
[39]
Selinger
E., “Does microcred
it “
e
mpower
”?
Ref
l
ections on the g
r
ameen bank
debate”,
Human Studies
,
vo
l/issue:
31(1), pp
. 27–41
, 2008
.
[40]
Dworkin S. L.,
Blankenship K., “Micro
fi
nance
and HIV/AIDS
prevention: asse
ssing its promise a
nd limitations”,
AIDS and Behavior,
2009. doi:10
.
1007/s10461-00
9-9532-3.
[41]
Osmani S. R.,
“Structural
chan
ge and pov
erty
in Bangladesh:
the case of
a f
a
lse turn
ing point”,
Banglad
es
h
Developmen
t S
t
u
d
ies
, vo
l/issue: 1
8
(3), 1990
.
[42]
Rahm
an A., Huque T., “
P
overt
y
a
nd inequali
t
y
in Banglad
esh in the eighti
e
s: an an
al
y
s
is of so
m
e
recent evid
enc
e
”
,
Research Report
, No. 91, Dhaka: Bangladesh Institu
te of D
e
velop
m
ent Studies, 19
88.
[43]
Momen M., Bhu
i
y
a
A., Chowdhur
y
M., “Vulner
a
ble of
the vuln
e
rables: the situ
ati
on of divorced, abandoned an
d
widowed women in a rural ar
ea of Bang
lad
e
sh”,
BRAC work
ing pape
r se
rie
s
,
1995
.
http:/
/rese
a
rch
.
br
ac.n
e
t/wor
kin
g
_
p
apers.php
?
s
cat=32.
[44]
Resnicow K., Page S.
E., “E
mbracing Ch
aos an
d Complexity
:
A qua
ntum change for
public h
ealth”,
Ameri
c
a
n
Journal of Public Health
, vol/issue: 98(8)
, 2008
.
BIOGRAP
HI
ES
OF AUTH
ORS
Madhurima Sarkar, PhD is a S
e
nior Research
Associate at th
e Center
for Inno
vation
in
P
e
diatri
c P
r
a
c
t
i
c
e
a
t
Na
tionwide
Childr
e
n’s
Hos
p
ital
.
He
r r
e
s
ear
ch focus
e
s
on
m
a
ternal
,
child
and
adol
es
cent
he
alth
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
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:
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06
IJP
H
S
V
o
l
.
3,
No
. 2,
Ju
ne
2
0
1
4
:
10
7 – 1
1
6
11
6
Muhiuddin Haid
er, PhD is a R
e
search
Associate
Professor at University
of Mar
y
l
a
nd. He
is a h
i
ghly
skilled public h
e
alth
professi
onal w
ho has manag
e
d
a
nd
led
diverse public
health projects
and resear
ch st
ud
ies in more than
a do
zen
countr
i
es worldwide ov
er th
ir
ty
ye
ars, on b
e
ha
l
f
of severa
l in
t
e
rnat
ional
agen
cies and
univer
s
ities. He
has r
e
search
expert
is
e in the
areas
of hea
lth communications, health promo
tion, health education, and
s
o
cial
m
a
rket
ing
.
Evaluation Warning : The document was created with Spire.PDF for Python.