Is microfinance associated with changes in women’s well-being and children’s nutrition? A systematic review and meta-analysis

BACKGROUND: Microfinance is the provision of savings and small loans services, with no physical collateral. Most recipients are disadvantaged women. The social and health impacts of microfinance have not been comprehensively evaluated. OBJECTIVE: To explore the impact of microfinance on contraceptive use, female empowerment and children’s nutrition in South Asia, Sub-Saharan Africa and Latin America and the Caribbean. DESIGN: We conducted a systematic search of published and grey literature (1990–2018), with no language restrictions. We conducted meta-analysis, where possible, to calculate pooled ORs. Where studies could not be combined, we described these qualitatively. DATA SOURCES: EMBASE, MEDLINE, LILACS, CENTRAL and ECONLIT were searched (1990–June 2018). ELIGIBILITY CRITERIA: We included controlled trials, observational studies and panel data analyses investigating microfinance involving women and children. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed risk of bias. The methodological quality of included studies was assessed using the Cochrane risk-of-bias tool for controlled trials and quasi-experimental studies and a modified Newcastle Ottawa Scale for cross-sectional surveys and analyses of panel data. Meta-analyses were conducted using STATA V.15 (StataCorp). RESULTS: We included 27 studies. Microfinance was associated with a 64% increase in the number of women using contraceptives (OR 1.64, 95% CI 1.45 to 1.86). We found mixed results for the association between microfinance and intimate partner violence. Some positive changes were noted in female empowerment. Improvements in children’s nutrition were noted in three studies. CONCLUSION: Microfinance has the potential to generate changes in contraceptive use, female empowerment and children’s nutrition. It was not possible to compare microfinance models due to the small numbers of studies. More rigorous evidence is needed to evaluate the association between microfinance and social and health outcomes. PROSPERO REGISTRATION NUMBER: CRD42015026018.