The effect of Self-Help Groups on access to maternal health services: evidence from rural India

Abstract

IntroductionThe main challenge for achieving universal health coverage in India is ensuring effective coverage of poor and vulnerable communities in the face of high levels of income and gender inequity in access to health care. Drawing on the social capital generated through women’s participation in community organizations like SHGs can influence health outcomes. To date, evidence about the impact of SHGs on health outcomes has been derived from pilot-level interventions, some using randomised controlled trials and other rigorous methods. While the evidence from these studies is convincing, our study is the first to analyse the impact of SHGs at national level.MethodsWe analyzed the entire dataset from the third national District Level Household Survey from 601 districts in India to assess the impact of the presence of SHGs on maternal health service uptake. The primary predictor variable was presence of a SHG in the village. The outcome variables were: institutional delivery; feeding new-borns colostrum; knowledge about family planning methods; and ever used family planning. We controlled for respondent education, wealth, heard or seen health messages, availability of health facilities and the existence of a village health and sanitation committee.ResultsStepwise logistic regression shows respondents from villages with a SHG were 19 per cent (OR: 1.19, CI: 1.13-1.24) more likely to have delivered in an institution, 8 per cent (OR: 1.08, CI: 1.05-1.14) more likely to have fed newborns colostrum, have knowledge (OR: 1.48, CI 1.39 – 1.57) and utilized (OR: 1.19, CI 1.11 – 1.27) family planning products and services. These results are significant after controlling for individual and village-level heterogeneities and are consistent with existing literature that the social capital generated through women’s participation in SHGs influences health outcome.ConclusionThe study concludes that the presence of SHGs in a village is associated with higher knowledge of family planning and maternal health service uptake in rural India. To achieve the goal of improving public health nationally, there is a need to understand more fully the benefits of systematic collaboration between the public health community and these grassroots organizations.

The Effect of Self Help Groups on Access to Maternal Health Services: Evidence from Rural India

“…With a global outreach to 205 million microfinance members [43], these groups are an innovative way to combine poverty alleviation and community health interventions into an integrated strategy that leverages existing resources to achieve greater impact and scale. Finally we conclude that to achieve the goal of improving public health, there is a need to better understand the benefits of systematic collaboration between the public health community and these grassroots organizations.…”

Delivering development? Evidence on self‐help groups as development intermediaries in South Asia and Africa

“…Many SHGs are not "single issue" organizations, and take on multiple functions and goals. For example, savings groups and women's groups often form the basis for other kinds of collective activities (Brody et al, 2016;Greaney et al, 2013;Prost et al, 2013;Saha, Annear, & Pathak, 2013).…”

“…Negative: Gugerty andKremer, 2008. 18 Positive: Caro, Pangare and Manfre, 2013;Deininger and Liu, 2009;Dongre, Deshmuk and Garg, 2007;Greaney et al, 2013;Hargreaves et al, 2010;Holvoet, 2005;Kaganzi et al, 2009;Molyneux et al, 2007;Saha, Annear and Pathak, 2013;Sinha et al, 2006;Swain et al, 2009;Swain, 2012. Mixed: Reddy and Manak, 2013.…”

The Structure of Social Exchange in Self‐help Support Groups: Development of a Measure

“…Self-help support groups possess several strengths that help to explain their popularity. The donation driven nature of self-help support groups allows them to reach individuals who cannot afford professional services (Saha, Annear, & Pathak, 2013). Further, participation in groups can help reduce treatment costs and rates of rehospitalization (Humphreys & Moos, 2001; Landers & Zhou, 2011).…”