Principal Investigator |
Dr. Molly Rosenberg |
International Collaborator(s) |
Dr. James Akiruga Amisi |
Project Type |
|
Project Title |
Microfinance and Investments in Health in Rural Kenya |
Priority Area |
Prevention |
The Intervention |
We propose to leverage an expanding population health platform in rural Kenya, the Bridging Income Generation with group Integrated Care (BIGPIC Family program), designed to address the health and well-being needs of the communities it serves by combining microfinance group formation with community-based primary care delivery and agricultural training. The proposed study is significant because it will provide one of the first evaluations of how a unique microfinance and population health program may increase health investments in resource-poor settings. This study is innovative because we are assessing the health impacts of the BIGPIC Family intervention, a novel and translational multi-pronged approach to improving health. Integrating microfinance and delivery of community-based healthcare to address structural socio-economic and healthcare access barriers is novel and has great promise to increase investments in health, and has not yet been studied in a Kenyan context. |
Key Facilitators |
This intervention is being piloted in Kenya with support of the public health system run by the Kenyan Ministry of Health. The Indiana CTSI is developing a program focused on reciprocal innovation that seeks to support the identification, adaptation, implementation, and evaluation of promising interventions developed at LMIC partner sites for use in Indiana. This infrastructure provides funding and other resources to adapt interventions to a US context. |
Target Population |
The proposed study will be conducted in Milo, a community of 15,000 people in western Kenya, and Matulo, a nearby community of similar size and demographic characteristics as Milo. We will sample from three different study populations. First, we will randomly sample 100 Milo community BIGPIC microfinance group members. We will pull a sample of 100 target participants from the full enumeration of all group members, as maintained by BIGPIC facilitators. As the majority of BIGPIC group members are female (approximately 75%), we will take a sex-stratified random sample to ensure an even sex distribution to match the sex distribution we anticipate in our community-based samples. For our second study population, we will randomly sample 100 community members from the Milo community. Some of these community members have likely been indirectly exposed to the BIGPIC Family intervention. Third, we will randomly sample 100 community members from the Matulo community, an area with no exposure to BIGPIC Family. |
Process to Implementation |
This intervention has not yet been implemented in Indiana but is being piloted in Kenya. If the pilot findings show positive outcomes, potential exists to apply this intervention to low resourced clinical settings in Indiana and the US. Following identification of potential pilot sites in Indiana, this intervention could be adapted and piloted for use in the US clinical context using support from the Indiana CTSI and other health partners in Indiana, e.g. State Department of Health, IU Health, Eskenazi, and other public health centers. |
Key Stakeholders |
There were community BIGPIC microfinance group members that helped with the intervention. We anticipate in transferring to the US that there would need to be similar stakeholders that would need to be engaged within the population health and microfinance systems. |
Scaled or Transferred? |
The aim is to work toward scaling this process into the US setting. |
Type of Research |
We will conduct a cross-sectional, tablet-based survey of 100 randomly sampled members of BIGPIC microfinance groups in a community in which the program was recently implemented, 100 individuals from the same community who are not current microfinance group members but may have received some of the other BIGPIC Family programming components, and 100 individuals from a nearby community that has not yet been exposed to any BIGPIC Family programming. Our primary analyses will compare self-reported investments in health between those who are current microfinance members and non-members, but we will also explore the potential cumulative effects of additional BIGPIC components. |
Published Materials |
Rosenberg, M., Amisi, J.A., Szkwarko, D., Tran, D.N., Genberg, B., Luetke, M., Kianersi, S., Namae, J., Laktabai, J. and Pastakia, S., 2020. The relationship between a microfinance-based healthcare delivery platform, health insurance coverage, health screenings, and disease management in rural Western Kenya. |
Year Funded |
2018 |