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PLoS One ; 15(8): e0237519, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810162


INTRODUCTION: Microfinance is a widely promoted developmental initiative to provide poor women with affordable financial services for poverty alleviation. One popular adaption in South Asia is the Self-Help Group (SHG) model that India adopted in 2011 as part of a federal poverty alleviation program and as a secondary approach of integrating health literacy services for rural women. However, the evidence is limited on who joins and continues in SHG programs. This paper examines the determinants of membership and staying members (outcomes) in an integrated microfinance and health literacy program from one of India's poorest and most populated states, Uttar Pradesh across a range of explanatory variables related to economic, socio-demographic and area-level characteristics. METHOD: Using secondary survey data from the Uttar Pradesh Community Mobilization project comprising of 15,300 women from SHGs and Non-SHG households in rural India, we performed multivariate logistic and hurdle negative binomial regression analyses to model SHG membership and duration. RESULTS: While in general poor women are more likely to be SHG members based on an income threshold limit (government-sponsored BPL cards), women from poorest households are more likely to become members, but less likely to stay members, when further classified using asset-based wealth quintiles. Additionally, poorer households compared to the marginally poor are less likely to become SHG members when borrowing for any reason, including health reasons. Only women from moderately poor households are more likely to continue as members if borrowing for health and non-income-generating reasons. The study found that an increasing number of previous pregnancies is associated with a higher membership likelihood in contrast to another study from India reporting a negative association. CONCLUSION: The study supports the view that microfinance programs need to examine their inclusion and retention strategies in favour of poorest household using multidimensional indicators that can capture poverty in its myriad forms.

Participação da Comunidade/estatística & dados numéricos , Organização do Financiamento/estatística & dados numéricos , Acesso aos Serviços de Saúde , Serviços de Saúde Materno-Infantil , Grupos de Autoajuda/organização & administração , Adolescente , Adulto , Características da Família , Feminino , Organização do Financiamento/organização & administração , Letramento em Saúde/economia , Letramento em Saúde/organização & administração , Promoção da Saúde , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Índia/epidemiologia , Recém-Nascido , Serviços de Saúde Materno-Infantil/economia , Serviços de Saúde Materno-Infantil/organização & administração , Serviços de Saúde Materno-Infantil/provisão & distribução , Pessoa de Meia-Idade , Pobreza/economia , Pobreza/estatística & dados numéricos , Gravidez , População Rural/estatística & dados numéricos , Grupos de Autoajuda/estatística & dados numéricos , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
Health Hum Rights ; 22(1): 199-207, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32669801


We propose that a Right to Health Capacity Fund (R2HCF) be created as a central institution of a reimagined global health architecture developed in the aftermath of the COVID-19 pandemic. Such a fund would help ensure the strong health systems required to prevent disease outbreaks from becoming devastating global pandemics, while ensuring genuinely universal health coverage that would encompass even the most marginalized populations. The R2HCF's mission would be to promote inclusive participation, equality, and accountability for advancing the right to health. The fund would focus its resources on civil society organizations, supporting their advocacy and strengthening mechanisms for accountability and participation. We propose an initial annual target of US$500 million for the fund, adjusted based on needs assessments. Such a financing level would be both achievable and transformative, given the limited right to health funding presently and the demonstrated potential of right to health initiatives to strengthen health systems and meet the health needs of marginalized populations-and enable these populations to be treated with dignity. We call for a civil society-led multi-stakeholder process to further conceptualize, and then launch, an R2HCF, helping create a world where, whether during a health emergency or in ordinary times, no one is left behind.

Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Organização do Financiamento/organização & administração , Saúde Global , Cooperação Internacional , Pneumonia Viral/epidemiologia , Betacoronavirus , Fortalecimento Institucional/organização & administração , Controle de Doenças Transmissíveis/economia , Prioridades em Saúde/organização & administração , Humanos , Pandemias