Microfinance and households coping with HIV/AIDS in Zimbabwe: An exploratory study

Barnes, Carolyn; Keogh, Erica; Nemarundwe, N.; L, Nyikahadzoi; Weiss, Ellen

doi:10.31899/hiv2.1044

Cited by 15 publications

(13 citation statements)

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“…Thus, the replication of this trial in a larger setting should entail partnering with a microfinance institution that is financially stable and whose business model can accommodate Shamba Maisha . Participant concerns around loan repayment are an important ethical consideration; particularly in light of recent findings that microfinance may fail to provide enough income for financially disadvantaged households (Stewart et al 2010 ; Barnes et al 2001 ; Kaboski & Townsend 2008 ). As a result, we plan to consult local and global experts in microfinance in order to ensure that this component meets the needs of the study, and is designed with the potential for scale-up and sustainability is similar settings in East Africa.…”

Section: Discussionmentioning

confidence: 99%

Shamba Maisha: Pilot agricultural intervention for food security and HIV health outcomes in Kenya: design, methods, baseline results and process evaluation of a cluster-randomized controlled trial

et al. 2015

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BackgroundDespite advances in treatment of people living with HIV, morbidity and mortality remains unacceptably high in sub-Saharan Africa, largely due to parallel epidemics of poverty and food insecurity.Methods/DesignWe conducted a pilot cluster randomized controlled trial (RCT) of a multisectoral agricultural and microfinance intervention (entitled Shamba Maisha) designed to improve food security, household wealth, HIV clinical outcomes and women’s empowerment. The intervention was carried out at two HIV clinics in Kenya, one randomized to the intervention arm and one to the control arm. HIV-infected patients >18 years, on antiretroviral therapy, with moderate/severe food insecurity and/or body mass index (BMI) <18.5, and access to land and surface water were eligible for enrollment. The intervention included: 1) a microfinance loan (~$150) to purchase the farming commodities, 2) a micro-irrigation pump, seeds, and fertilizer, and 3) trainings in sustainable agricultural practices and financial literacy. Enrollment of 140 participants took four months, and the screening-to-enrollment ratio was similar between arms. We followed participants for 12 months and conducted structured questionnaires. We also conducted a process evaluation with participants and stakeholders 3–5 months after study start and at study end.DiscussionBaseline results revealed that participants at the two sites were similar in age, gender and marital status. A greater proportion of participants at the intervention site had a low BMI in comparison to participants at the control site (18% vs. 7%, p = 0.054). While median CD4 count was similar between arms, a greater proportion of participants enrolled at the intervention arm had a detectable HIV viral load compared with control participants (49% vs. 28%, respectively, p < 0.010). Process evaluation findings suggested that Shamba Maisha had high acceptability in recruitment, delivered strong agricultural and financial training, and led to labor saving due to use of the water pump. Implementation challenges included participant concerns about repaying loans, agricultural challenges due to weather patterns, and a challenging partnership with the microfinance institution. We expect the results from this pilot study to provide useful data on the impacts of livelihood interventions and will help in the design of a definitive cluster RCT.Trial registrationThis trial is registered at ClinicalTrials.gov, NCT01548599.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-015-0886-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Shamba Maisha: Pilot agricultural intervention for food security and HIV health outcomes in Kenya: design, methods, baseline results and process evaluation of a cluster-randomized controlled trial

et al. 2015

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“…As a result, credit and savings programs have attracted women in unprecedented numbers ( Chen et al, 2005 ). Moreover, women invest their savings in their children, leading to better nutrition and educational outcomes ( Barnes, 2001 ; Barnes, Gaile, & Kibombo, 2001 ; Chen & Snodgrass, 2001 ; Chowdhury & Bhuiya, 2001 ; Khandker, 1998 ; Todd, 1996 ). For example, the Village Savings and Loan Microfinance Program (part of the Livingstonia Synod AIDS Program in Ekwendani, Malawi) establishes and capacitates community-based credit associations open to the whole community; 83% of its participants are women.…”

Section: Solutions Within Reachmentioning

confidence: 99%

HIV/AIDS, declining family resources and the community safety net

Heymann

Kidman

2009

AIDS Care

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Families play central roles in the HIV/AIDS pandemic, caring for both orphaned children and the ill. This extra caregiving depletes two family resources essential for supporting children: time and money. We use recent data from published studies in sub-Saharan Africa to illustrate deficits and document community responses. In Botswana, parents caring for the chronically ill had less time for their preschool children (74 versus 96 hours per month) and were almost twice as likely to leave children home alone (53% versus 27%); these children experienced greater health and academic problems. Caregiving often prevented adults from working full time or earning their previous level of income; 47% of orphan caregivers and 64% of HIV/AIDS caregivers reported financial difficulties due to caregiving. Communities can play an important role in helping families provide adequate childcare and financial support. Unfortunately, while communities commonly offer informal assistance, the value of such support is not adequate to match the magnitude of need: 75% of children's families in Malawi received assistance from their social network, but averaging only US$81 annually. We suggest communities can strengthen the capacity of families by implementing affordable quality childcare for 0–6 year olds, after-school programming for older children and youth, supportive care for ill children and parents, microlending to enhance earnings, training to increase access to quality jobs, decent working conditions, social insurance for the informal sector, and income and food transfers when families are unable to make ends meet.

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“…In Thailand, loans to business partnerships involving an HIV-negative and HIV-positive individual not only improved the economic conditions of PLHA but also reduced stigma and discrimination towards PLHA in the community [ 19 ]. Barnes (2002) examined the effects of microcredit on entrepreneurs in Zimbabwe and found that among HIV-affected households those that accessed microcredit had more sources for securing income, higher proportion of boys in school, and a savings account in a bank, compared to those that did not access credit [ 20 ]. Regarding PLHA on ART, we know of only one qualitative study conducted in Cote d'Ivoire in which the authors found that when PLHA were using appropriate medical treatment, they were capable of engaging in microcredit activities which led to improvements in economic self-sufficiency and provided recipients with psychosocial support [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Exploration of the Economic and Social Effects of Microcredit among People Living with HIV/AIDS in Uganda

Wagner

Rana

Linnemayr

et al. 2012

AIDS Research and Treatment

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HIV medical care, including antiretroviral therapy (ART), is often successful in restoring physical health and functioning. But in developing countries, HIV medical care is often insufficient to achieve social and economic health, and hence innovative economic support programs are much needed. We conducted semistructured interviews with 30 adults receiving ART and microcredit loans operated by Uganda Cares. Using content analysis, we explored the impact of the microcredit loans on the economic, social, and psychological well-being of respondents. Most respondents indicated that the microcredit loans played a positive role in their lives, helped them to keep their children in school and sustain their families, and improved their self-esteem and status in the community. In addition, we also found significant positive knowledge spill-over and network effects in the program with regard to business management and support. However, more than half of the participants indicated experiencing repayment problems either personally or with other group members due to unexpected emergencies and sickness. These findings highlight that microcredit programs have the potential of being an economic support system for HIV clients trying to reestablish their livelihoods, especially in resource-constrained settings, though more research is needed to determine the overall economic viability of such programs.

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Microfinance and households coping with HIV/AIDS in Zimbabwe: An exploratory study

Cited by 15 publications

References 0 publications

Shamba Maisha: Pilot agricultural intervention for food security and HIV health outcomes in Kenya: design, methods, baseline results and process evaluation of a cluster-randomized controlled trial

Shamba Maisha: Pilot agricultural intervention for food security and HIV health outcomes in Kenya: design, methods, baseline results and process evaluation of a cluster-randomized controlled trial

HIV/AIDS, declining family resources and the community safety net

A Qualitative Exploration of the Economic and Social Effects of Microcredit among People Living with HIV/AIDS in Uganda

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