Adapting an adherence support workers intervention: engaging traditional healers as adherence partners for persons enrolled in HIV care and treatment in rural Mozambique

Women's Participation in a Savings Group and Depression: a Community-Based Financial Capability Intervention in Mozambique

Background

As one of the fastest growing community-based financial capability approaches, village savings and loan group (VSLG) is an organized group and formal entity that creates opportunities for participants to save and access financial assets. VSLG has potentially positive impacts on increasing women's financial resources and social support and further improves their mental health. Participation in a VSLG not only increases women's opportunities for asset-building and income generation, but also facilitates trust and promotes social capital development. However, few studies have examined the association between the VSLG participation and women's depression status. To fill the knowledge gap, we examined the association between the VSLG participation and depressive symptoms among low-income women in Mozambique.

Methods

The data was collected as part of the VSLG program evaluation. The study applied a posttest-only comparison group quasi-experimental design and sampled female VSLG participants and non-participants from three sub-villages in the Sofala province, Mozambique. A multi-stage sampling technique was employed, and a total of 205 women were randomly selected, including 105 VSLG participants and 100 non-participants. Depressive symptoms were measured using the short version of the Edinburgh Depression Scale (EDS) with a summative score ranging from 7 to 28. Using the cutoff value at a score of 14, we created a dichotomous depression indicator. Linear and logit models were used to examine the associations of the VSLG participation and the participation duration with the depression score and the presence of depression controlling for demographic variables.

Results

The VSLG participants had a statistically lower mean depression score of 12.2 (SD = 4.4) compared to non-participants (15.0, SD = 4.0, p < .001). The regression analysis suggested that the VSLG participants had a mean depression score of 2.7 lower than the non-participants (p < .001). Nearly 60% of the non-participants reported the presence of depression; however, this percentage is 31% for participants (p < .001). The multivariate logit model indicated the odds of the presence of depression for participants are .34 of that for non-participants. Similar results were obtained when the VSLG program duration was used as an independent variable.

Conclusions

Study findings showed a positive association between the VSLG participation and women's mental health. Future research should further explore the intervention mechanisms and assess how the VSLG participation affects women's mental health. Findings also provided important insights into developing community-based financial capability interventions to improve low-income women's mental health.