Impact of financial inclusion in low- and middle-income countries: A systematic review of reviews

Engaging men in women's empowerment: impact of a complex gender transformative intervention on household socio-economic and health outcomes in the eastern democratic republic of the Congo using a longitudinal survey

BACKGROUND

In the Democratic Republic of the Congo, women in (peri-)urban areas are commonly engaged in small trade, which allows them to meet the basic needs of their families. Microsaving approaches are a low-risk option to obtain financing for economic activities. A project combining men's sensitization on gender equity and women's empowerment through village savings and loan associations were implemented in North and South Kivu to raise the household economic level.

OBJECTIVE

This study assessed how involving men in gender equity affects women's health and socio-economic outcomes, including food security.

METHODS

A cohort study was conducted with 1812 women at the baseline; out of them 1055 were retrieved at the follow-up. Baseline data collection took place from May to December 2017 and the follow-up from July 2018 to January 2019. To identify socio-economic changes and changes of gender relations, linear and logistic regressions were run.

RESULTS

Results showed that the household income improved with intervention (coefficient = 0.327; p = 0.002), while the capacity to pay high bills without contracting debts decreased (coefficient = 0.927; p = 0.001). We did not find enough statistically significant evidence of the influence of the intervention on skilled birth attendance (coefficient = 0.943; p = 0.135), or family planning use (coefficient = 0.216; p = 0.435) nor women's participation in the decision-making (coefficient = 0.033; p = 0.227) nor on couple's cohesion (coefficient = 0.024; p = 0.431). Food insecurity levels decreased over time regardless of being in the intervention or control area.

CONCLUSION

Empowering women while sensitizing men on gender aspects improves financial well-being (income). Time, security, and strong politics of government recognizing and framing the approach are still needed to maximize the benefit of such projects on social factors such as women's participation in decision-making and social cohesion.

Digital financial inclusion, environmental quality, and economic development: the contributions of financial development and investments in OECD countries

Economic development has long acknowledged the significance of financial innovation and technological advancement. Communication technology increases the availability of information, generates new modes of communication, restructures production processes, and enhances the efficacy of a wide range of economic operations. This study investigates the effects of digital financial inclusion and information and communication technology (ICT) on economic growth in 38 OECD nations between 2004 and 2020, with a focus on the contributions of financial development and investments in non-financial assets. To this end, advanced econometric methodologies are employed to conduct an exhaustive empirical analysis utilizing second-generation panel unit root and cointegration techniques. The results demonstrate a positive correlation between digital financial inclusion, information and communication technology, population growth, and non-financial investments in OECD nations. It is recommended that OECD policymakers promote digital financial inclusion by utilizing cost-effective digital technologies to reach currently financially excluded and underserved populations. This can be achieved through a variety of formal financial services that are tailored to their needs and responsibly delivered at a cost that is affordable to customers and sustainable for providers. Moreover, policymakers are recommended to promote information and communication technologies that strengthen the means for implementing Sustainable Development Goals through international cooperation and coordination, technology transfer, capacity building, strengthening multi-stakeholder partnerships, and data monitoring and accountability. Finally, a detailed conclusion is provided to discuss the research limitations and future directions.

PROTOCOL: Effects of interventions to improve access to financial services for micro-, small- and medium-sized enterprises in low- and middle-income countries: An evidence and gap map

Background

Micro-, small-, and medium-sized enterprises (MSMEs) account for the vast majority of firms in most economies, particularly in developing nations, and are key contributors to job creation and global economic development. However, the most significant impediment to MSME development in low- and middle-income countries is a lack of access to both investment and working capital financing. Due to a lack of essential track record, appropriate collateral, and credit history, MSMEs are frequently denied business loans by traditional lending institutions. In addition, SMEs' inability to access funding is hindered by institutional, structural, and non-financial factors. To address this, both the public and private sectors employ indirect and direct finance interventions to help MSMEs in developing and emerging economies enhance and increase their financing needs. Given the importance of MSMEs in the economy, a comprehensive overview of and systematic synthesizing of the evidence of the effects of financial access interventions for MSMEs, capturing a wide variety of outcome variables, is useful.

Objectives

The objective of this evidence and gap map (EGM) is to describe the existing evidence on the effects of various interventions dedicated to supporting and improving MSMEs' access to credit, as well as the corresponding firm performance and/or welfare outcomes.

Methods

An EGM is a systematic evidence product that displays the existing evidence relevant to a specific research question. An EGM's end product is a research article or report, but it can also be shared via an interactive map drawn as a matrix of included studies and their corresponding interventions and outcomes. Interventions in low- and middle-income countries that target specific population subgroups are included on the map. The EGM considers five types of interventions: (i) strategy, legislation and regulatory; (ii) systems and institutions; (iii) facilitate access; (iv) lending instruments or financial products; and (v) demand-side interventions. The map, on the other hand, covers outcome domains for policy environment, financial inclusion, firm performance, and welfare. Impact evaluations or systematic reviews of relevant interventions for a previously defined target population are included in the EGM. Studies using experimental or non-experimental designs, as well as systematic reviews, are eligible. The EGM excludes before-and-after study designs with no suitable comparison group. Furthermore, the map excludes literature reviews, key informant interviews, focus group discussions, and descriptive analyses. Search strings were used to conduct electronic searches in databases. To ensure that the research team had identified a significant portion of relevant research works, the search strategy was supplemented with gray literature searches and systematic review citation tracking. We have compiled studies that are either completed or in progress. For practical reasons, studies are limited to papers written in English and are not restricted by publication date.

Selection Criteria

We included studies that examined interventions to enhance MSMEs' access to finance in low- and middle-income countries targeting MSMEs including households, smallholder farmers and single person enterprise as well as financial institutions/agencies and their staff. The EGM considers five types of interventions that aim to: (i) deliver strategy, legislation, and regulatory aspects; (ii) systems and institutions that enable financing; (iii) facilitate access to finance; (iv) deliver different lending instruments or financial products, including traditional forms of microcredit; and (v) demand-side interventions such as programs on financial literacy. The map includes outcome domains surrounding policy environment, financial inclusion, firm performance, and welfare. Eligible studies must be experimental, non-experimental, or systematic reviews. In addition, the study designs must have a suitable comparison group before and after the implementation of interventions.

Results

The EGM includes 413 studies. The majority of the studies (379 studies) analyzed microenterprises, such as households and smallholder farmers; 7 studies analyzed community groups; while 109 studies analyzed small and medium enterprises. There were 147 studies on interventions that targeted multiple firm sizes. Lending instruments/financial products are the most common intervention across all firm types. When it comes to the types of firms that receive the said financial intervention, the data is overwhelmingly in favor of microenterprises (278 studies), followed by systems and organizations (138 studies) that support better access to such financial products and services. Welfare outcomes have the most evidence out of all of the outcomes of interest, followed by firm performance and financial inclusion. Among all firm types, welfare outcomes are primarily targeted at microenterprises. With 59 studies, we can say that small businesses have a significantly large number of enterprise performance outcomes. of the 413 studies, 243 used non-experimental or quasi-experimental designs (mainly propensity score matching and instrumental variable approaches), 136 used experimental methods, and 34 were systematic reviews. 175 studies (43%) provided evidence from Sub-Saharan Africa, 142 studies (35%) from South Asia, 86 studies (21%) from East Asia and the Pacific, 66 studies (16%) from Latin America and the Caribbean, 28 studies (7%), Europe and Central Asia, and 21 studies (5%) from the Middle East and North Africa. Most of the included evidence covers low-income (26%) and lower-middle income countries (66%), and to a lesser extent upper-middle-income countries (26%).

Conclusion

This map depicts the existing evidence and gaps on the effects of interventions to enhance MSMEs' access to financial services in low and middle-income countries. Interventions directed at microenterprises with welfare outcomes have a significant number of research outcomes in the literature. SME evaluations have looked at firm performance, with less focus to employment and the welfare effects on owners and employees, including poverty reduction. Microcredit/loans have been the focus of a large number of research papers (238 studies), indicating the field's growing popularity. However, emerging financial interventions such as facilitating access to digital financial services are relatively under-studied. Several studies also investigate rural or population in remote areas with 192 studies, 126 studies on poor and disadvantaged, and 114 papers on women. Most of the research is conducted in Sub-Saharan Africa (175 studies) and South Asia (142 studies) so further research in other regions could be conducted to allow a more holistic understanding of the effects of financial inclusion interventions. Credit lines, supply chain finance, and trade financing, which are some of the ADB's financial tools have limited evidence. Future studies should look into strategy, law, and regulation interventions, as well as interventions targeted at SMEs, and examine policy and regulatory environment outcomes as well as welfare outcomes. Interventions on the demand side and their impact on the policy and regulatory environment, as well as facilitating access are relatively understudied.

Spatial-temporal Evolution and Influencing Factors of Digital Financial Inclusion: County-level Evidence from China

The vigorous development of information and communications technology has accelerated reshaping of the financial industry. The COVID-19 pandemic has further catalyzed the demand for digital financial services. Digital financial inclusion relies on information technology to overcome spatial limitations. In this case, the research question is whether it adheres to the spatial laws governing conventional financial activities. This study uses exploratory spatial data analysis and a geographical detector to elucidate the spatiotemporal characteristics and factors influencing digital financial inclusion at the county level in China (Data don't include that of Hong Kong, Macao and Taiwan of China) from 2014 to 2020. The research findings indicate: first, China's county-level digital financial inclusion is generally increasing and exhibits significant spatial autocorrelation. Second, population density, level of traditional financial development, government regulation, and education level are key determinants of China's county-level digital financial inclusion. Third, policies should be differentiated by region to narrow the spatial gap in digital financial inclusion. The results provide a reference for other developing countries on using digital technology to develop financial inclusion.

Impact of social protection on gender equality in low- and middle-income countries: A systematic review of reviews

Background

More than half of the global population is not effectively covered by any type of social protection benefit and women's coverage lags behind. Most girls and boys living in low-resource settings have no effective social protection coverage. Interest in these essential programmes in low and middle-income settings is rising and in the context of the COVID-19 pandemic the value of social protection for all has been undoubtedly confirmed. However, evidence on whether the impact of different social protection programmes (social assistance, social insurance and social care services and labour market programmes) differs by gender has not been consistently analysed. Evidence is needed on the structural and contextual factors that determine differential impacts. Questions remain as to whether programme outcomes vary according to intervention implementation and design.

Objectives

This systematic review aims to collect, appraise, and synthesise the evidence from available systematic reviews on the differential gender impacts of social protection programmes in low and middle-income countries. It answers the following questions: 1.What is known from systematic reviews on the gender-differentiated impacts of social protection programmes in low and middle-income countries?2.What is known from systematic reviews about the factors that determine these gender-differentiated impacts?3.What is known from existing systematic reviews about design and implementation features of social protection programmes and their association with gender outcomes?

Search Methods

We searched for published and grey literature from 19 bibliographic databases and libraries. The search techniques used were subject searching, reference list checking, citation searching and expert consultations. All searches were conducted between 10 February and 1 March 2021 to retrieve systematic reviews published within the last 10 years with no language restrictions.

Selection Criteria

We included systematic reviews that synthesised evidence from qualitative, quantitative or mixed-methods studies and analysed the outcomes of social protection programmes on women, men, girls, and boys with no age restrictions. The reviews included investigated one or more types of social protection programmes in low and middle-income countries. We included systematic reviews that investigated the effects of social protection interventions on any outcomes within any of the following six core outcome areas of gender equality: economic security and empowerment, health, education, mental health and psychosocial wellbeing, safety and protection and voice and agency.

Data Collection and Analysis

A total of 6265 records were identified. After removing duplicates, 5250 records were screened independently and simultaneously by two reviewers based on title and abstract and 298 full texts were assessed for eligibility. Another 48 records, identified through the initial scoping exercise, consultations with experts and citation searching, were also screened. The review includes 70 high to moderate quality systematic reviews, representing a total of 3289 studies from 121 countries. We extracted data on the following areas of interest: population, intervention, methodology, quality appraisal, and findings for each research question. We also extracted the pooled effect sizes of gender equality outcomes of meta-analyses. The methodological quality of the included systematic reviews was assessed, and framework synthesis was used as the synthesis method. To estimate the degree of overlap, we created citation matrices and calculated the corrected covered area.

Main Results

Most reviews examined more than one type of social protection programme. The majority investigated social assistance programmes (77%, N = 54), 40% (N = 28) examined labour market programmes, 11% (N = 8) focused on social insurance interventions and 9% (N = 6) analysed social care interventions. Health was the most researched (e.g., maternal health; 70%, N = 49) outcome area, followed by economic security and empowerment (e.g., savings; 39%, N = 27) and education (e.g., school enrolment and attendance; 24%, N = 17). Five key findings were consistent across intervention and outcomes areas: (1) Although pre-existing gender differences should be considered, social protection programmes tend to report higher impacts on women and girls in comparison to men and boys; (2) Women are more likely to save, invest and share the benefits of social protection but lack of family support is a key barrier to their participation and retention in programmes; (3) Social protection programmes with explicit objectives tend to demonstrate higher effects in comparison to social protection programmes without broad objectives; (4) While no reviews point to negative impacts of social protection programmes on women or men, adverse and unintended outcomes have been attributed to design and implementation features. However, there are no one-size-fits-all approaches to design and implementation of social protection programmes and these features need to be gender-responsive and adapted; and (5) Direct investment in individuals and families' needs to be accompanied by efforts to strengthen health, education, and child protection systems. Social assistance programmes may increase labour participation, savings, investments, the utilisation of health care services and contraception use among women, school enrolment among boys and girls and school attendance among girls. They reduce unintended pregnancies among young women, risky sexual behaviour, and symptoms of sexually transmitted infections among women. Social insurance programmes increase the utilisation of sexual, reproductive, and maternal health services, and knowledge of reproductive health; improve changes in attitudes towards family planning; increase rates of inclusive and early initiation of breastfeeding and decrease poor physical wellbeing among mothers. Labour market programmes increase labour participation among women receiving benefits, savings, ownership of assets, and earning capacity among young women. They improve knowledge and attitudes towards sexually transmitted infections, increase self-reported condom use among boys and girls, increase child nutrition and overall household dietary intake, improve subjective wellbeing among women. Evidence on the impact of social care programmes on gender equality outcomes is needed.

Authors' Conclusions

Although effectiveness gaps remain, current programmatic interests are not matched by a rigorous evidence base demonstrating how to appropriately design and implement social protection interventions. Advancing current knowledge of gender-responsive social protection entails moving beyond effectiveness studies to test packages or combinations of design and implementation features that determine the impact of these interventions on gender equality. Systematic reviews investigating the impact of social care programmes, old age pensions and parental leave on gender equality outcomes in low and middle-income settings are needed. Voice and agency and mental health and psychosocial wellbeing remain under-researched gender equality outcome areas.

Women's economic status, male authority patterns and intimate partner violence: a qualitative study in rural North West Province, South Africa

There are conflicting views on the impact of microfinance-only interventions on women's economic empowerment and intimate partner violence in low and middle-income countries. Evidence suggests however that when microfinance is combined with complementary programmes (microfinance plus) it may be effective for empowering women and addressing intimate partner violence. We conducted in-depth interviews with adult women in rural South Africa who had received microfinance loans for more than a year and had recently completed gender training. We explored women's perceptions on income generation; the effects on their relationships, including intimate partner violence; their notions of power; and perspectives on men's reactions to their empowerment. Findings reveal that the notion of 'power within the self' is supported by women's income generation, alongside a sense of financial independence and improved social support. Women reported increased happiness and reduced financial stress, although social norms and gender expectations about women subservience and male headship remain salient, particularly among older women. Furthermore, younger women appeared to tolerate abuse due to financial and caring responsibilities. These findings underpin the importance of complementary gender training programmes and of including men as participants for enhancing the effectiveness of economic strengthening interventions.

Economic Aspects of Delivering Primary Care Services: An Evidence Synthesis to Inform Policy and Research Priorities

Policy Points The 2018 Declaration of Astana reemphasized the importance of primary health care and its role in achieving universal health coverage. While there is a large amount of literature on the economic aspects of delivering primary care services, there is a need for more comprehensive overviews of this evidence. In this article, we offer such an overview. Evidence suggests that there are several strategies involving coverage, financing, service delivery, and governance arrangements which can, if implemented, have positive economic impacts on the delivery of primary care services. These include arrangements such as worker task-shifting and telemedicine. The implementation of any such arrangements, based on positive economic evidence, should carefully account for potential impacts on overall health care access and quality. There are many opportunities for further research, with notable gaps in evidence on the impacts of increasing primary care funding or the overall supply of primary care services.

CONTEXT

The 2018 Declaration of Astana reemphasized the importance of primary health care and its role in achieving universal health coverage. To strengthen primary health care, policymakers need guidance on how to allocate resources in a manner that maximizes its economic benefits.

METHODS

We collated and synthesized published systematic reviews of evidence on the economic aspects of different models of delivering primary care services. Building on previous efforts, we adapted existing taxonomies of primary care components to classify our results according to four categories: coverage, financing, service delivery, and governance.

FINDINGS

We identified and classified 109 reviews that met our inclusion criteria according to our taxonomy of primary care components: coverage, financing, service delivery, and governance arrangements. A significant body of evidence suggests that several specific primary care arrangements, such as health workers' task shifting and telemedicine, can have positive economic impacts (such as lower overall health care costs). Notably absent were reviews on the impact of increasing primary care funding or the overall supply of primary care services.

CONCLUSIONS

There is a great opportunity for further research to systematically examine the broader economic impacts of investing in primary care services. Despite progress over the last decade, significant evidence gaps on the economic implications of different models of primary care services remain, which could help inform the basis of future research efforts.

Financial inclusion and physical health functioning among aging adults in the sub-Saharan African context: Exploring social networks and gender roles

BACKGROUND

It remains poorly understood how financial inclusion influences physical health functioning in later life in sub-Saharan African context and whether the association differs by gender and social relationships. We aim 1) to examine the associations of financial inclusion with functional impairment during older age in Ghana; and 2) to evaluate whether gender and social networks modify this association.

METHODS

The cross-sectional analyses are based on a sample (N = 1,201) of study participants aged 50 years and over (M = 66.5 years, SD = 11.9, 63.3% female) deriving from the 2016-2017 AgeHeaPsyWel-HeaSeeB Study. Ordinary least squares (OLS) regression analyses with interactions were performed to estimate the link between financial inclusion and functional health and how the association is modified by gender and older age social networks.

RESULTS

The mean financial inclusion score was 1.66 (SD = 1.74) in women and 2.33 (SD = 1.82) in men whilst mean activities of daily living (ADL) score was 13.03 (SD = 4.99) and 14.85 (SD = 5.06) in women and men respectively. We found that financial inclusion was associated with decreases in ADL (total sample: β = -.548, p < .001; women: β = -.582, p < .001; men: β = -1.082 p < .001) and instrumental ADL (IADL) (total sample: β = -.359, p = .034; women: β = -.445, p = .026 but not in men). Social networks significantly moderated the association of financial inclusion with ADL such that the financially included who were embedded in a stronger constellation of social networks were 6% less likely to report ADL impairment compared to those with weaker social networks (β = -.062, p = .025).

CONCLUSIONS

The study provides empirical evidence for a better understanding of the association between financial inclusion and physical health functioning in the context of later life social networks. Interventions for functional health through financial inclusion in sub-Saharan Africa should include improving interpersonal and social networks for older adult and also through gender lenses.

PROTOCOL: Impact of social protection on gender equality in low- and middle-income countries: A systematic review of reviews

This is the protocol for a Campbell review. The review aims to systematically collect, appraise, map and synthesise the evidence from systematic reviews on the differential gender impacts of social protection programmes in Low- and Middle-Income Countries (LMICs). Therefore, it will answer the following questions: (1) What is known from systematic reviews on the gender-differentiated impacts of social protection programmes in LMICs? (2) What is known from systematic reviews about the factors that determine these gender-differentiated impacts? (3) What is known from existing systematic reviews about design and implementation features of social protection programmes and their association with gender outcomes?

A relational perspective on women's empowerment: Intimate partner violence and empowerment among women entrepreneurs in Vietnam

Research has mainly studied women's empowerment assessing personal (e.g., self-esteem) or relational (e.g., decision-making) empowerment indicators. Women are not isolated individuals; they are embedded in social relationships. This is especially relevant in more collectivist societies. The current research provides a relational perspective on how husbands may hamper women's empowerment by inflicting intimate partner violence (IPV) assessing women's self-reported experience. We tested the link between self-esteem and experienced IPV on financial intra-household decision-making power among women entrepreneurs (N = 1,347) in Northern Vietnam, a collectivistic society undergoing economic development. We report two measurement points. As expected, self-esteem (and not IPV) was positively related to more power in intra-household decision-making on small expenditures, which are traditionally taken by women. However, IPV (and not self-esteem) was related to less decision-making power on larger expenditures, traditionally a domain outside women's power. We test and discuss the directionality of the effects and stress the importance of considering women's close relationship when investigating signs of women's empowerment.