Bulletin of the World Health Organization

Assessing the incremental effects of combining economic and health interventions: the IMAGE study in South Africa

Julia Kim, Giulia Ferrari, Tanya Abramsky, Charlotte Watts, James Hargreaves, Linda Morison, Godfrey Phetla, John Porter & Paul Pronyk

Volume 87, Number 11, November 2009, 824-832

Table 2. Comparison of intervention effects on economic well-being, empowerment, IPV and HIV risk behaviour among women participating in IMAGE, women receiving microfinance only and a control group, Limpopo province, South Africa, 2001–2005

Outcome Control
 MF
 IMAGE
 MF vs control
 IMAGE vs control
 IMAGE vs MF
No./n % No./n % No./n % RR 95% CI aRRa 95% CI RR 95% CI aRRa 95% CI RR 95% CI aRRa 95% CI
Economic well-being
Greater food security 129/361 36 350/480 73 177/371 48 2.58 0.83–8.01 2.33 0.73–7.42 1.34 0.22–8.21 1.28 0.20–8.31 0.59 0.19–1.85 0.63 0.22–1.85
Estimated household asset value > US$ 300 182/361 50 313/480 65 207/370 56 1.29 1.20–1.38 1.22 1.15–1.30 1.10 0.79–1.54 1.08 0.81–1.45 0.84 0.57–1.25 0.88 0.64–1.20
Greater expenditure on home improvements 70/361 19 147/474 31 129/370 35 1.57 0.78–3.17 1.46 0.71–2.97 1.82 1.25–2.64 1.68 1.22–2.32 1.14 0.64–0.03 1.14 0.62–2.08
Better able to pay back debt 86/360 24 340/480 71 194/371 52 3.71 1.16–11.80 3.38 1.09–10.50 2.41 0.55–10.56 2.34 0.50–11.01 0.72 0.37–1.40 0.77 0.38–1.56
Membership in stokvel (savings group) 55/363 15 98/480 20 140/387 36 1.32 1.22–1.43 1.38 1.03–1.85 2.13 0.92–4.94 2.06 0.84–5.08 1.64 0.74–3.66 1.53 0.64–3.64
Able to meet basic needs in past year 39/316 12 167/434 38 94/350 27 3.65 1.77–7.49 3.17 1.69–5.94 1.86 0.26–13.10 1.71 0.21–14.25 0.58 0.11–3.10 0.63 0.12–3.40
Possesses bank account 111/360 31 210/474 44 147/371 40 1.42 1.02–1.98 1.29 0.99–1.68 1.25 0.91–1.71 1.21 0.87–1.66 0.87 0.56–1.36 0.94 0.72–1.24
Better perception of household economic well-being 186/361 52 347/474 73 277/371 75 1.43 0.87–2.42 1.40 0.86–2.28 1.48 0.80–2.75 1.43 0.75–2.71 1.03 0.78–1.36 1.03 0.75–1.42
Has not had to beg in past month 120/362 33 346/480 72 201/387 52 2.31 1.29–4.14 2.22 1.32–3.73 1.45 0.56–3.73 1.36 0.47–3.94 0.67 0.25–1.80 0.66 0.24–1.81
Empowerment
Individual level
Greater self-confidence 227/358 63 235/480 49 278/383 73 0.76 0.71–0.82 0.76 0.71–0.82 1.16 0.83–1.61 1.12 0.82–1.53 1.49 1.05–2.13 1.44 1.00–2.06
Greater financial confidence 140/360 39 219/480 46 278/386 72 1.50 0.32–7.07 1.48 0.33–6.55 2.26 0.43–1.91 2.13 0.42–10.82 1.51 0.84–2.68 1.44 0.77–2.69
Challenges gender norms 154/361 43 248/478 52 233/381 61 1.26 0.62–2.58 1.30 0.68–2.50 1.54 0.84–2.79 1.53 0.86–2.71 1.19 0.99–1.43 1.16 0.97–1.38
Household level
Supportive partner relationshipb 151/248 61 189/338 56 212/290 73 0.93 0.65–1.31 0.85 0.61–1.19 1.21 0.81–1.80 1.18 0.84–1.67 1.28 1.02–1.62 1.37 1.09–1.72
Autonomy in decision-makingb 55/149 37 84/220 38 105/184 57 1.21 0.39–3.75 1.35 0.42–4.30 1.70 0.72–4.01 1.67 0.92–3.03 1.41 0.66–3.02 1.27 0.62–2.59
Perceived contribution to householdb 56/146 38 148/206 72 121/185 65 1.89 1.36–2.63 0.92 0.84–1.02 1.70 1.12–2.58 1.73 1.19–2.53 0.88 0.59–1.30 1.84 1.35–2.51
Community level
Larger social network 134/363 37 267/480 56 275/386 71 1.57 0.74–3.32 1.37 0.67–2.77 1.95 1.00–3.80 1.81 0.92–3.56 1.29 0.85–1.96 1.38 0.94–2.01
Greater sense of community support 184/362 51 204/480 43 232/387 60 0.86 0.54–1.33 0.82 0.50–1.33 1.14 0.39–3.36 1.10 0.38–3.17 1.33 0.57–3.13 1.33 0.59–3.01
Greater solidarity in a crisis 179/363 49 253/479 53 306/387 79 1.12 0.56–2.23 1.12 0.59–2.12 1.68 0.83–3.39 1.60 0.81–3.13 1.49 1.20–1.85 1.43 1.11–1.83
Intimate partner violence
Attitudes condoning IPV 233/361 65 326/472 69 182/382 48 1.07 0.84–1.37 1.05 0.81–1.36 0.73 0.44–0.23 0.73 0.42–1.27 0.66 0.48–0.90 0.67 0.50–0.90
Past year experience of controlling behaviourb 101/242 42 158/337 47 95/282 34 1.12 0.74–1.70 1.18 0.77–1.80 0.78 0.34–1.82 0.84 0.38–1.87 0.68 0.35–1.33 0.69 0.35–1.36
Past year experience of physical and/or sexual IPVb 30/248 12 39/337 12 17/290 6 0.79 0.22–2.93 0.86 0.22–3.36 0.50 0.28–0.89 0.51 0.28–0.93 0.63 0.11–3.61 0.59 0.09–3.66
HIV-related risk behaviour
Household communication about sex and HIV 197/361 55 308/480 64 331/383 86 1.15 0.76–1.72 1.17 0.76–1.80 1.60 1.25–2.05 1.57 1.20–2.05 1.37 0.98–1.93 1.32 0.90–1.93
Participation in HIV march or rally 124/361 34 151/480 31 290/383 76 0.92 0.57–1.49 0.91 0.58–1.41 2.21 1.03–4.76 2.14 1.00–4.54 2.37 1.32–4.25 2.32 1.33–4.03
Condom use at last sex with all non-spousal partnersc 10/45 22 17/52 33 23/51 45 1.74 0.37–8.21 1.17 0.32–4.29 2.41 0.77–7.54 1.83 0.94–3.57 1.41 0.97–2.04 1.41 0.97–2.04

aRR, adjusted risk ratio; IMAGE, Intervention with Microfinance for AIDS and Gender Equity; IPV, intimate partner violence; MF, microfinance; RR, risk ratio.
a aRRs adjusted for village triplet, age group, marital status, education, parity and sex of household head.
b Among currently partnered women (aRRs do not control for marital status).
c Among women aged < 35 years old reporting at least one non-spousal partner.