Nanda P
Center for Health and Gender Equity, Takoma Park, MD 20912, USA.
Health Econ. 1999 Aug;8(5):415-28. doi: 10.1002/(sici)1099-1050(199908)8:5<415::aid-hec450>3.0.co;2-l.
Within the overall aim of poverty alleviation, development efforts have included credit and self-employment programmes. In Bangladesh, the major beneficiaries of such group-based credit programmes are rural women who use the loans to initiate small informal income-generating activities. This paper explores the benefits of women's participation in credit programmes on their own health seeking. Using data from a sample of 1798 households from rural Bangladesh, conducted in 1991-1992 through repeated random sampling of 87 districts covered by Grameen Bank, Bangladesh Rural Advancement Committee (BRAC) and Bangladesh Rural Development Board (BRDB), this paper addresses the question: does women's participation in credit programmes significantly affect their use of formal health care? A non-unitary household preference model is suggested to test the hypothesis that women's empowerment through participation in these programmes results in greater control of resources for their own demand for formal health care. The analysis controls for endogeneity due to self-selection and other unobserved village level factors through the use of a weighted two stage instrumental variable approach with village level fixed effects. The findings indicate a positive impact of women's participation in credit programmes on their demand for formal health care. The policy simulations on the results of this study highlight the importance of credit programmes as a health intervention in addition to being a mechanism for women's economic empowerment.
在扶贫的总体目标范围内，发展努力包括信贷和自营职业项目。在孟加拉国，这类基于群体的信贷项目的主要受益者是农村妇女，她们利用贷款开展小型非正规创收活动。本文探讨了妇女参与信贷项目对其自身寻求医疗保健行为的益处。利用1991 - 1992年对孟加拉国农村1798户家庭抽样的数据，这些数据是通过对格莱珉银行、孟加拉国农村进步委员会（BRAC）和孟加拉国农村发展委员会（BRDB）覆盖的87个地区进行重复随机抽样获得的，本文探讨了以下问题：妇女参与信贷项目是否会显著影响她们对正规医疗保健的利用？本文提出了一个非单一家庭偏好模型，以检验通过参与这些项目增强妇女权能会导致她们对自身正规医疗保健需求的资源控制能力增强这一假设。分析通过使用具有村庄层面固定效应的加权两阶段工具变量方法，控制了由于自我选择和其他未观察到的村庄层面因素导致的内生性。研究结果表明，妇女参与信贷项目对她们对正规医疗保健的需求有积极影响。基于本研究结果的政策模拟突出了信贷项目作为一种健康干预措施的重要性，此外它还是增强妇女经济权能的一种机制。
