Morrison Joanna, Thapa Rita, Sen Aman, Neupane Rishi, Borghi Jo, Tumbahangphe Kirti Man, Osrin David, Manandhar Dharma, Costello Anthony
Centre for International Health and Development, Institute of Child Health, University College London, UK.
Mother and Infant Research Activities (MIRA), Kathmandu, Nepal.
Community Dev J. 2010 Jan;45(1):75-89. doi: 10.1093/cdj/bsn029. Epub 2008 Aug 21.
Maternal and neonatal mortality rates are highest in the poorest countries, and financial barriers impede access to health care. Community loan funds can increase access to cash in rural areas, thereby reducing delays in care seeking. As part of a participatory intervention in rural Nepal, community women's groups initiated and managed local funds. We explore the factors affecting utilization and management of these funds and the role of the funds in the success of the women's group intervention. We conducted a qualitative study using focus group discussions, group interviews and unstructured observations. Funds may increase access to care for members of trusted 'insider' families adjudged as able to repay loans. Sustainability and sufficiency of funds was a concern but funds increased women's independence and enabled timely care seeking. Conversely, the perceived necessity to contribute may have deterred poorer women. While funds were integral to group success and increased women's autonomy, they may not be the most effective way of supporting the poorest, as the risk pool is too small to allow for repayment default.
孕产妇和新生儿死亡率在最贫困国家最高，经济障碍阻碍了人们获得医疗保健。社区贷款基金可以增加农村地区的现金获取，从而减少寻求医疗服务的延误。作为尼泊尔农村参与式干预的一部分，社区妇女团体发起并管理当地基金。我们探讨了影响这些基金使用和管理的因素以及基金在妇女团体干预成功中的作用。我们通过焦点小组讨论、小组访谈和非结构化观察进行了一项定性研究。基金可能会增加被判定有能力偿还贷款的受信任“内部”家庭成员获得医疗服务的机会。基金的可持续性和充足性令人担忧，但基金增强了妇女的独立性并使她们能够及时寻求医疗服务。相反，认为需要缴款可能会使较贫困的妇女望而却步。虽然基金是团体成功的不可或缺的一部分并增强了妇女的自主权，但它们可能不是支持最贫困者的最有效方式，因为风险池太小，无法承受还款违约。
