Women's empowerment and child health: exploring the impact of Rojiroti Microfinance in poor communities in Bihar, Northern India

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Every year, 2.2 million children die of malnutrition. Many more feel the effects of malnutrition on their health and intellect. Programmes to combat malnutrition include: distributing food directly; giving children micronutrients; giving nutritional advice; and protecting malnourished children through immunisation. Research by the World Health Organisation (WHO) has shown that these strategies can lead to better nourished children. However, these approaches may fail to reach those most in need (those living in extreme poverty). In very poor countries, where men are dominant, women are often prevented from making important family decisions and this may be linked to poor nutrition in their children.We are a group of community workers, economists, social scientists and doctors. Our partners are the Centre for Promoting Sustainable Livelihood (CPSL) - which is a non-governmental organisation in India; a UK charity (Rojiroti UK); the School of Sociology & Social Policy; and the School of Medicine (both at the University of Nottingham). Our team have experience of helping very poor people in rural areas of India to fight poverty. Our community workers encourage people in poor hamlets or "tolas" in Northern India to form self help groups (SHGs). Most SHGs are formed by women. They are asked to save a little money regularly, initially Rs2.5 (3 pence) per week. If they save regularly, their savings entitle them to a loan. These loans start small - Rs50 (50 pence). Women in the group can receive external loans (from CPSL) of Rs500 (£5) after 3 months and Rs3,000 (£30) after 6 months (if credit is good). Loans may be used for emergencies (eg medical expenses); to allow women access existing government support schemes (eg money to travel to subsidised food shops); or to invest in livestock or agricultural equipment. Using these loans helps women avoid local money lenders (who charge much higher interest) and avoid emergency sales of their property (at knock down prices). We call this programme Rojiroti (which translates as "daily bread"). We have recently completed a trial which tested whether Rojiroti improves children's health. This was a "cluster randomised trial" where 28 tolas (small village communities) were chosen at random to receive Rojiroti immediately and 28 to get the programme only after 18 months (control group). At the end of the first 18 months (before the control group started) we weighed and measured all the children under 5 in both sets of tolas. We found that the nutritional measures were better in the Rojiroti group. The effect was big enough to be important in practice and was unlikely to have arisen by chance. Overall 1326 mothers and 2064 children took part.We now want to understand how Rojiroti improved children's nutrition. We also want to know if the scheme helps empower women (improve their status in society and their freedom to make decisions). We have already collected economic data such as whether loans were emergency or general loans, the amount borrowed, the purpose of the loan, whether the loan was repaid. We will carefully check and collate these data. We will also conduct 20 in-depth interviews with women who took part in the Rojiroti trial and around 10 interviews with CPSL volunteers. These interviews will be conducted by an ethnographer (someone who studies different cultures) who will visit Bihar for one month. We will analyse these interviews carefully. The voices of the participants and volunteers, combined with the economic data will allow us to work out what are the essential features of Rojiroti which allow the scheme to benefit children. We will also see whether Rojiroti helps empower women. We hope this will allow others to use Rojiroti in other parts of the work where there is poverty and malnutrition and where women do not get to make important decisions about their lives.