Microcredit and Health Services Experiment in Bangladesh

描述（申请人提供）：该项目是一个四单元析因实验，旨在测试单独和联合采用微额信贷和基本（保健）服务一揽子措施对赋予妇女权力的相对影响，64个联盟内的村庄小组的家庭经济福利和预防保健服务的使用情况（孟加拉国中部一个村庄以上的政治单位，由10-30个村庄组成）。将在4个地区对3 900个家庭进行基线和后续抽样调查（对贫困家庭进行过度抽样），这些家庭的已婚妇女人数大致相同，干预措施将在2.7个过渡年进行。这些干预措施将由伙伴机构-格莱珉银行、Gonoshastra Kendra和社会进步协会-实施，这些机构将扩大在孟加拉国中部的活动，并接受随机分配的地区。在每个选定的联盟中，一组没有此类计划的村庄将被随机分配到3个干预部门中的1个或控制部门（仅提供常规政府服务）。有关的主要结果变量是赋予妇女权力、家庭经济福利和利用具体保健和计划生育服务。计划进行的后续调查主要是在与基线相同的群组中进行，以便能够对相同的妇女进行访谈，从而进行纵向分析。还将对每个研究组中的一部分新聚类进行采样，以评估基线调查的潜在“测试”效应。要检验的假设包括：B）所有试验区的保健、计划生育和经济指标的改善程度都大于对照区; c）MC和ESP方案的合并或综合将对避孕药具的使用、保健利用、和儿童保健相比，那些简单的单独的方案加在一起。将使用按地区比较前后指标的简单统计数据以及多层次统计模型来检验假设。此外，还将利用计量经济学方法，在调整自我选择的情况下，估计个人一级的干预效果。这项研究是约翰霍普金斯大学、摩根州立大学（一所历史悠久的黑人大学）和布朗大学、孟加拉国的伙伴关系组织以及一名具有妇女赋权专门知识的顾问的共同努力。

DESCRIPTION (provided by applicant): The project is a 4-celled factorial experiment designed to test the relative effects of separately and jointly introducing micro-credit (MC) and essential (health) services package (ESP) interventions on women's empowerment, economic well-being of the family and use of preventive health services in groups of villages within 64 unions (the political unit above a village and composed of 10-30 villages) in central Bangladesh. Baseline and follow-up surveys of samples of 3900 households (over-sampling of poor households) with about the same number of ever-married women will be interviewed in the 4 areas and the interventions will be carried out in the 2.7 interim years. The interventions will be implemented by partner agencies-Grameen Bank, Gonoshastra Kendra and Association for Social Advancement-which will expand activities in central Bangladesh and accept random assignment of areas. In each selected union, a cluster of villages without such programs will be randomly allocated to 1 of the 3 intervention arms or a control arm (with usual government services only). The main outcome variables of interest are women's empowerment, economic well-being of the family and use of specific health and family planning services. The follow-up survey is planned to be mostly in the same clusters as the baseline so the same women can be interviewed, allowing longitudinal analyses. A fraction of new clusters in each study arm will be sampled as well to permit assessment of a potential "testing" effect of the baseline survey. Hypotheses to test include: a) Improvement in empowerment indicators will be greater in experimental areas with MC than in areas without MC; b) The improvement in health, family planning and economic indicators will be greater in all experimental areas than in the control area; c) The combined or integrated MC and ESP programs will have greater effects on contraceptive use, health care utilization, and child health care than those of the simple addition of the separate programs. Simple statistics comparing before-after indicators by area as well as multi-level statistical models will be used to test the hypotheses. In addition, econometric methods will be utilized to estimate intervention effects at the individual level adjusting for self-selection. This research represents a joint effort of investigators at Johns Hopkins University Morgan State University (a historically black university), and Brown University, the partnership organizations in Bangladesh, and a consultant with expertise in women's empowerment.