Microcredit and Health Services Experiment in Bangladesh

说明（由申请人提供）：该项目是一项四单元析因实验，旨在测试单独和联合引入小额信贷和基本（保健）服务一揽子干预措施对孟加拉国中部64个联盟（一个村庄以上的政治单位，由10-30个村庄组成）内的村庄小组赋予妇女权力、家庭经济福利和使用预防性保健服务的相对影响。将在这4个地区对3900个家庭（贫困家庭的过度抽样）的样本进行基线和后续调查，这些家庭的已婚妇女人数大致相同，并将在中间的2.7年中进行干预。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，它们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，一组没有此类项目的村庄将被随机分配到三个干预部门中的一个或一个控制部门（只提供通常的政府服务）。关心的主要结果变量是赋予妇女权力、家庭经济福利和使用具体保健和计划生育服务。后续调查计划主要在与基线相同的集群中进行，因此可以采访相同的女性，进行纵向分析。每个研究部门的新集群的一小部分也将被抽样，以便评估基线调查的潜在“测试”效果。需要检验的假设包括：a)在有MC的试验区，赋权指标的改善将比没有MC的试验区更大；b)所有试验区在保健、计划生育和经济指标方面的改善将大于控制区；c)结合或综合MC和ESP项目对避孕药具使用、卫生保健利用和儿童卫生保健的影响大于单独增加的项目。将采用简单的统计数据，按区域比较前后指标，以及多层次的统计模型来检验假设。此外，计量经济学方法将用于估计干预效果在个人水平调整自我选择。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）和布朗大学的调查人员、孟加拉国的合作组织以及一位具有妇女赋权专业知识的顾问共同努力的结果。

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.