Aims Globally, poverty is the single most important cause of ill health. Microfinance initiatives (MFI), involving small loans, can alleviate poverty and may impact on children’s health. However, methodology of existing studies is often weak and systematic reviews report conflicting findings. Rojiroti is an innovative MFI that functions through self-help groups of village women and supports community development at a low cost.
Methods We undertook a cluster randomised controlled trial (RCT) following consent from self-help groups in 56 villages to determine if the Rojiroti MFI can improve nutritional indices in children under-five-years old. Basic demographic and anthropometric data were collected at baseline and 18 months after Rojiroti implementation in the intervention arm. Z-scores were calculated (ENA and WHO AnthroPlus tools). The primary outcome was weight for height z-score (WHZ). Secondary outcomes were weight for age z-score (WAZ), height for age z-score (HAZ), and mean mid-upper arm circumference (MUAC).
Results Data were collected from 2469 children born to 1560 mothers at baseline and 2534 children born to 1446 mothers at follow-up. There were no significant differences between groups in village and maternal characteristics at baseline. There was no difference in the primary outcome, mean WHZ, at baseline between the two groups. After 18 months of intervention, the mean WHZ score of the under five-year-old children in the intervention tolas was significantly higher when compared with the mean WHZ of those in the control tolas. This difference was because while there was almost no change in the mean WHZ in the intervention tolas over the study period, in control tolas the mean WHZ worsened. At follow up, the mean WAZ and MUAC, and the prevalence of wasting, underweight, and at least moderate malnutrition were also significantly better in the intervention tolas as compared with the control tolas. (See Table).
Conclusion Rojiroti microfinance low cost, focussed on women and led by peers among socio-economically deprived populations can have clinically important impacts on child nutrition.
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