Evidence map›Paper›PMID 38781744›Full record

Trial reportSocial science & medicine (1982)2024

Economic outcomes among microfinance group members receiving community-based chronic disease care: Cluster randomized trial evidence from Kenya.

M Wilson-Barthes, J Steingrimsson, Y Lee, D N Tran, J Wachira, C Kafu, S D Pastakia, R Vedanthan, J A Said, B L Genberg and 1 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Social science & medicine (1982), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04417127 (Harambee), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04417127 nacompletednot on this map

Harambee: Integrated Community-based HIV/NCD Care & Microfinance Groups in Kenya

TypeinterventionalSponsorBrown UniversityRan2020 to 2023Enrolled1,200ConditionsHIV/AIDS, Noncommunicable Diseases, Hypertension, DiabetesArmsIntegrated Community-Based (ICB) Care, Group-level Microfinance
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

M Wilson-BarthesBrown University School of Public Health, International Health Institute, Providence, RI, USA. Electronic address: marta_wilson-barthes@brown.edu.
J SteingrimssonBrown University School of Public Health, Department of Biostatistics, Providence, RI, USA.
Y LeeBrown University School of Public Health, Department of Biostatistics, Providence, RI, USA.
D N TranTemple University, School of Pharmacy, Philadelphia, PA, USA.
J WachiraMoi University College of Health Sciences, School of Medicine, Department of Behavioral Science, Eldoret, Kenya.
C KafuAcademic Model Providing Access to Healthcare, Eldoret, Kenya.
S D PastakiaPurdue University College of Pharmacy, Center for Health Equity and Innovation, Indianapolis, IN, USA.
R VedanthanNew York University Grossman School of Medicine, Department of Population Health, New York, NY, USA.
J A SaidAcademic Model Providing Access to Healthcare, Eldoret, Kenya.
B L GenbergJohns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA.
O GalárragaBrown University School of Public Health, Department of Health Services, Policy and Practice; and International Institute, Providence, RI, USA.

Funding

Harambee: Integrated Community-Based HIV/NCD Care & Microfinance Groups in KenyaR01MH118075 · NIMH · BROWN UNIVERSITY · PI GALARRAGA, OMAR, GENBERG, BECKY LYNN · 2019 to 2023
$2.8M
NIMH NIH HHS R01 MH118075
6 · The paper itself

Abstract

backgroundPoverty can be a robust barrier to HIV care engagement. We assessed the extent to which delivering care for HIV, diabetes and hypertension within community-based microfinance groups increased savings and reduced loan defaults among microfinance members living with HIV.

methodsWe analyzed cluster randomized trial data ascertained during November 2020-May 2023 from 57 self-formed microfinance groups in western Kenya. Groups were randomized 1:1 to receive care for HIV and non-communicable diseases in the community during regular microfinance meetings (intervention) or at a health facility during routine appointments (standard care). Community and facility care provided clinical evaluations, medications, and point-of-care testing. The trial enrolled 900 microfinance members, with data collected quarterly for 18-months. We used a two-part model to estimate intervention effects on microfinance shares purchased, and a negative binomial regression model to estimate differences in loan default rates between trial arms. We estimated effects overall and by participant characteristics.

resultsParticipants' median age and distance from a health facility was 52 years and 5.6 km, respectively, and 50% reported earning less than $50 per month. The probability of saving any amount (>$0) through purchasing microfinance shares was 2.7 percentage points higher among microfinance group members receiving community vs. facility care. Community care recipients and facility care patients saved $44.90 and $25.24 over 18-months, respectively, and the additional amount saved by community care recipients was statistically significant (p = 0.036). Overall and in stratified analyses, loan defaults rates were not statistically significantly different between community and facility care patients.

conclusionsReceiving integrated care in the community was significantly associated with modest increases in savings. We did not find any significant association between community-delivered care and reductions in loan defaults among HIV-positive microfinance group members. Longer follow up examination and formal mediation analyses are warranted.

Indexed as

HIV InfectionsAdultChronic DiseaseCluster AnalysisCommunity Health ServicesFemaleHumansKenyaMaleMiddle AgedPovertyGroup medical visitsHIVMicrofinanceNon-communicable diseasesPovertySub-Saharan Africa

Identifiers

PMID38781744
PMCPMC11180555

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.