Affiliation:
1. Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
2. Harvard Medical School, Boston, Massachusetts
3. Cambridge Health Alliance, Cambridge, Massachusetts
4. Department of Counselling, Developmental and Educational Psychology, Boston College, Chestnut Hill, Massachusetts
Abstract
ImportanceAn estimated 27% of ever-partnered women aged 15 to 49 years have experienced intimate partner violence (IPV) in their lifetimes, which has been associated with a wide range of both acute and chronic illness. Poverty is thought to be a major driver of IPV, and economic empowerment programs may reduce violence.ObjectiveTo evaluate whether microfinance interventions are associated with reductions in various forms of IPV.Data SourcesOn August 3, 2022, PubMed, CINAHL, Embase, Web of Science, EconLit, and 5 global health databases were searched from inception.Study SelectionIncluded studies were randomized clinical trials evaluating the effect of microfinance interventions vs control on exposure to IPV. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline.Data Extraction and SynthesisAuthors independently assessed study eligibility, extracted prespecified data, and evaluated risk of bias using the Cochrane Risk of Bias tool.Main Outcomes and MeasuresOutcome measures of interest were exposure to overall IPV and 4 World Health Organization–designated IPV domains: physical, psychological and emotional, sexual, and controlling behaviors. Univariate meta-analyses using a random effects model were used to calculate the standardized mean differences (SMDs) and 95% CIs for each IPV outcome. The Grading of Recommendations Assessment, Development, and Evaluation method was used to rate the certainty of findings.ResultsOverall, 10 randomized clinical trials met inclusion criteria, with a total of 16 136 participants, of whom 98% identified as women, with a mean age of 28.9 years. Compared with no intervention, participation in microfinance was associated with lower rates of psychological and emotional violence (SMD, 0.87; 95% CI, 0.80-0.95; I2 = 46%; high certainty), sexual violence (SMD, 0.76; 95% CI, 0.63-0.90; I2 = 44%; low certainty), and controlling behaviors (SMD, 0.82; 95% CI, 0.74-0.92; I2 = 54%; high certainty). There was no significant association with physical violence (SMD, 0.89; 95% CI, 0.76-1.04; very-low certainty).Conclusions and RelevanceThis systematic review and meta-analysis of microfinance interventions found a reduction in exposure to psychological and emotional IPV as well as controlling behaviors among participants receiving microfinance interventions, with high certainty evidence. Further work is needed to evaluate which types of microfinance interventions are most effective at reducing the various forms of IPV.
Publisher
American Medical Association (AMA)
Reference53 articles.
1. Global, regional, and national prevalence estimates of physical or sexual, or both, intimate partner violence against women in 2018.;Sardinha;Lancet,2022
2. Medical and psychosocial diagnoses in women with a history of intimate partner violence.;Bonomi;Arch Intern Med,2009
3. Risk of cardiometabolic disease and all-cause mortality in female survivors of domestic abuse.;Chandan;J Am Heart Assoc,2020
4. The intersection of intimate partner violence and HIV: detection, disclosure, discussion, and implications for treatment adherence.;Sullivan;Top Antivir Med,2019
5. Health consequences of intimate partner violence.;Campbell;Lancet,2002