Saving Groups Plus: A review of the evidence

1. Savings Groups Plus
A R E V I E W O F T H E E V I D E N C E
CORE Group Conference | May 15, 2016

2. Savings Groups Plus
A R E V I E W O F T H E E V I D E N C E
Jennine Carmichael, FHI 360 | jcarmichael@fhi360.org
This information was produced under United States Agency for International
Development (USAID) Cooperative Agreement No. AID-OAA-LA-13-00001.
The contents are the responsibility of FHI 360 and do not necessarily reflect
the views of USAID or the United States Government

3. Search Parameters
• Savings-led microfinance paired with any sort
of cross-sectoral development initiative
– Excluded additional financial interventions
– Included all forms of “plus” integration modes
• Inclusive of all types of SG
• Published and unpublished documents
• In English
• 1996 to 2014

4. Evidence Base
• Initial pool: 2,000
docs
• Abstract screening:
928
• Full text evaluation:
71
• Evaluation of program
effectiveness or impact
• Comparison group
• Reviewed for
evidence: 10
Level I Randomized controlled trial
(RCT).
Level II-1 Controlled trial without
randomization.
Level II-2 Cohort or case-control
analytic studies, preferably
from more than one center or
research group.
Level II-3 Multiple time series and
dramatic results in
uncontrolled experiments.
Level III Expert opinion
Quality of Evidence Rating System

5. Overall Findings
• Current evidence base is
not overwhelmingly strong
• Limited in size
• Mixed outcomes
• Multiple delivery methods
in use
• Evidence for impact
varies by type of “plus”
• Promising preliminary
findings in some areas
Delivery Description
Linked 2 or more institutions
Parallel
Distinct staff in the
same institution provide
different services
Unified
All services provided by
the same staff of the
same institution.

6. The Plus Activities
• Health
– Malaria education and prevention
– Maternal, newborn and child health services
• Food security
• Social capital
– Rotating shared labor scheme
• Gender
– Gender dialogues to reduce IPV
– Women’s empowerment
– Male engagement and gender equity
• Child wellbeing
– OVC care and support
– Parenting curriculum

7. Outcomes
Health
(4 studies)
Positive: Health education and demand creation
Promising: Behavior change (mixed, but more positive)
Food Security &
Nutrition (4 studies)
Majority positive, with some nuance such as children’s
dietary diversity not improving significantly.
Child Protection and
Well-being
(4 studies)
Mixed findings, majority no impact. Education in particular
saw little significant impact. Only one negative impact, on
spending on child health (no context to explain).
Gender
Equality/Women’s
Empowerment
(3 studies)
Positive impacts on most outcomes, no negative impacts
observed, mixed impacts on intimate partner violence (1
study found no impacts, 1 found mixed positive/no impact, 1
found positive impacts)
Economic
(most studies)
Majority positive, but mixed findings (positive/no impact) on
assets and investments
Cost-effectiveness
(2 studies)
1 found no impact, so could only assess cost of
implementation (low). 1 study assessed return on
investment, found modest impacts at low cost.

8. Highlight: MNCH Demand Creation
• Chitral Child Survival Program, five-year USAID-funded Aga Khan
Foundation project in Chitral Province, Pakistan
– Community Midwives (CMWs)
– Community Based Savings Groups (CBSGs)
• Research hypothesis
– Is membership in CBSGs by women and their family members associated
with greater utilisation of MNCH services provided by skilled providers
particularly CMWs?
• Findings:
– Increased knowledge of MNCH services and CMWs
– Increased use of health services for birth
– Greater empowerment and involvement in selecting maternal health
provision
– Little change in how participants funded MNCH services
• CBSGs “couldn't provide sufficient funding [for MNCH] but managed to
sensitise the families to mobilise resources” and facilitated women’s
decision-making and health-seeking behaviors (Noorani et al 2013).

9. Conclusions
• Limited in the conclusions we can draw
• More rigorous research is needed
• SG+ outcomes in ES and food security
consistent with SG-only findings
• Health education and health services demand
creation appear to work well with SG
• Evidence for SG+ behavior change and
changing social norms is promising

10. Recommendations
• More rigorous study design in SG+
– RCT and quasi-experimental designs
• More robust measurement tools and longer study
time periods
– Standardized indicators for “plus” interventions
– Longitudinal designs
• Theories of change and factorial research
• Implementation and cost research
– Little evidence on cost-effectiveness and cost-benefit
– Lacking evidence on effectiveness of integration
methods