Caroline Wainaina is a mid-level-career public health scientist with an interest in non-communicable diseases and improving healthcare systems. She has combined experience in laboratory research and community engagement, with expertise in qualitative research methodologies. She is currently a PhD fellow at the University Medical Center Utrecht (UMCU), focusing on maternal mental health. She works as a Research Officer, managing maternal and child health projects at the African Population and Health Research Center (APHRC) in Nairobi, Kenya. With a specific focus on maternal mental health, Caroline’s work is driven by a profound commitment to women’s empowerment and a belief in the transformative power of research. Beyond her professional pursuits, Caroline finds joy and rejuvenation in an array of hobbies and interests. An avid consumer of inspirational films, music, and motivational speeches, she also loves creative outlets like interior design and cooking, which provide an artistic balance to her analytical work.
The WEE-DiFine team interviewed Caroline to delve into her passion for research, her WEE-DiFine-supported project in Kenya, and more.
Q: What motivated you to explore the link between DFS and maternal mental well-being?
My interest in this work grew naturally from my background in maternal, newborn, and child health (MNCH). It began with a longitudinal study in rural Kenya evaluating the i-PUSH health insurance subsidy program, where I was struck by how access to mobile platforms gave women greater confidence and control over decisions about their health.
That insight encouraged my team and me to explore the intersection of digital financial services (DFS), women’s empowerment, and maternal mental health. This issue is especially close to my heart. While many women relied on family members for financial support, those using platforms like M-Tiba and M-Pesa often experienced greater independence and better access to care. Again and again, financial strain emerged as a major source of maternal stress.
Motivated by these experiences, we pursued the WEE-DiFine opportunity to understand better how financial inclusion can strengthen women’s well-being in low-resource settings.
Q: What is something that surprised you in your ongoing WEE-DiFine-supported study? (e.g., interesting early results)
As my team conducted this study in rural communities, several findings really surprised and intrigued us. First, we were struck by just how widespread the adoption of DFS has become, even in these remote areas. The digital revolution, with women relying heavily on DFS platforms like Fuliza [1] to access small loans and economic opportunities, was quite profound and unexpected.
We didn’t anticipate how integral services like mobile money borrowing had become to many of these women’s financial lives and livelihoods. On one hand, this new access to credit enabled some really positive impacts – increased participation in household decision-making, the ability to invest in small businesses, joining community groups, and a noticeable boost in confidence and reduced stress levels.
However, we also witnessed potential downsides and risks. Several women found themselves trapped in cycles of debt, continually taking out new loans just to repay previous ones with high fees and interest rates. There were also challenges around digital illiteracy, with some women lacking access to their own phones or the skills to use DFS independently, rendering them reliant on spouses or relatives in ways that sometimes led to lost funds.
So while the proliferation of digital finance presented new economic opportunities, it also exposed certain vulnerabilities, especially for the most marginalized women lacking resources and technological know-how. Seeing both the empowering and disempowering dynamics play out so vividly on the ground was really eye-opening. It underscored how critical it is to pair financial inclusion efforts with education, digital literacy training, and robust consumer protection measures.
Q: What challenges did you experience during your project? How did you overcome them?
One of the primary challenges we encountered during our project was the recruitment of eligible participants. We initially targeted women with children aged 12 months and below, but we faced difficulty meeting this criterion. As a solution, we broadened our inclusion criteria to encompass women with children aged below two years. Another challenge during the participant observations was the absenteeism of respondents for an extended period of time. It became impossible to complete the observation exercise, so we had to wait until the respondent returned to the study site. There was also the challenge of heavy rainfall, which affected the field team’s access to respondents’ homes. In such cases, the team rescheduled interviews and went to homes that were more accessible as they waited for the weather to improve. Additionally, we encountered a sensitive situation when one respondent experienced the loss of her newborn. This deeply impacted both the respondent and the team member who had been observing her. In response, we rescheduled the observation exercise until the respondent was emotionally ready to continue. To support the mental health of the field interviewers, I assessed them monthly through a mental health assessment tool. The women who needed psychological support were referred to the psychosocial counselor at the local public health facility.
Q: How did your team integrate the measurement of women’s economic empowerment into your study guides? (Please explain any innovative methods for readers who may be unfamiliar!)
We used the EMERGE website to access tools that have been used to measure women’s economic empowerment (WEE). We defined the initial themes or sections of the qualitative tool using the five levels of WEE measurement outlined in the Longew framework. This included welfare (access to basic needs), access (access to economic resources and opportunities), knowledge (conscientization on gender roles, gender norms), participation (women participating in decision-making at home and in the community), and control (women have equal control over resources).
Q: In a prior post, you describe how your team uses the “deep hanging out” method. In what ways can this methodology complement quantitative measures of women’s economic empowerment?
“Deep hanging out” is an ethnographic technique where researchers fully immerse themselves in the lives of the study population through participant observation. This method offers an unfiltered glimpse into the population’s daily realities and enables researchers to capture behavior change in real-time, validating insights from survey interviews. By combining this rich qualitative data with our quantitative measures, we aimed for a holistic understanding of how DFS impacts women’s economic empowerment.
Q: How has the WEE-DiFine initiative supported you in your work? (e.g., coaching)
The WEE-DiFine team has been supportive throughout the project. They have been available to offer support on any issues that arise, for example, when we had to change timelines. The team has also supported me in guiding the finalization of the project outputs.
Q: What impact do you aim to create with your research in the next five years? (e.g., at the community level and policy level.)
Over the next five years, I aim for my research to drive tangible impacts at both the community and policy levels. At the community level, the findings from this study are already informing the integration of women’s economic empowerment and DFS components into other projects. This expanded inclusion means more communities across Kenya will benefit from the insights and learnings gained through our work.
Moreover, I envision the outputs we’ve developed – a policy brief, scientific paper, and blog – contributing substantively to broader discussions on enhancing women’s financial inclusion and addressing gender inequalities. By providing evidence-based recommendations, I hope our research will influence policies and initiatives aimed at creating an enabling environment for women’s economic empowerment through digital finance and other avenues.
Q: Is there anything else you would like to share with WEE-DiFine’s readership?
The role of men in the successful empowerment of women. It is important to consider empowerment programs for men that focus on how they can best support women’s empowerment in their communities.
The World Health Organization defines mental health as a “state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can make a contribution to his or her community. The mental well-being of women is critical to successful empowerment and productivity and, therefore, should be included in interventions aimed at empowering women.
[1] Fuliza is an overdraft facility launched by Safaricom in 2019 that allows M-Pesa users in Kenya to complete transactions even when they don’t have enough money in their M-criterionPesa accounts, with overdraft fees applying.
