Studies

Digital Financial Services, Women’s Economic Empowerment, and Maternal Mental Wellbeing: An Ethnographic Study in Rural Kenya

Motivation

While more than one-third of the Kenyan population earns just 1.9 USD per day, women disproportionately experience poverty due to unequal access to labor and lack of economic control in their households. Previous studies suggest an increase in access to digital financial services (DFS) can lead to economic growth, poverty reduction, wellbeing of households, and an increase in women’s economic empowerment (WEE).

Objective

This study will employ a qualitative, ethnographic approach to examine the causal connection between access to and the use of DFS on economic empowerment and maternal mental wellbeing in Kakamega, Kenya. This study builds on a randomized control trial (RCT) investigating a mobile phone-based health insurance scheme in western Kenya known as the i-PUSH program. i-PUSH offers women the opportunity to set aside money in a commitment savings device on their mobile phones. The women are required to register their mobile number in their name to be able to transfer funds into their wallet through M-PESA or to obtain funds from their spouses, relatives, or the i-PUSH program. Funds are ‘reserved’ for payments at connected health providers or for payment of the health insurance co-premium. The savings calendar is added to the program to enhance further savings. In order to examine women’s mental wellbeing, repetitive screenings are given to the women to test their perinatal depression and self-efficacy. Participant observations involve “deep hanging out” with participants in order to observe their interaction with DFS. Furthermore, perceptions of women’s empowerment will be linked to the Edinburgh Postnatal Depression Scale (EPDS) scores to unpack the relationship between DFS, WEE, and maternal mental health.

Proposed impact

The intervention of the i-PUSH program expects to increase savings for health-related expenses as well as the uptake and renewal of health insurance among the target population. The funds transferred into the wallet are kept safe and secure until they are needed for health-related purposes. In addition, the improved knowledge on health and health financing of women through the program is expected to translate into improved health behaviors and attitudes towards enrollment in insurance and saving for health and insurance. The study hypothesizes that women who have better mental wellbeing will be more empowered and further increase their use of the digital financial platform to save for healthcare. Moreover, by layering on this rich qualitative data collection, a better understanding of the motivations to save and use the i-PUSH program will be obtained.  


Overview

Associated Institute: The African Population and Health Research Centre (APHRC)

Associated Investigators: Caroline Wainaina, APHRC and Utrecht University; Estelle Sidze, APHRC; Amanuel Abajobir, APHRC; Emmy Igonya, APHRC; Wendy Janssen, Vrije Universiteit Amsterdam; Amsterdam Institute for Global Health and Development (AIGHD)

Country: Kenya

Implementation Partners: The Amsterdam Institute for Global Health and Development (AIGHD); the African Population and Health Research Center (APHRC); PharmAccess Foundation; Amref Health Africa

WEE-DiFine thematic areas: access to finance; access to digital non-financial services; behavioral influence

Up