PARTICIPATION IN MICRO-FINANCE PROGRAMS AND WOMEN’S MENTAL HEALTH AND WELL-BEING IN KARACHI, PAKISTAN: AN INTERPRETIVE DESCRIPTION

Abstract

Background. In striving to achieve the UN Millennium Development Goals, Pakistan pledged to focus on eradicating extreme poverty for its population. The association between socio-economic status and health is well established. Micro-finance institutions provide access to credit for poor women where cultural and social constraints limit their opportunities for economic advancement. While involvement in a micro-finance program has been shown to reduce poverty, little is known about how this involvement impacts women’s mental health. Objective. The purpose of this qualitative study was; (a) to gain an understanding of how women conceptualize the meaning of their mental health; (b) to explore the impact of women participation in micro-finance programs on their mental health; (c) to determine how they promote their mental health; and (d) to obtain their recommendations for change to micro-finance institutions. Methods. Using interpretive description methodology, data were collected and analyzed through interviews with 32 urban-dwelling women who have been micro-finance loan recipients for a period of 1 to 5 years. A total of six micro-finance administrative personnel were also interviewed; five institutional documents were reviewed. Data were analyzed in the source language Urdu, following three main phases of content analysis methods, preparation, organization and reporting. Results. Women conceptualize mental health as being the presence of peace and the absence of tension. Participants relate this tension to absence of basic resources in their day-to-day living and lack of safety and security around the city. Women recognized micro-finance programs as being a major inspiration towards their flourishing mental health. Regular practice of religion, being resilient towards adversity and securing family respect through a consistent source of income and repayment of the loans were identified approaches to promoting mental health. In enhancing micro-finance programs further, the women recommended for them to initiate vocational training institutions and to provide opportunities for their children to seek education at affordable cost. Conclusion. The women participants of this study represented “everyday women” of Pakistan, who thrive through their resilience and courage to mitigate poverty and to achieve peace. Combating obstacles to meet the basic needs, including access to education, would be a useful first step towards mental health promotion for Pakistani women. Financial services of micro-finance, along with provision of vocational skills training, “women-to-women” approach and modifications in policy would assist women to utilize their loan productively. Multiple stakeholders should work collaboratively for the promotion of mental health determinants. As nurses are now moving beyond the traditional roles and counteracting complex issues, this study identifies implications for research, education, and practice.