Microfinance and Peer Health Leadership InterventionImplementation for Men in Dar es Salaam Tanzania: A QualitativeAssessment of Perceived Economic and Health Outcomes

摘要

Men in sub-Saharan Africa continue to experience health disparities thatare exacerbated by low employment. This study qualitatively assessedmen’s perceptions of the economic and health-care-seeking effects ofparticipation in an integrated microfinance and peer health leadershipintervention on violence and HIV risk reduction in Tanzania. Threefocus group discussions with 27 men, aged 20 to 44 years, examined theperceived effects on income generation, employability, mental health,and uptake of HIV and related health services. All discussions wererecorded, transcribed, and analyzed using deductive and inductivecoding methods. Men reported that the benefits of the interventionincluded increased employability and income-earning activities due togreater access to entrepreneurial training, low-interestmicrofinancing, and male-oriented group supports to start orstrengthen their businesses. Increased wages through business or otherforms of employment were also attributed to men’s lower anxiety anddistress as financial providers for their families. However, menindicated that apart from the uptake of free HIV testing services,there was limited change in overall health-care-seeking behavior giventhe high clinic fees and lost time to earn income when attendingroutine health visits. Men recommended that future microfinance andhealth promotion interventions provide larger loan amounts, lessfrequent repayment intervals, and access to health and socialinsurance. Microfinance and peer health leadership interventions mayhelp to address economic and health disparities in poor, urban men.Efforts are needed to assist lower income men in accessing financialtools as well as fee-based preventive and health-care services.