Gender Transformative Approaches to Financial Health: A Systematic Review of Interventions in Resource Constrained Settings

Background and Purpose: Financial health is critical for improving the livelihoods and well-being of the most vulnerable. Currently, many vulnerable families are more likely to be excluded from mainstream financial products and services (e.g., emergency savings and credit) and are susceptible to financial fraud and catastrophic borrowing. Gender transformative approaches (GTAs) are emerging as powerful tools to address the structural barriers in social and economic systems and promote financial health for all. This systematic review explores the effectiveness of interventions applying GTAs to promote financial health.

Methods: We systematically searched nine databases: Academic Search Premier (EBSCOhost), AgEcon, Business Source Premier (EBSCOhost), EconLit (EBSCOhost), ECONSTOR, Global Health (EBSCOhost), Global Index Medicus, PubMed, and Scopus from inception date to March 2, 2023. We included peer-reviewed articles on economic empowerment interventions if they: 1) quantitatively evaluated the effectiveness of evaluating financial health-related interventions that apply GTA or evaluated GTA interventions that promoted financial health, 2) included women and girls. Data extracted from eligible studies included study characteristics (i.e., country, region, study design, and study objectives), characteristics of the intervention's target population and setting (e.g., sample description, sex distribution, description, and location), intervention characteristics (e.g., intervention name, components of financial health or GTA, randomization, study arms/conditions), intervention measures and effectiveness. We used the Methodological Quality Rating Scale (MQRS) to establish the level of rigor of the studies (high and low)—ranging from 0 to 23.

Results: Of the 19 studies included, most (n=9) were conducted in sub-Saharan Africa and Asia (n=9), and only one study from North America (i.e., Mexico). For the methodological quality, more than half of the studies (n=11) scored equal to or above the median (high rigor), while seven scored below the median (medium rigor). Notable methodological strengths of the studies include the use of RCTs (the gold standard of intervention research) as study designs (n=8), a more extended follow-up period <12 months (n=12), discussing the validity and reliability of measures (n=14), conducting parallel intervention replications across region/provinces (n=11). Financial health interventions were delivered at the household level (n=13), and provided multiple components, including cash transfers (n=3), business-related cash injection or microcredit (n=5), savings accounts (n=5), financial literacy training (n=6), business training and mentorship (n=9), and micro-insurance (n=4). Across interventions, gender transformative-specific components, include gender awareness and gender-based violence training, affordable daycare, and nutritional or livelihood support. Financial health was measured using women's asset accumulation, bargaining power and budget allocation at the household level, household income, and access to financial services, including savings account ownership and micro-credit. Overall, most interventions effectively improved at least one of the financial health outcomes measured (n=17).

Conclusions and Implications: The findings underscore the significance of gender transformative approaches in promoting financial health in resource-constrained settings. By challenging traditional gender roles and empowering individuals economically and socially, these interventions have the potential to equitable financial health. Social workers can leverage these insights to design and implement gender-specific, and culturally sensitive financial guidance services (e.g., education, coaching, and counseling) to address the multifaceted barriers to financial health.