From the 4,196 non-elderly adult, non-Paniya women identified in the Panchayat, we included 2,364 women who responded to the women's well-being module. We then limited the population to women from households below the poverty line, yielding a sample size of 928 women.
There are 336 women who did not participate in a SHG, of which 100 women are from households already containing a SHG participant. The main reason reported for non-participation was financial barriers (over 50%), confirming the need to control for socioeconomic characteristics in our analyses. Three percent of households reported ill-health as a reason for non-participation. Sensitivity analysis showed that including women from these households did not affect our results; therefore, these women were retained in the analysis.
SHG participation and loans
Over half of the women are members of a SHG (150 early joiners and 442 late joiners). Almost 75% of members had received at least one loan (91% of early joiners and 67% of late joiners). In addition to productive activities, 42% of women who had ever received a loan reported health consumption purposes.
SHG participation and socioeconomic and demographic characteristics (S1)
Women are less likely to be a SHG member if they are in the youngest or oldest age category and had less than a high school education (Table ). There are no significant associations between SHG participation and employment status, household landholdings, or caste.
Demographic and socioeconomic characteristics of women, by SHG participation (percentages)
The results of the models of SHG participation are presented in Table . Having no education is associated with a lower odds of being an early or a late joiner, compared to non-participants (reference group). The odds ratio is lower for early joiners than it is for late joiners, suggesting a gradient between education and SHG duration. Having a primary education is associated with a lower odds of being an early joiner compared to non-participants. Women belonging to the middle age category (31 to 44 years) have a higher odds of being an early or late joiner than younger women (under 30 years). These results indicate that education and age are influencing women's self selection into a SHG and confirms the need to control for these characteristics in our analyses.
SHG participation, by characteristics. Multinomial logistic regression: odds ratios with 95% confidence intervals, using non-member as reference groupa
SHG participation and health determinants (A1)
The results of the models of exclusion to health care, exposure to health risks, and male decision-making are shown in Tables , , .
Models for exclusion to health care. Binomial logistic regression: odds ratios with 95% confidence intervals and goodness of fit statisticsa
Models for exposure to health risks. Binomial logistic regression: odds ratios with 95% confidence intervals and goodness of fit statisticsa
Models for limited decision-making agency. Binomial logistic regression: odds ratios with 95% confidence intervals and goodness of fit statisticsa
Thirty-five percent of women come from households reporting at least one episode of exclusion to health care. The odds ratios in Model 0 suggest that SHG participation is associated with lower rates of exclusion: compared to the reference group, which in this case is non-participants living in a household without a SHG member, the odds of facing exclusion is significantly lower among early joiners (OR = 0.56, CI = 0.36–0.86), late joiners (OR = 0.57, CI = 0.41–0.79), and non-participants who live in a household with a SHG member (OR = 0.58, CI = 0.35–0.94). Belonging to a household with small landholdings (i.e. less than 50 cents of land) and having OBC affiliations is associated with exclusion (Model 1). Notably, there were no statistically significant differences between forward caste and SC/ST women – who rank the lowest on the caste hierarchy. This finding may be attributed to the poorest tribal group (the Paniyas) not being included in the sample. Model 2 shows that after adjusting for women's characteristics, SHG participation is a significant factor for exclusion to care (deviance = (24.2 (3)). The odds ratios are similar to the estimates of Model 0: the odds of facing exclusion is significantly lower among early joiners (OR = 0.58, CI = 0.41–0.80), late joiners (OR = 0.60, CI = 0.39–0.94), and non-participants who live in a household with a SHG member (OR = 0.53, CI = 0.32–0.90) (M2).
Perceived exposure to health risks was reported by 22% of the women. Exposure to health risks is not significantly associated with any women's characteristic (Model 1) or SHG participation (Model 0 and Model 2).
Globally, there appears to be a high level of decision-making agency, only 12% of women reported male decision-making. As an independent predictor, SHG participation was not significantly associated with decision-making (Model 0). There is a lower odds of reporting male decision-making if a woman is engaged in paid employment (Model 1). Models One and Two are significantly different (deviance = 10.4(2)). After adjusting for women's characteristics, we found a lower odds of reporting male decision-making if women are late joiners (OR = 0.62, CI = 0.39–0.97), but contrary to our expectations, we found no significant associations between decision-making and being an early joiner (Model Two).
SHG participation and health achievements (A2)
This section presents the results of the binomial logistic regressions for A2 for each of the four health achievements (self perceived health, limitations in ADLs, emotional stress, life satisfaction).
Results for models of self assessed health are presented in Tables and . Thirty-five percent of women reported bad health. We found no associations between self perceived health and SHG participation (Model 0). There are significantly greater odds of reporting bad health if a woman is not engaged in paid employment and comes from a household with small landholdings (Model 1). Even after adjusting for women's characteristics, SHG participation is not associated with perceived health (Model 2). As a block, the determinants of health significantly contribute to the model (deviance = 366.0(3)). There are robust associations between bad health and all three health determinants (Model Three). A woman has a significantly greater odds of reporting bad health if she faces exclusion to health care, is exposed to health risks, and reported male decision-making. Limitations in ADLs were reported by 41% of women. The logistic regression results for limitations in ADLs are comparable to those for bad health.
Models for self perceived health. Binomial logistic regression: odds ratios with 95% confidence intervals and goodness of fit statisticsa
Models for Limits in Activities in Daily Living (ADL). Binomial logistic regression: odds ratios with 95% confidence intervals and goodness of fit statisticsa
Table and shows the results for the markers of mental health. Eighty-eight percent of women reported emotional stress. SHG participation as a sole independent variable was not found to be associated with emotional stress (Model 0). There is a significantly greater odds of reporting emotional stress if a woman is engaged in paid employment and if she comes from a household with small landholdings (Model One). After controlling for women's characteristics, SHG participation significantly improves the model for emotional stress (deviance = 18.6(2)). Inspection of the odds ratios highlight a striking result: although we find no associations between emotional stress and being a late joiner, the odds of reporting emotional stress is significantly lower for early joiners compared to non-participants (OR = 0.52, CI = 0.30–0.93) (Model Two). The determinants of health significantly improve the model (deviance = 55.8 (3)).
Models for disturbances in mental peace. Binomial logistic regression: odds ratios with 95% confidence intervals and goodness of fit statisticsa
Models for life satisfaction. Binomial logistic regression: odds ratios with 95% confidence intervals and goodness of fit statisticsa
Emotional stress is positively associated with exclusion to health (Model 3). The odds of reporting emotional stress is lower if women reported male decision-making (Model 3). After entering the health determinants in the model, the odds ratios for SHG participation remained constant. This indicates that exclusion to health care and decision-making agency are not mediators between SHG participation and emotional stress, but that other explanatory factors, not included in our models, link participation and emotional stress.
Eleven percent of women reported being unsatisfied in life. Interestingly, the odds of being unsatisfied is significantly lower for early joiners (OR = 0.34, CI = 0.16–0.73), but not for late joiners (Model 0). There are no statistically significant associations between life satisfaction and women's characteristics (Model 1). Adding SHG participation to the model after controlling for women's characteristics, significantly improves the model (Model 2) and we find a similar pattern of odds ratios found in Model 0, early joiners are less likely to report being unsatisfied than non-members (OR = 0.32, CI = 0.14–0.71). There are no associations between any of the health determinants and life satisfaction (Model 3).