Microfinance for malaria control and social determinants of health

An anonymous emailer (many thanks) wrote to me to share news about a successful  microfinance program which improved malaria education. I was impressed with their work, and their efforts at rigorous evaluation.

Something bugged me though – the juxtaposition of microfinance and malaria appeared unnatural. Making microfinance available is a worthwhile initiative, but why do it in the name of malaria? We can advance microfinance for its own sake – because it gives opportunity and income to those who want it. That is reason enough. Will it benefit malaria control? Absolutely. Communities with economic means will be healthier, in all aspects, relative to those without.

Understanding the connection between social determinants and health is critical to public health. However, this need to link worthwhile broad social programs (education, microfinance, women’s empowerment, etc) with narrow health outcomes strikes me as folly. I understand why this is tempting – there is much more funding for the latter (first the AIDs pot, now malaria!). Resisting this pressure may be hard, saying No to money is a very high act of discipline, and  communities need resources now. But could the aggregate risk from many such instances, by many groups, be a real risk to a broader vision of social justice (even if somewhat intangible)?

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