http://orcid.org/0000-0001-6938-2068
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ABSTRACT
Background: Saving groups are increasingly being used to save in many developing countries. However, there is limited literature about how they can be exploited to improve maternal and newborn health.
Objectives: This paper describes saving practices, factors that encourage and constrain saving with saving groups, and lessons learnt while supporting communities to save through saving groups.
Methods: This qualitative study was done in three districts in Eastern Uganda. Saving groups were identified and provided with support to enhance members’ access to maternal and newborn health. Fifteen focus group discussions (FGDs) and 18 key informant interviews (KIIs) were conducted to elicit members’ views about saving practices. Document review was undertaken to identify key lessons for supporting saving groups. Qualitative data are presented thematically.
Results: Awareness of the importance of saving, safe custody of money saved, flexible saving arrangements and easy access to loans for personal needs including transport during obstetric emergencies increased willingness to save with saving groups. Saving groups therefore provided a safety net for the poor during emergencies. Poor management of saving groups and detrimental economic practices like gambling constrained saving. Efficient running of saving groups requires that they have a clear management structure, which is legally registered with relevant authorities and that it is governed by a constitution.
Conclusions: Saving groups were considered a useful form of saving that enabled easy acess to cash for birth preparedness and transportation during emergencies. They are like ‘a sprouting bud that needs to be nurtured rather than uprooted’, as they appear to have the potential to act as a safety net for poor communities that have no health insurance. Local governments should therefore strengthen the management capacity of saving groups so as to ensure their efficient running through partnerships with non-governmental organizations that can provide support to such groups.
Responsible Editor Nawi Ng, Umeå University, Sweden
Responsible Editor Nawi Ng, Umeå University, Sweden
Acknowledgments
We are thankful to the participants, data collectors and entrants, and the district health office from the districts of Kamuli, Kibuku and Pallisa for their time during data collection. We would also like to acknowledge Comic Relief, which funded this study and the Future Health Systems consortium, which provided technical support. We are also grateful to Dr Lynn Atuyambe, who led the qualitative component of data collection, and Suzan Mutesi and Grace Atiang, who facilitated the focus group discussions and key informant interviews.
Disclosure statement
No potential conflict of interest was reported by the authors.
Ethics and consent
Verbal informed consent was obtained from participants in the survey, key informant interviews and focus group discussions. Ethical approval for the study was provided by the Makerere University School of Public Health Higher Degrees Research and Ethics Board and the National Council of Science and Technology. Permission to publish the findings was sought from all the participants after assuring them of anonymity and confidentiality in reporting. The monitoring and evaluation team of the MANIEFST study hosted at Makerere University School of Public Health safely stores the data used to undertake this study. The same data are freely available on request through the first author of this paper.
Paper context
There is a dearth of literature about the use of saving groups to support birth preparedness. Our work shows that saving through saving groups enhanced the ability of households to meet financial costs at the time of birth and provided a safety net during emergencies. More effort should be directed towards increasing awareness about the benefits of saving for maternal health through saving groups and strengthening the management of these saving groups.
Additional information
Funding
Notes on contributors
Elizabeth Ekirapa-Kiracho
EEK participated in conceptualization of the study, data collection, and analysis and drafted the manuscript. RMK participated in conceptualization of the study, data collection; analysis, reviewed drafts of the manuscripts and made important intellectual contributions. LP, AM, JT, JP, MT and SNK participated in conceptualization of the study, data collection, reviewed drafts of the manuscripts and made important intellectual contributions.
