Results Most interventions combined microfinance with health education , which demonstrated positive effects on health knowledge and behaviours , though not health status .
Interventions combining multiple health components in a given study demonstrated positive effects , though it was unclear which component was driving the effect .
Discussion Integrated microfinance and health education programs were effective , though longer intervention periods are necessary to measure more complex pathways to health status .
The effect of microfinance combined with other health components was less clear .
Background Solutions delivered within firm sectoral boundaries are inadequate in achieving income security and better health for poor population s.  Integrated microfinance and health interventions leverage networks of women to promote financial inclusion , build livelihoods , and safeguard against high cost illnesses .
Our underst and ing of the effect of integrated interventions has been limited by variability in intervention , outcome , design , and method ological rigour .
This systematic review synthesis es the literature through 2015 to underst and the effect of  integrated microfinance and health programs .
Effect of a participatory intervention with women's groups on birth outcomes in Nepal: cluster-randomised controlled trial
BACKGROUND Neonatal deaths in developing countries make the largest contribution to global mortality in children younger than 5 years . 90 % of deliveries in the poorest quintile of households happen at home . We postulated that a community-based participatory intervention could significantly reduce neonatal mortality rates . METHODS We pair-matched 42 geopolitical clusters in Makwanpur district , Nepal , selected 12 pairs r and omly , and r and omly assigned one of each pair to intervention or control . In each intervention cluster ( average population 7000 ) , a female facilitator convened nine women 's group meetings every month . The facilitator supported groups through an action-learning cycle in which they identified local perinatal problems and formulated strategies to address them . We monitored birth outcomes in a cohort of 28?931 women , of whom 8 % joined the groups . The primary outcome was neonatal mortality rate . Other outcomes included stillbirths and maternal deaths , uptake of antenatal and delivery services , home care practice s , infant morbidity , and health-care seeking . Analysis was by intention to treat . The study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N31137309 . FINDINGS From 2001 to 2003 , the neonatal mortality rate was 26.2 per 1000 ( 76 deaths per 2899 livebirths ) in intervention clusters compared with 36.9 per 1000 ( 119 deaths per 3226 livebirths ) in controls ( adjusted odds ratio 0.70 [ 95 % CI 0.53 - 0.94 ] ) . Stillbirth rates were similar in both groups . The maternal mortality ratio was 69 per 100000 ( two deaths per 2899 livebirths ) in intervention clusters compared with 341 per 100000 ( 11 deaths per 3226 livebirths ) in control clusters ( 0.22 [ 0.05 - 0.90 ] ) . Women in intervention clusters were more likely to have antenatal care , institutional delivery , trained birth attendance , and hygienic care than were controls . INTERPRETATION Birth outcomes in a poor rural population improved greatly through a low cost , potentially sustainable and scalable , participatory intervention with women 's groups
Results Most interventions combined microfinance with health education , which demonstrated positive effects on health knowledge and behaviours , though not health status .
Interventions combining multiple health components in a given study demonstrated positive effects , though it was unclear which component was driving the effect .
Discussion Integrated microfinance and health education programs were effective , though longer intervention periods are necessary to measure more complex pathways to health status .
The effect of microfinance combined with other health components was less clear .
Background Solutions delivered within firm sectoral boundaries are inadequate in achieving income security and better health for poor population s.  Integrated microfinance and health interventions leverage networks of women to promote financial inclusion , build livelihoods , and safeguard against high cost illnesses .
Our underst and ing of the effect of integrated interventions has been limited by variability in intervention , outcome , design , and method ological rigour .
This systematic review synthesis es the literature through 2015 to underst and the effect of  integrated microfinance and health programs .