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 .
Evidence-based public health: moving beyond randomized trials.
R and omized controlled trials ( RCTs ) are essential for evaluating the efficacy of clinical interventions , where the causal chain between the agent and the outcome is relatively short and simple and where results may be safely extrapolated to other setting s. However , causal chains in public health interventions are complex , making RCT results subject to effect modification in different population s. Both the internal and external validity of RCT findings can be greatly enhanced by observational studies using adequacy or plausibility design s. For evaluating large-scale interventions , studies with plausibility design s are often the only feasible option and may provide valid evidence of impact . There is an urgent need to develop evaluation st and ards and protocol s for use in circumstances where RCTs are not appropriate
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 .