Sustainable Outcomes in HIV Prevention: Empowering High Risk Young Women in Northern Namibia With Microcredit Loans and Health Education

Background: Young women (aged 15-24) have the highest HIV infection rate in many sub-Saharan African nations, including Namibia. To address this, Project HOPE implemented a program combining microfinance loans and health education for women, in the abovementioned age group, from the Kavango and Caprivi Regions of Namibia. Method: To evaluate the impacts of this program, a qualitative evaluation was conducted. A local team was trained in qualitative data collection. They conducted 16 focus group discussions with women from the program and 100 in-depth interviews with those who were successful payers, delinquent/late payers, health activists, and women's next of kin. Results: Successful women reported the ability to support themselves, lessening dependence on family and wealthy men. These women described feeling empowered, and reported an ability to negotiate safer sexual relationships. They also reported the desire and initiative to impart knowledge on safe sexual practices, condom use, and HIV/STIs, to relationship partners, friends, family, and community members. Dedication to their businesses, budgeting, banking profits and having creative business ideas were characteristics shared by successful women. Unsuccessful women did not report the same impacts. They described their businesses as burdensome and showed an inability to put health education lessons into practice. Recommendations: Microfinance loans coupled with health education can be a useful mechanism of empowering women to make safer sexual choices. However, women must be supported with consistent business and health training that can enhance skills and promote confidence. Successful women should also be used as vehicles to deliver health information to communities.