The paper states that microfinance can only be a major contributor to achieving the first seven Millennium Development Goals when it creates direct and positive impacts on the lives of the "extreme poor" (a.k.a. the "very poor" living on roughly a dollar a day or less) as well as the better-off poor.

The question is "Can microfinance reach very large numbers of the very poor and still be sustainable and have important impacts contributing to achievement of the MDGs?" It argues that microfinance has the main objective of reducing poverty worldwide and it has the ability to do so with the right combination of products and delivery systems. And that microfinance does offer opportunities to contribute to the achievement of all seven Millennium Development Goals (MDGs), primarily through its direct impact on poverty, which can support improvements in schooling, gender equity, health and resource conservation. The paper then discusses the measurement of impact and finds a need to distinguish change due to participation in microfinance from what would have happened without microfinance; avoid 'self-selection' and the 'program placement' biases; and stress on the 'randomized control trial' design. The paper looks at specific cases of sustainable microfinance outreach to large numbers of the very poor, with credible evidence of impact on poverty; it applies the benchmarks of scale, sustainability and impact to two large databases for microfinance programs: the Microcredit Summit Campaign and the MIX Market. The report finds enough evidence that microfinance increases incomes and savings, improves nutrition and health, and empowers women. It concludes that microfinance can and does contribute to the achievement of MDGs.