Marcia Metcalf from Freedom from Hunger and the Health and Microfinance Alliance, co-author of the recently released report titled Integrated Health and Microfinance in India: Harnessing the Strengths of Two Sectors to Improve Health and Alleviate Poverty—State of the Field of Integrated Health and Microfinance in India, 2012, visited India in June for the launch of the report. During her trip, she met with a number of partners and allies in the field, visiting some of the health and microfinance programs they are implementing, which she describes in part one of this blog. In part two, Marcia describes the potential for MFIs to expand their health interventions and scale up to include more clients, as well as for successful program replication across India.
The potential to scale up integrated health and microfinance in India is tremendous. Our current implementing partners and other organizations that we’re learning from are very strong, committed organizations, and they have the potential to reach millions of clients. They have already implemented health education interventions, and report that it adds value to their financial services and supports their missions. They are looking for ways to extend health services to more clients in the most efficient way. There is a real opportunity for a more comprehensive and cohesive approach to health protection packages.
ESAF Micro Finance and Investments in Kerala state is looking at the potential to build linkages between the education and their healthcare providers. They want to research how to extend education into the areas of prevention and management of chronic diseases such as diabetes and cardiovascular disease.
Sri Kshetra Dharmasthala Rural Development Project (SKDRDP) is keen to systematize all the education modules that they are providing to clients using the Freedom from Hunger Credit with Education (CwE) approach. The Alliance may conduct a workshop with senior leaders in order to improve their awareness and support for these kind of programs, building a broader base of support for health education within the organization overall. The course would probe, Are there ways that we could integrate the education more fully and efficiently?
IKP Centre for Technologies in Public Health (ICTPH) and SughaVazhvu Health are currently developing a prepaid health program that will eventually also include hospital insurance. Their experiences and their learning are colossal resources to understand more about different models available for linking quality service provision with financing and to consider the potential for replication with MFIs. This model is not proven yet, but it provides a glimpse of the potential for very creative delivery and financing models. Their program is not yet fully sustainable, but it has the potential to achieve sustainability provided they can enroll enough of the community in the prepaid program and also increase use of the clinics by other community members. Once demonstrated, why not replicate it to MFIs?
We also took the opportunity of being in India to meet with other organizations, potential partners, that are working in this space. With Global Health Advocates India, Intrahealth, Population Foundation of India, Center for Chronic Disease Control, and Dell Foundation, we can study questions such as these:
- What are the potential products or approaches that we might develop in order for those in the health sector to reach greater numbers of people and new markets represented by MFI and SHG clients?
- How can we develop outreach and get more buy-in for integrated health and microfinance from the health sector?
I left India thinking that the best potential for us was to work with two very different types of microfinance providers. The first are the large and successful programs, like Bandhan and Equitas. They have a strong commercial orientation and very lean microfinance operations, but they also have a very strong and overt social mission. They’ve set up parallel development foundations and are funding these foundations with 5% of their net earnings. I think this will turn out to be a very strong strategy, given the new regulations in India, which will limit the amount of capital an MFI can divert for non-credit purposes. It could potentially be very limiting to an MFI that is trying to do both. There is much concern about that and how it’s going to be interpreted.
The other potentially promising market comprises NGOs that have added financing products and capabilities as part of their community development mission. Again, these organizations have a very strong mission towards poverty alleviation, women’s empowerment, and improving people’s lives. They do a whole range of activities, such as education for income generation, value chain development, and loans for housing or micro-enterprise. With those organizations, our challenge is to help knit together what they’re doing related to health, and enhance and improve programs where there is an opportunity to do so. Our hope is that this will enable even greater positive, measureable impacts for clients.
Our work is going to be more difficult with mid and small-sized MFIs, especially owing to the new regulation. They may not be in a position to generate sufficient earnings to make the initial investment to develop non-financial services. Therefore, the replication of integrated programs in new, smaller organizations is more of a challenge—at least for now.
Is your organization is interested in learning more about the Health and Microfinance Alliance, our work in India, and our expansion plans? If so, please address an email to Sabina Rogers at firstname.lastname@example.org.