Video Corner | Shamsul Haque on reducing poverty through an integrated approach

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18th Microcredit Summit Video Corner Interview Series

Shamsul Haque, executive director and CEO of Society for Development Initiatives in Bangladesh, interviewed by Miranda Beshara, editor of the Arabic Microfinance Gateway.


Shamsul Haque of Society for Development Initiatives (Bangladesh) discusses his organization, the role of microfinance to help end poverty, and the lessons learned at the 18th Microcredit Summit with Miranda Beshara, editor of the Arabic Microfinance Gateway. Haque explains that SDI’s objective is to reduce poverty in Bangladesh through an integrated approach involving components such as microcredit, education, and the environment.

Haque is attending the Summit to gain experience from people in other countries on how they providing non-financial services like health, education, and the environment. “Microfinance plus at least education and health,” Haque said. “If we combine education, health and microcredit ….they [clients] will graduate [out of poverty]. They will be a respectable people in society. That is also our objective.”

New database tool can help you define and refine client outcomes

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Global Health Indicators Project
The Microcredit Summit Campaign has long been committed to promoting the uptake of measurement tools in the microfinance sector, especially the poverty measurement tools. Such tools provide MFIs the means to know for sure if they really are reaching the poorest. More recently, we have encouraged MFIs to implement these tools to track the movement of clients (hopefully) out of poverty. At the 18th Microcredit Summit next month, we have several sessions that will show participants the benefits and challenges of such tools, including the Client Outcome Performance (COPE) Indicators Database, which you’ll read about here.


>> Authored by Bobbi Gray, Freedom from Hunger

When I joined Freedom from Hunger several years back, I had the responsibility to carry on a decades-long commitment to research and evaluation. My predecessor, Barbara MkNelly, as well as my then-supervisor and president of Freedom from Hunger, Christopher Dunford, were already known for their contributions to the research efforts of the growing microfinance sector and the original set of SEEP/AIMS client assessment tools. Freedom from Hunger’s commitment to promoting easy-to-use and cost-effective tools also led to years of developing monitoring and evaluation systems for microfinance organizations that were coined as “Progress Tracking.” Fast-forward several years, and this is much better known as Social Performance Management.

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Create lasting change at the 18th Microcredit Summit

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The 2015 State of the Campaign Report underscores the challenge microfinance faces in realizing its original goal — to alleviate poverty by providing quality microfinance services to the poorest segments of society. In it, we make the case for the scale-up of financial services “pathways” that can advance the end of extreme poverty with prescriptive actions for financial service providers, government policymakers, and others. These “Six Pathways,” which you can read all about in the report, will be featured throughout our 18th Microcredit Summit.

Financial inclusion is “the first step” in achieving the World Bank’s twin goals by “giving people the tools to get out of poverty [by 2030] and into shared prosperity,” as explained by Alfonso García Mora at the 17th Microcredit Summit in Mexico. Participants will engage in a thoughtful discussion around effective ways to reach the most vulnerable and marginalized and the microfinance services and financial inclusion strategies that promote inclusive, sustainable economic growth and social empowerment that helps improve their lives.

Join us in Abu Dhabi, U.A.E., on March 14-17, 2016, for another great microfinance conference!

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Celebrate improving maternal and child health in the Philippines

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Over the past 20 years, the Philippines has enjoyed an increase in life expectancy, improved access to education and economic opportunity, and a decrease in communicable diseases. However, maternal health has lagged behind, and as 2015 draws to a close, the world will be reflecting on the Millennium Development Goals like #5, “Improve maternal health.” Three development organizations took action in 2014 to tackle this challenge and are now celebrating what has been achieved, new partnerships that have been formed, and plans for moving forward.

Freedom from Hunger and the Microcredit Summit Campaign partnered with CARD Mutually Reinforcing Institutions (CARD MRI) to implement a project called “Healthy Mothers, Healthy Babies: Kalinga kay Inay.” The project is supported by an educational grant from Johnson & Johnson and will conclude at the end of 2015.

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The 2015 State of the Campaign Report in a nutshell

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An African farmer is linked into the financial system via her mobile phone.
In his presentation today at the Inclusive Finance India Summit New Delhi, Larry Reed featured Mapping Pathways out of Poverty: The State of the Microcredit Summit Campaign Report, 2015. The report is now available online. We will also publish the full report in French, Spanish, and Arabic in early 2016. You can also read previous reports online, just select the year of interest from the drop-down menu “Previous Reports.”

At our 2013 Microcredit Summit in the Philippines, we focused on the partnerships required to deliver financial services to those living in poverty. At our 2014 Summit in Mexico, we focused on innovations in microfinance with a demonstrated capacity to reach those in extreme poverty. This year, we use the report to explore, in more detail, our six financial “pathways.” Each pathways has a chapter, and each chapter does the following:

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Mental health matters for microfinance

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>>Authored by Bobbi Gray, Research Director, Freedom from Hunger

First of all, a disclaimer. I am by no means a mental health expert. Like many, I’ve had my own experiences which have led to interests into the causes and impacts of mental health issues as well as the coping mechanisms we might use when we or someone we know suffers from a mental illness.

It’s Mental Illness Awareness Week, as you might know, and it has reminded me of a conversation that Josh Goldstein, vice president of economic citizenship and disability inclusion at the Center for Financial Inclusion at Accion, and I started a while back. A conversation that also led to an exchange of ideas on his blog post “4 interventions to help victims of trauma find hope and dignity” in which he summarized his remarks at the 8th Annual PCAF Pan-African Psychotrauma Conference held in Nairobi, Kenya. (Josh’s full conference remarks can be found here.) During this conference, Josh tried to answer the question of whether microfinance institutions (MFIs) can help victims of trauma who suffer from mental health disorders, such as post-traumatic stress disorder (PTSD), to find hope and dignity through self-employment.

In his post, Josh suggests steps to be taken by our sector to be inclusive of those suffering from mental health disorders. In this post, I’ll address two of those steps:

  1. More linkages between mental health providers and MFIs can take place such that people have access to financial services and business and financial training.
  2. Create a set of global standards and indicators for MFIs and other financial service providers to follow that will establish the importance of and offer guidance on serving PTSD survivors and other persons with psycho-social disabilities.

While Freedom from Hunger works actively with our partners to link their clients to health service providers through our integrated approach, I can’t speak yet to having a lot of success on Josh’s first step above — i.e. the specific linkage to mental health service providers. Though this doesn’t mean there aren’t already bright spots. This (really interesting) Freakonomics podcast discusses how cognitive behavioral therapy (CBT) and cash transfers are being combined for child soldiers in Liberia. Spoiler alert, CBT plus cash transfers leads to men staying out of trouble, compared to getting only CBT or only a cash transfer.

On Josh’s second point, regarding the need to start by understanding and measuring the extent of psycho-social disabilities, we’re just dipping our toes in the water.

In the paper we produced called “Healthy, Wealthy, and Wise: How Microfinance Can Track the Health of Clients,” in which we share experiences in selecting and pilot-testing our Health Outcome Performance Indicators (HOPI) among MFIs, some of our initial testing around mental health indicators was limited and was initially driven by the acknowledgement that consequences of domestic violence should be better understood and tracked.

Since the publication of that paper, we’ve conducted research in Burkina Faso with 46 women that we followed over a 7-month period to better understand resilience. We tried to look at resilience holistically and included “attitude” questions in all 10 surveys we conducted. One survey focused entirely on attitudes and perceptions of one’s life. We pulled heavily from research conducted by Johannes Haushofer, who is a professor and researcher of psychology and public affairs at Princeton. He took variables from a World Values Survey and compared them to poverty status.

In the research in Burkina Faso, we compared self-perceived resilience status (i.e., “Based on what you consider to be a resilient household, do you believe your household is resilient?”) to a series of indicators, approximately 14 of which were attitude/perception indicators. We found that those who considered themselves resilient were also likely to report feeling supported, hopeful, capable of meeting one’s financial obligations, trustful of others, and not living one’s life “day to day.” They reported that they would try anything to improve their life. (This research will be available by the end of October through CGAP).

These indicators are just one slice of mental health — but it is a starting point. We have Haushofer’s research as well as our simple forays into developing the HOPI, which we think MFIs can use to measure and monitor client status. Given this headway, I think we all can have a greater appreciation of the power that positive or negative mental health can have on a person’s productivity and their likelihood of success with the types of financial tools we can provide.

For microfinance and beyond, I think we have the research we need to argue that mental health matters. (See this recently published paper in the Lancet regarding mental health research in Europe.) The direct costs (i.e., healthcare costs and productivity losses) and the indirect costs (i.e., wage and productivity losses of caregivers and family members) can be significant.

And mental health matters even if we’re not distinguishing between people with diagnosed mental health impairments versus the mental health challenges poverty often creates. In fact, in the book Scarcity by Sendhil Mullainathan and Eldar Shafir, we are challenged to recognize this. They explain how “scarcity captures the mind. The mind orients automatically, powerfully, toward unfulfilled needs. Scarcity…changes the way we think. It imposes itself on our mind. The consequence of having less than we want is simple: we are unhappy.”

I think we’ve all had periods of our life in which we can relate to what mental distress feels like. Your mental bandwidth is limited, and its hard to feel hopeful when you’re going through a trial. I wonder if we should assume that the starting point is that all clients we serve could benefit from mental health support given what we know about the psychology of poverty. Everyone deserves a financial product or process that helps them through life’s short and long-term crises — whether it’s a purely economic crisis, a visible health crisis like dealing with cancer, or a mental health crisis that has no obvious cause.

Obviously, this is easier said than done. But, over time, I’ve come to really value and appreciate what the mental health and psychosocial indicators can tell me about a person’s life. Even if a person’s poverty status hasn’t changed but their belief that their life is better and more manageable, I can see where that can be considered success.

psychologyofscarcity_v2Related reading

Better health for every woman and every child in the Philippines

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The maternal mortality rate in the Philippines is among the highest in Southeast Asia. To help improve maternal health in the Philippines, three development institutions have come together to implement the Healthy Mothers, Healthy Babies: Kalinga kay Inay Project. Freedom from Hunger and the Microcredit Summit Campaign are partnering with CARD Mutually Reinforcing Institutions (CARD MRI) to implement an 18-month project to provide access to health education and healthcare, build sustainability of such services, and document evidence of improved lives. The project is supported by an educational grant from Johnson & Johnson.

More than 800,000 women have received vital information to ensure healthy pregnancies, and thousands more will. At community health fairs like you see in the short video above, thousands of women have received free OB/GYN consultations, have signed up for the national health insurance, PhilHealth, and have received free prenatal vitamins. We’re reaching for better health for every woman and every child. Join us.

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Philippines program provided 800,000+ women maternal health education and care

Summary:
CARD Mutually Reinforcing Institutions (CARD MRI), the Microcredit Summit Campaign, and Freedom from Hunger announced that under the “Healthy Mothers, Healthy Babies” program, some 800,000 women have received maternal health education in the past 5 months and 3600 women have received healthcare in the past 12 months. The project aims to improve maternal health alongside their microfinance services in the Philippines, accelerating achievement of UN Millennium Development Goal 5.


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WASHINGTON, D.C. [September 24]—Partners in a joint-program aiming to improve maternal health in the Philippines announced today that they provided more than 800,000 women with maternal health services in the past year. CARD Mutually Reinforcing Institutions (CARD MRI), the Microcredit Summit Campaign, and Freedom from Hunger began rolling out health education in April to poor and rural communities in Luzon, Mindanao, and, notably, the Visayas, which had catastrophic destruction in the wake of Typhoon Haiyan.

With the support of program partners, CARD MRI trained more than 1,000 account officers (AOs) in 14,650 centers to deliver the health education to CARD members. The AOs educated an average of 5,000 women per day over the last five months on important maternal health issues. Each woman received two hours of instruction on simple but important lessons like the food and nutritional supplements that pregnant and young women need and the importance of giving birth in a health facility.

“Helping poor communities through financial access is undeniably important in poverty eradication,” said Marilyn M. Manila, director of the Community Development Group at CARD MRI (a Filipino microfinance institution), “but this is insufficient to reach our goal. Poor health and having no access to health care service are a big part of continuous poverty in many countries. We realize the importance of good health of microfinance institutions’ (MFIs’) clients to help them continue improve their quality of life.” Ms. Manila also chairs the MFIs for Health, a consortium of 21 Filipino MFIs committed to providing access to health care services to poor communities.

At 30 years old, CARD MRI client Barrera is eight months pregnant with her fourth child. Barrera is one of the 3,634 women who received routine gynecological examinations and 2,222 mother and baby kits at four community health fairs over the last 12 months. Berrera attend the fair in Davao this July “for the ultrasound—to be able to see my baby. It was my first time.” More than 100 healthcare providers have participated in the four health fairs, and many more will. The next health fair will take place in very rural areas of Mindanao October 2nd and 3rd.

Community health fairs are important for improving maternal health in poor, rural communities where accessing health services is a challenge. Program partners organize health fairs with support from local foundations and professional associations like the Philippines OB/GYN Society, community health workers and private health providers, as well as the government: the Department of Health, local government units, and PhilHealth (the national insurance program).

Over the last 15 years, the Philippines has improved in many key indicators such as life expectancy, access to education, and infant mortality; however, maternal mortality has remained at unacceptably high levels. Delays in accessing medical care is a key bottleneck in achieving better results for mothers and babies. With 99 days to the end of the Millennium Development Goals and the Global Goals for Sustainable Development on the horizon, this collaboration to educate about and expand access to health services is critical for meeting the needs of poor communities. This project is supported by an educational grant from Johnson & Johnson.

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About CARD Mutually Reinforcing Institutions
The CARD MRI is a group of mutually reinforcing institutions with a common goal of alleviating poverty in the Philippines and improving the quality of lives of the socially-and-economically challenged women and families towards nation building. Based in San Pablo City in Laguna in the Philippines, CARD MRI has 1,845 offices located all over the country and has program/partnership offices in Cambodia, Vietnam, Laos, Myanmar, and Hong Kong. CARD MRI has 2.99 million members and clients as of July 2015 throughout the country, continuously providing them holistic and integrated financial and social services that help uplift their lives and eventually transform them into responsible citizens for their community and their environment.
www.cardmri.com

About Freedom from Hunger
Founded in 1946, Freedom from Hunger is a US-based international development organization that brings innovative and sustainable self-help solutions to the fight against chronic hunger and poverty. By partnering with local microfinance institutions (MFIs) and nongovernmental organizations (NGOs) throughout Asia, Africa and Latin America, Freedom from Hunger is reaching 5.7 million women, equipping them with resources they need to build futures of health, hope and dignity.
www.freedomfromhunger.org

About the Microcredit Summit Campaign
The Microcredit Summit Campaign (the “Campaign”), a project of RESULTS Educational Fund, is the largest global network of institutions and individuals involved in microfinance and is committed to two important goals: 1) reaching 175 million of the world’s poorest families with microfinance and 2) helping 100 million families lift themselves out of extreme poverty. The Campaign convenes a broad array of actors involved with microfinance to promote best practices in the field, to stimulate the exchange of knowledge and to work towards alleviating world poverty through microfinance. In early 2016, the Microcredit Summit Campaign will host the 18th Microcredit Summit in Abu Dhabi. The agenda will focus on “Mapping Pathways out of Poverty” and will feature innovations from the Africa-Middle East Region.
www.microcreditsummit.org

Media Contact Information
Microcredit Summit Campaign
Sabina Rogers
Manager, Communications and Relationships
+1 (202) 637-9600
rogers@microcreditsummit.org
Freedom from Hunger
Piper Gianola
Senior Director, Development and Communications
+1 (530) 758-6200 x 1018
piper@freedomfromhunger.org
CARD MRI
Cleofe Montemayor-Figuracion
Deputy Director, Corporate Communications
+63 (49) 562-4309 local 108
corpcomm@cardbankph.com; cardmri.corpcomm@gmail.com

Insufficient and greatly uneven progress on the maternal health MDG

Millennium Development Goals: 2015 Progress Chart
Published articles to date: Introduction | MDG 1 | MDG 2 | MDG 3 | MDG 4

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The United Nations recently issued The Millennium Development Goals Report, 2015, the latest assessment of progress towards the eight MDGs. In short, they have had mixed results. This article is part of a blog series reflecting on the MDGs and the U.N. report. These are produced in partnership with our colleagues at RESULTS, a grassroots advocacy organization. They are lobbying for bipartisan legislation in the Senate that can impact the lives of mothers and children worldwide. (See the Fact Sheet.)


>>Authored by Marion Cosquer and Sabina Rogers

MDG 5: Improve maternal health

Target 5.A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio

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Click to enlarge. Source: The Millennium Development Goals Report, 2015

In 1990, 380 pregnant women were dying for every 100,000 live births. As of 2013, the global maternal mortality ratio has decreased by 45 percent to 210 women per 100,000 live births. The highest gains were seen in South and Southeast Asia with a 64 percent and 57 percent reduction, respectively. Developing regions overall achieved a 46 percent reduction. Maternal survival has been aided by a one-third increase in childbirth attendance by skilled health personnel. Thus, the news in the U.N. Millennium Development Goals Report for MDG 5 is promising.

Nonetheless, progress towards improving maternal health so far falls far short of the targets set under MDG 5 and has lagged far behind the other MDGs. Additionally, global figures tend to mask regional inequalities. For example, there were 510 maternal deaths per 100,000 live births in sub-Saharan Africa compared to 190 in South Asia and 140 in Southeast Asia.

Progress in raising the proportion of births delivered with skilled personnel has been modest over the last 15 years, reflecting the lack of universal access to care. Indeed, one in four babies still being delivered without skilled personnel and wide disparities are found among regions. For example, there is a 52 percent spread between the largest rural/urban disparity across regions:

  • In Central Africa, 32 percent of births were attended by skilled personnel compared to 84 percent in urban areas.
  • In East Asia, there is no difference between urban and rural areas.

Sub-Saharan Africa and South Asia pull down the developing region average. Overall, 56 percent of births in rural areas are attended by skilled health personnel compared to 87 percent of births in urban areas.

From The Millennium Development Goals Report, 2015

Click to enlarge. Source: The Millennium Development Goals Report, 2015

Target 5.B: Achieve, by 2015, universal access to reproductive health
After 25 years of slow progress, only half of pregnant women in developing regions receive the minimum of four antenatal care visits recommended by the World Health Organization. Once more, coverage levels in sub-Saharan Africa and South Asia trail the other regions. Sub-Saharan Africa has barely increased from 47 percent to 49 percent of pregnant women; South Asia has the lowest coverage at 36 percent (though it increased from 23 percent). Moreover, despite having doubled contraceptive use [1] in sub-Saharan Africa from 13 to 28 percent, sub-Saharan Africa still trails all other regions.

From The Millennium Development Goals Report, 2015

Click to enlarge. Source: The Millennium Development Goals Report, 2015

Proven health-care interventions can prevent or manage the complications that cause maternal deaths, such as hemorrhage, infections, and high blood pressure. These complications are concentrated in sub-Saharan Africa and South Asia, accounting for 86 percent of all deaths worldwide in 2013. Use of contraceptives also contributes to maternal health by reducing unintended pregnancies, unsafe abortions, and maternal deaths.

The report tells us that contraceptive use has risen in all regions and 90 percent of users were using effective contraceptive methods. However, the unmet need is still high (24-25 percent) in sub-Saharan Africa and Oceana. Other developing regions hover around 11-14 percent unmet need, and the overall use in those regions is significantly higher than in sub-Saharan Africa and Oceana.

The adolescent birth rate shows a mixed story. While the global rate for developing regions has fallen by half (from 34 to 17 births per 1000 girls), it hides poor progress in Africa and Latin America and the Caribbean. Indeed, in three regions (Southeast Asia, the Caucasus and Central Asia, and North Africa), some of the gains in the adolescent birth rate from 2000 reversed in 2015. Moreover, progress in East Asia was stagnant over the last 15 years.

The report calls for urgently needed intensified efforts to delay childbearing and prevent unintended pregnancies among adolescents. By increasing opportunities to go to school and for paid employment, we would see an overall improved maternal and child health as well as reduced poverty, greater gender equality, and women’s empowerment.

Maternal health in the post-2015 development agenda

The new Global Goals for Sustainable Development, which are set to be approved at the Sustainable Development Summit September 25 to 27, encompasses a broader, more ambitious and inclusive health goal. Goal 3 seeks to “Ensure healthy lives and promote well-being for all at all ages.” Indeed, it seeks to reduce the global mortality ratio to fewer than 70 deaths per 100,000 live births. Under Goal 3, countries will agree to ensure, by 2030, universal access to sexual and reproductive healthcare services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs — for which the microfinance sector can be a key partner.

The report concludes on the inequalities in data availability on maternal health among and within regions. The lack of data is a key factor contributing to the unfinished MDG agenda, hampering efforts to establish priorities on national, regional, and global health. In the post-2015 period, it is imperative to have better and more data, especially concerning registration of births and deaths, in order to set adequate policy priorities, target resources more efficiently, and measure improvements.

In order to build on the successes of the MDGs and achieve Goal 3 of the SDGs, the 18th Microcredit Summit will focus on integrated health and microfinance as one of the six pathways out of poverty. Empowerment of women — which can help reduce maternal mortality more quickly and efficiently — will also be an important theme.


Footnote

[1] “Contraceptive use” is defined concerning women aged 15-49, married or in union, who are using any method of contraception

Post MDG-4: Integrating health services to reduce child mortality

Millennium Development Goals: 2015 Progress Chart
Published articles to date: Introduction | MDG 1 | MDG 2 | MDG 3

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The United Nations recently issued The Millennium Development Goals Report, 2015, the latest assessment of progress towards the eight MDGs. In short, they have had mixed results. This article is part of a blog series reflecting on the MDGs and the U.N. report. These are produced in partnership with our colleagues at RESULTS.


>>Authored by Carley Tucker and Sabina Rogers

MDG 4: Reduce child mortality

Target 4.A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

From The Millennium Development Goals Report, 2015

From The Millennium Development Goals Report, 2015

The numbers appear heartening. According to the latest assessment on the Millennium Development Goals (MDGs), deaths of infants and children under five have greatly reduced. The under-five mortality rate has declined by more than half, from 90 to 43 deaths per 1000 births. Moreover, the annual rate of reduction in child deaths has more than doubled since 1990, and the rate has accelerated the most in Africa.

We learn that 4 out of every 5 of children have received at least one dose of the measles vaccine, preventing 15.6 million deaths between 2000 and 2013. In all, some 48 million children under five are alive today because of smart investments and increasing access to cost-effective health programs over the last 15 years.

This is good news for children around the world; however, underlying these advances is news that the achievements are not equitably distributed regionally, between rural and urban areas, nor socioeconomically.

Across all regions, progress toward MDG 4 has been “fair” to “excellent.” Furthest from reaching the target, though, are those living in sub-Saharan Africa and South Asia. While sub-Saharan Africa has had the largest decline in child mortality rates, it still experiences half of all child deaths in the world. Of the 10 countries with the highest number of under-five deaths, 5 are in Africa: Nigeria (#2 at 750,000), DR Congo (#4 at 305,000), Ethiopia (#5 at 184,000), Angola (#7 at 169,000), and Tanzania (#10 at 98,000). See the full list in this infographic from Humanosphere.

Children living in rural areas are 1.7 times more likely to die than those living in urban populations. Child mortality is 1.9 times as prevalent among poor households as among wealthy. Those whose mothers lack education are 2.8 times more likely to die than if their mothers had reached the secondary or higher level. So, of the 16,000 children under five who die each day — mostly due to preventable causes such as pneumonia, diarrhea, and malaria — they are likely to be from poor, rural, and uneducated households.

Have we really made substantial progress achieving MDG 4 when young kids in rural and poor communities continue to be the ones more likely to die before their fifth birthday? Allowing this population to fall behind will only exacerbate the vicious cycle of poverty. In order to make permanent advances in reducing early deaths, global development actors need to narrow in on rural and impoverished areas, especially in sub-Saharan Africa and South Asia.

Where do we go from here?

Recognizing the need for a renewed effort towards improving health of the poorest households, the Microcredit Summit Campaign has identified integration of health and microfinance programming as one of its six pathways strategies key to ending extreme poverty. Poverty is both a factor contributing to and consequence of illness and disease, so it is not enough for clients to have access to financial services. The microfinance sector must look for ways to integrate healthcare to their microfinance services. Microfinance institutions (MFIs) can provide health services directly or through linkages with healthcare programs.

Campaign believes that microfinance services provide an optimal place for healthcare. Many MFIs are reaching very rural communities — to say nothing of savings groups, which are primarily a rural financial tool. MFIs have developed trust relationships with families; they meet regularly with clients and can, therefore, pass along information like how to care for their children. In addition, since many MFIs serve regions in Africa and South Asia where child mortality rates are the highest, a strong focus on healthcare will allow these organizations to directly combat this issue in the most afflicted regions.

Microfinance clients must also have access to good healthcare in order to run their businesses, and a healthy lifestyle begins at birth. In the “Healthy Mothers, Healthy Babies: Kalinga kay Inay” project, microfinance clients are learning simple but important lessons like the food and nutritional supplements that pregnant and young women need and the importance of giving birth in a health facility. They are attending community health fairs organized by CARD MRI and partners, receiving free gynecological exams, urinalysis, and vitamins and supplements to improve their chances of delivering a healthy baby.

70 percent of maternal and child deaths now concentrated in just 16 countries, health and non-health investments such as sanitation, education, infrastructure and gender equality can potentially double the impact on lives saved.

70 percent of maternal and child deaths are now concentrated in just 16 countries. Investments in sanitation, education, infrastructure, and gender equality can potentially double the impact on lives saved. Go to the Newborn Survival Map to learn more.

Integrating health and microfinance services will also support the efforts of the new Global Goals for Sustainable Development, which are set to be approved at the Sustainable Development Summit September 25 to 27. The ambitious Goal 3 (“Good health and well-being”) includes ending preventable deaths of newborns and children under 5 years of age by reducing child mortality to 20 or fewer deaths per 1000 births by 2030. It also seeks to reduce by one third premature mortality from non-communicable diseases through prevention, treatment, and promotion of mental health and well being.

There also efforts underway in the United States to maximize future investments by US Agency for International Development (USAID). To reach the goal of ending preventable child and maternal deaths by 2035, USAID has set bold, intermediate goals of saving 15 million child lives and 600,000 women’s lives by 2020. RESULTS, a grassroots advocacy organization, is lobbying for bipartisan legislation that will provide strong congressional oversight and ensure that “returns [are] measured in lives saved and healthy, prosperous communities.” (See the Fact Sheet.)

“We now have the chance to end these needless deaths in our lifetime,” said Joanne Carter, executive director of RESULTS and RESULTS Educational Fund (our parent organization). “The science shows we have the tools. That means in 2035 a child born in the poorest setting could have the same chance of reaching her fifth birthday as a child born in the richest.”

Free ultrasounds draw thousands to community health fairs

A doctor provides free checkups as part of a health outreach program in the Philippines. Photo by: CARD MRI

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World leaders are convening in New York this week to finalize the Global Goals for Sustainable Development, an ambitious plan that will build on the successes and tackle problems where the Millennium Development Goals fell short. Freedom from Hunger and the Microcredit Summit Campaign are partnering with CARD Mutually Reinforcing Institutions (CARD MRI) to implement an 18-month project to address one of these MDG achievement gaps: maternal health in the Philippines. The project, “Healthy Mothers, Healthy Babies: Kalinga kay Inay,” is supported by an educational grant from Johnson & Johnson and will wrap up in December.

We have prepared a newsletter to let you know how things are going. To receive a copy of the newsletter, please sign up for our integrated health and microfinance news mailing list. Here is a sneak peek at the first issue of our Healthy Mothers, Healthy Babies: Kalinga kay Inay Project Newsletter.


Charyle is 32 years old and nine months pregnant with her fourth child. She attended the Davao City community health fair organized in July by CARD MRI, a Philippine microfinance institution (MFI), with partners from the MFIs for Health consortium.

Charyle was very excited to get an ultrasound. While Charyle goes monthly to a nearby health center for prenatal checkups, this was likely her first ultrasound. Charyle plans to deliver at a birthing center (an affordable alternative to a hospital for low-risk pregnancies). “I like it [the birthing center] better because it’s more personal,” she said. “I have PhilHealth, which helps with costs and point-of-care service.”

CARD has made a point to engage the local health insurance office of the Philippines’ national health insurance program, PhilHealth, in the fairs. Many women do not know the benefits or financial savings of PhilHealth membership, such as the fact that a year’s premium is less than a typical uninsured delivery. So, they provide orientation, enrollment of non-members, and other services to health fair attendees.

Irish (27) is four months pregnant with her first child. She has visited a health clinic three times already and plans to deliver at a regional hospital because she has hypertension. “So,” said Irish, “I think I will look at PhilHealth while at this health fair.”

Barrera (30) is 8 months pregnant with her fourth child. Barrera learned of the fair during her prenatal visit at the health center, which is within walking distance and offers free prenatal checkups. She said she decided to come to the fair “For the ultrasound — to be able to see my baby. It was my first time.” Berrera also plans to deliver at her local birthing center. “It is walking distance from where I live, and it is PhilHealth accredited, so free.”

Charyle, Irish, and Barrera were among 435 women who attended the two fairs; however, they were not typical in their prenatal care and delivery plans. OB/GYNs, general physicians, pediatricians, and other medical professionals provided services to these women that many normally would not be able to access or afford. In the four health fairs held so far, some 3600 pregnant and lactating women have gotten a free check-up.

HMHB_CMYK_English_Beveled

What else is in the newsletter?

Increasing Healthcare Access

Through “Healthy Mothers, Healthy Babies,” 8,000 women of child bearing age (primarily pregnant and lactating women) will receive education and preventive services through five community health fairs by the end of 2015. Women from the local community and surrounding areas access maternal health products and services like urine tests, OB/GYN consults, ultrasounds, sonograms, and vitamins provided by BotiCARD (part of the CARD family). Such services are otherwise unavailable them. The next health fair will be October 2-3 in rural communities in Mindanao. Contact Mharra de Mesa to learn more.

What’s in the Mother and Baby Kit?

health-kit_HMHB-PH_Oct2014_Courtesy-of-CARD-MRI

Building Capacity to Provide Health Education

What does it take to deliver maternal health education to 600,000 women? In January 2015, 17 CARD staff and 1 nurse took part in a training of trainers (ToT) on the maternal and child health education module, “Healthy Pregnancies Make Healthy Communities.” In March, four members of MFIs for Health — ASA Philippines Foundation Inc., KMBI, TSPI, and CCT — joined the Integration Workshop and ToT facilitated by CARD MRI. Learn how CARD is taking a leadership role in the Philippines to extend health products and services to more microfinance clients. Contact Cassie Chandler to learn more about the education module.

“MFIs for Health” Provide Health Services to Poor Communities

The Filipino “MFIs for Health” consortium expanded to 21 microfinance institutions (MFIs) in May when they inked a Memorandum of Agreement to provide access to health care services to poor communities. “The microfinance industry has grown so much over the past year,” Sen. Paulo Benigno “Bam” Aquino said. “It is crucial that the MFI industry should continue to innovate…and unlock more accessible opportunities that go beyond financing and bring it to our countrymen especially in the areas who have less opportunities.” Learn how the Filipino microfinance sector is mobilizing to improve the health of poor communities. Contact MAHPSecretariat@gmail.com to learn more.

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ESAF Microfinance commits to comprehensive services for clients

ESAF Microfinance trains community health workers and organizes health fairs for their clients and poor communities. Photo courtesy of ESAF Microfinance
— Read the press release announcing ESAF Microfinance’s Campaign Commitment
— Read their Commitment letter

Lea en español *** Lisez en français


The Microcredit Summit Campaign welcomes ESAF Microfinance as the 57th organization to make a Campaign Commitment. ESAF joins a global coalition to help 100 million families lift themselves out of extreme poverty. ESAF will help support their clients in uplifting themselves from poverty by providing them with education, training, and support services.

ESAF and the Campaign strongly believe that microfinance services should be complemented by education, training, and other supporting programs that help poor families battle chronic poverty and social exclusion. For example, in partnership with the Campaign, ESAF trained community health workers (Arogya Mithras in Hindi) to provide health education and front-line screening services for non-communicable diseases to poor communities. You can learn about that project in “Integrating Health with Microfinance: Community Health Workers in Action.”

For the financial year 2015-2016, ESAF Microfinance aims to reach out to new clients through its products and services, committing to the following:

  1. To offer microfinance services to 200,000 new clients through expanding the geographic reach in some of the backward states of Chattisgarh, Jharkhand, West Bengal, and Bihar.
  2. To increase the reach of financial services to an additional 10% of clients, making it to a total of 50% of clients who belong to socially backward communities/tribes (scheduled castes and scheduled tribes as per government of India)
  3. To offer livelihood support services to at least 10,000 clients who shall be in a position to contribute to the income of their household.
  4. To measure the poverty levels of 200,000 clients using PPI.
  5. To offer financial literacy training to at least 50,000 clients.
  6. To offer health education and awareness sessions to at least 50,000 clients and to offer health check-up services to benefit at least 5,000 clients.
  7. To offer financial and non-financial services to at least 3,000 PWD (persons with disabilities) clients.
  8. To offer women’s leadership and empowerment programs to benefit at least 50,000 clients.
  9. To reach at least 2,000 children through educational programs for academic growth and value education.
  10. Educate at least 50,000 clients on environment protection and use of clean energy products.

Chairman and managing director, K. Paul Thomas, explains why their commitment includes a number or programs addressing multiple aspects of the client’s life such as health:

“ESAF’s vision and mission very clearly emphasize on holistic transformation of its poor clients,” he said, “and, we are convinced this cannot be achieved unless their health issues are addressed.”

ESAF Microfinance is one of the premier microfinance institutions in India today, particularly in Kerala, effectively empowering 750,000 members through 160 dedicated branches. The founder of ESAF ventured into microfinance in 1995, by organizing self-sustainable groups, to alleviate poverty and generate employment. Since then, ESAF has grown by leaps and bounds in the microfinance sector, promoting microfinance as a viable, sustainable, and effective means for creating jobs and reducing poverty.

Read the Commitment Letter from ESAF Microfinance.

The Microcredit Summit Campaign looks forward to welcoming our new partners to the global coalition and sharing their progress towards the Commitment achievement at the 18th Microcredit Summit. The Campaign’s 100 Million Project is building a movement among financial service stakeholders committed to helping to end extreme poverty through: public statements of commitment to action, expanding practices to reliably measure movement out of extreme poverty, and promoting innovations and best practices to accelerate movement out of poverty.


We invite you to join ESAF Microfinance and…

Get Inspired. Set a Goal. Make a Commitment.

Join the movement to help 100 million families lift themselves out of extreme poverty:

Does your microfinance program improve newborn survival?

Products provided to microfinance clients through the “Healthy Mothers, Health Babies” project in the Philippines implemented by the Microcredit Summit Campaign, Freedom from Hunger, and CARD MRI. The products included are selected for their usefulness to women soon to give birth.

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>>Authored by Larry Reed, Director, Microcredit Summit Campaign

Research from the World Health Organization shows that half of the decline in under-5 child deaths is due to factors outside the health sector. In addition to health improvements, advancements in girls’ education, women’s economic status, water, sanitation and hygiene, energy, and infrastructure all make a vital difference. We believe that the microfinance sector has an important role to play in bringing child mortality down even further.

At the Microcredit Summit Campaign, we know how powerful integrating health programs can be. Microfinance institutions (MFIs) that offer health products and services to their clients help them to manage shocks and improve the health of clients and their families. In partnership with Freedom from Hunger and with the support of Johnson & Johnson, we are working with microfinance partners in India and the Philippines to provide health products and services to hundreds of thousands of families.

In the Philippines, our project focuses on improved health outcomes for pregnant women and their newborns. To date, CARD MRI (our local partner) has delivered the “Healthy Pregnancies Make Healthy Communities” education to nearly 300,000 women clients. The education is delivered using an innovative pictorial learning conversation (PLC) methodology developed by Freedom from Hunger. This PLC module distills important information about pre- and post-natal care into easily digested 15-minute segments.

An image from the “Healthy Pregnancies Make Healthy Communities” PLC. It teaches about the importance of visiting a health facility throughout the pregnancy.

An image from the “Healthy Pregnancies Make Healthy Communities” PLC. It teaches about the importance of visiting a health facility throughout the pregnancy. Contact Cassie Chandler at Freedom from Hunger to learn more about the education module.

At the Community Health Day events organized under the project, thousands of women (pregnant and with newborns) also get free consultations and medical checkups — many for the very first time. In addition, attendees have learned important information for ensuring healthy pregnancies and healthy newborns. Medical professionals have delivered lectures on family planning, signs and symptoms to be aware of during pregnancy, as well as prenatal care like nutrition during pregnancy and post-natal care like breastfeeding or caring for a newborn.

The Campaign is helping CARD and other members of the MFIs for Health consortium to leverage this small, one-time grant by building a strong, local resource base for their work. Through our Campaign Commitments, we are mobilizing microfinance actors around the world to take specific, measurable, and time-bound actions to address the multiple dimensions of poverty. We hope to do the same in the Philippines to improve the health of microfinance clients and their families.

Mapping integrated solutions

An effort is underway to develop a new online map to capture such programs around the world. Called the Newborn Survival Map, this initiative hopes to encourage the development of cross-sector partnerships delivering integrated solutions. In our experience, when an MFI hesitates to introduce health programs, it is often because they say that their job is to provide financial services, not health. In this case, partnering with health development organizations and other health sector actors is a viable alternative to offering health services in-house. The map could direct your organization to potential future partners in health.

The Newborn Survival Map will initially focus on 16 countries where newborn deaths are concentrated (see the map below). It will focus on programs with a total value of US$500,000 and above across 14 different sectors whose work greatly impacts newborn survival. Note that this threshold is for the life of the project and represents a total investment. Investments will also be tracked by sub-region, so it may be that an organization has a series of smaller investments in different locations or over a period of time, but the total current and planned investment for their work in a sub-region may equal or exceed the $500,000 threshold.

Priority countries (MDG 4, child mortality)

Priority countries are India, Nigeria, Pakistan, Democratic Republic of Congo, China, Ethiopia, Angola, Indonesia, Bangladesh, Kenya, Uganda, Afghanistan, Tanzania, Sudan, Sierra Leone, and Niger. Send in your program information by August 24th to be sure that you are included in the Newborn Survival Map.

The initiative is led by FHI 360, an international development organization, in partnership with the MDG Health Alliance and Johnson & Johnson. FHI 360 and partners invite actors in the microfinance sector to take part in this exciting initiative. We encourage you, our audience, to make sure that significant microfinance programs — especially those benefiting women of reproductive age — are represented on The Newborn Survival Map.

The Newborn Survival Map is in collaboration with the Every Newborn Action Plan and in support of the UN Secretary-General’s Every Woman Every Child movement.

Take action today!

Email Christina Blumel (cblumel[at]fhi360.org) with the name and email of a contact person in your organization who will be responsible for getting your microfinance program included on the map. Christina will guide your colleague through the necessary steps to an online form, which takes approximately 20 minutes to fill out.

Many thanks for your partnership as we enter the Sustainable Development Goal era where achievement of the ambitious new goals will require unprecedented levels of collaboration. Read the letter from Leith Greenslade of the MDG Health Alliance inviting your organization to be part of this exciting initiative (and en français).

About the organizations responsible for the map

The MDG Health Alliance is an initiative of the UN Special Envoy for Financing the Health Millennium Development Goals and for Malaria. The Alliance operates in support of Every Woman Every Child, an unprecedented global movement spearheaded by the Secretary-General to mobilize and intensify global action to improve the health of women and children.

FHI 360 is a nonprofit human development organization dedicated to improving lives in lasting ways by advancing integrated, locally driven solutions. Our staff includes experts in health, education, nutrition, environment, economic development, civil society, gender, youth, research and technology — creating a unique mix of capabilities to address today’s interrelated development challenges. FHI 360 serves more than 70 countries and all U.S. states and territories.

At Johnson & Johnson, our Credo inspires our strategic philanthropy to advance the health of communities in which we live and work, and the world community as well. We focus on saving and improving the lives of women and children, preventing disease among the most vulnerable, and strengthening the health care workforce. Together with our partners, we are making life-changing, long-term differences in human health.


Related reading

Event Recap: Partnerships to End Poverty Workshop

RESULTS grassroots activists discuss the policy implications of the six pathways that were presented by the Microcredit Summit Campaign. It’s now their turn as RESULTS volunteers to decide what to do with that information. Learn how you can join RESULTS.

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On Sunday, July 19th, the Microcredit Summit Campaign hosted a standing-room-only workshop with attendees to the 2015 RESULTS International Conference. Those who came heard from leading voices on the future of financial inclusion, focusing on the crucial role of partnerships and advocacy in reaching the poorest.

Larry Reed, director of the Microcredit Summit Campaign, began the session by introducing the Campaign’s role in pushing for an understanding that achieving full financial inclusion means including those living in extreme poverty.

From the start, the Microcredit Summit Campaign has advocated scaling up microfinance and other financial inclusion interventions. They can provide those living in extreme poverty with the diverse array of financial and non-financial services that will support their journey out of poverty.

Reed spoke about the need for continued innovation in client-centered development of financial tools, creative ideas for reaching the hard-to-reach at affordable prices, and the promise that smart microfinance can help create positive and durable changes in the lives of those being served.

Six Pathways

Read more about the six pathways.

The Campaign is advocating for closer consideration of six financial inclusion strategies — our “six pathways” — that show promise in reaching people living in extreme poverty with needed products and services. These are the six pathways:

  1. Integrated health and microfinance
  2. Savings groups
  3. Graduation programs
  4. Financial technology
  5. Agricultural value chains
  6. Conditional cash transfers

In the discussion that followed, moderated by Sonja Kelly (fellow at the Center for Financial Inclusion at Accion), the panelists responded to questions about the importance of partnerships in achieving the goal of ending extreme poverty by 2030 and the role, present and future, of microfinance and financial inclusion in supporting these efforts.

DSK Rao, regional director for Asia-Pacific at the Campaign, focused on the immense potential for integration of health education and services into the delivery model of microfinance. He explained that “microfinance institutions shouldn’t run hospitals, but should spread essential health information and services to their clients when needed.”

Rao explained that the presence of MFIs, with their deep penetration into hard-to-reach communities, offer important opportunities to also deliver valuable health services (both financial and non-financial) to families often excluded from more mainstream service channels.

Larry Reed discussion possible advocacy options RESULTS’ citizen activists could take to policy makers in the coming days and months.

Reed also expanded on the power of government partnerships — specifically through conditional cash transfer and graduation programs — to reach those living further down the poverty ladder than those included in other social protection program designs.

Another guest speaker in the workshop, Olumide Elegbe from FHI 360, has extensive experience designing long-term partnerships between the government, nonprofit, and private sectors. He explained that “successful development is cross-sectoral and integrated,” much like poverty itself.

The mission of RESULTS and RESULTS Educational Fund, the parent organization of the Microcredit Summit Campaign, is to end the worst aspects of hunger and poverty. The annual International Conference aims to empower their grassroots activists from around the world to become strong and knowledgeable advocates for issues related to the RESULTS mission.

Therefore, after the panel discussion, workshop participants broke into small groups to take the discussion into brainstorming advocacy actions that can promote the kinds of financial inclusion interventions that will help end extreme poverty. These small group discussions focused on tangible points of action both for the longer term future as well as in anticipation of their meetings with representatives on Capitol Hill and at the World Bank on Tuesday, July 21st.

Voice your opinion in our comments section. How can you advocate for financial inclusion?

Learn more

Become a citizen advocate!

The Microcredit Summit Campaign’s role at RESULTS is to lift up microfinance solutions designed for the world’s extreme poor, creating economic opportunities to help lift themselves out of poverty.

The Campaign hosted a standing-room-only workshop with attendees to the 2015 RESULTS International Conference who came to hear from leading voices on the future of financial inclusion and the crucial role of partnerships and advocacy in reaching the poorest. Read RESULTS’ annual report today!


Related reading

The power of story in our work

RESULTS IC

Join us at the 2015 RESULTS International Conference in Washington, D.C., this July 18-21. Leading poverty experts, activists, policymakers, and YOU will convene for a unique conference that mixes an educational experience and advocacy opportunities around increased access to education, health, and economic opportunity. Together, we can change the world!

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This article was originally posted by RESULTS on June 09, 2015. Re-posted with permission.

>>Authored by Kristy Martino, U.S. Poverty Organizer, RESULTS

Last week, the Coalition on Human Needs (CHN) and TalkPoverty.org presented a fantastic webinar on the importance of telling your story. As advocates, we may understand the value of statistics, lobby meeting “leave behinds”, and fact sheets, but we sometimes forget the need for powerful stories.

As RESULTS gears up for our annual International Conference, we are looking for ways to elevate the voices of the real experts in poverty, and support them to tell their story – a key element in creating change.

The Community Voices: Why Nutrition Assistance Matters webinar is a resource for those new to, or nervous about, sharing their experiences. It’s also a great reminder that legislators and those in power learn from stories, both good and bad. In a climate where misinformation is rampant, it is critical we not only bring facts to the table, but also humanize our issues, putting a face (or rather, many diverse faces) to the problems and the solutions, as many of the programs we fight for (e.g. the Earned Income Tax CreditChild Tax Credit, and SNAP) are successful programs that lift millions out of poverty.

As Greg Kaufman, editor of TalkPoverty.org said during the webinar, “In DC, we have plenty of numbers, plenty of data. What’s lacking is experts with a seat at the table; stories of real people.”

Tammy Santiago, from Witnesses to Hunger, shared her story and how she found the confidence to tell it. She drew from her own personal experience growing up in Boston. She saw so many around her with the same struggles who didn’t have the strength or ability to speak up, so she felt obligated to do it for them. “I hope that others listening to what I share will feel empowered and obligated to share their voices too-it’s needed,” Tammy said. “I’m not just a number, I’m an individual.”

To learn more about this new project from CHN and other coalition allies, download the presentation slides or listen to the recording of the webinar. RESULTS is also working to lift the voices of these “experts” who have witnessed the impacts of poverty first-hand. Some of them will share their stories at the RESULTS International Conference, July 18-21 in Washington, DC.  We hope to have more exciting news about our work with our “Experts on Poverty” in the coming weeks.