5 lessons on expanding financial inclusion and usage

Source

Source: The 2015 Brookings Financial and Digital Inclusion Project Report: Measuring Progress on Financial Access and Usage.

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>>Authored by Mbaye Niane, 100 Million Project intern

The Center for Technology Innovation (CTI) at the Brookings Institute recently published the 2015 Brookings Financial and Digital Inclusion Project (FDIP) Report and Scorecard. It evaluates access to and usage of affordable financial services across 21 different countries in Africa, Asia, and Latin America.

These countries are geographically, economically, and politically very diverse, but many of their citizens share a common experience of being excluded from formal financial services. Governments from these 21 countries [1] have made a commitment to achieve financial inclusion by improving access to and usage of appropriate, affordable, and accessible financial services. At the Microcredit Summit Campaign, we are mobilizing commitments from private sector actors as well as governments to expand access to and usage of just such high quality financial — as well as non-financial — services.

We know many organizations in the microfinance and financial inclusion sectors affirm a vision of ending poverty. The aim of this coalition is to tie visions to actions and action to achievement. For example, the Technical Secretariat for Disabilities (Secretaría Técnica de Discapacidades) of the Vice-What is a Commitment + Actions to end extreme povertypresidency of the Republic of Ecuador has committed to support 500 entrepreneurial projects led by persons with disabilities through the Productive & Financial Inclusion Network and to implement of a set of poverty measurement indicators that will allow the Technical Secretariat to assess progress in meeting its objectives in serving persons with disabilities.

Brookings’ Financial and Digital Inclusion Project (FDIP) measures the progress achieved in those 21 countries and seeks to answer important questions related to global financial inclusion efforts [2], questions that we are interested to know the answer to as well.

  1. Do country commitments make a difference in progress toward financial inclusion?
  2. To what extent do mobile and other digital technologies advance financial inclusion?
  3. What legal, policy, and regulatory approaches promote financial inclusion?

The FDIP Scorecard assesses the accessibility and usage of financial services in each country using 33 indicators across four dimensions: country commitment, mobile capacity, regulatory environment, and adoption of traditional and digital financial services. This scorecard will help non-governmental organizations, policy makers, private sector representatives, and others examine the best practices for facilitating and measuring financial inclusion.

The FDIP reports that Kenya, South Africa, and Brazil lead the 21 countries overall on financial inclusion. Rwanda and Uganda follow, tied at fourth place. These high-performing countries took the critical steps towards financial inclusion such as policy and regulatory changes. Creating an accessible and affordable path for poor families to use digital technology is a strategic way to get them out of poverty. The FDIP report and scorecard give us valuable information about financial inclusion. It is valuable to show that countries making commitments, solving regulatory issues, and creating an accessible and affordable path for poor families to use digital financial services (i.e., mobile money and e-wallets) is a strategic way to get them out of poverty.

Achieving financial inclusion: Five critical conclusions

The 2015 FDIP Report can be summarized with the following five critical conclusions on how to best expand financial inclusion across the world.

[ONE] Country commitments are vital to reach financial inclusion.

They facilitate knowledge-sharing and engagement among groups and assure that national financial inclusion strategies include measurable targets and a strong coordination across government agencies with the public and private sectors. Country commitments allow the creation of developing surveys that diagnose the status of financial inclusion, a critical step to develop a targeted strategy and assessing the success of future inclusion initiatives.

[TWO] Digital financial services are important for accelerating financial inclusion.

Governments and the private sector will need to increase investments in digital communication and payments infrastructure and ensure services are affordable. The use of digital financial services has grown significantly in recent years among many people who have little or no previous experience with formal financial services. Many households have more than one mobile phone, smartphone or tablet.

We believe that mobile money linked with agent networks in low-income communities is a key financial inclusion strategy — one of our six “pathways” — to help end extreme poverty. According to the Groupe Speciale Mobile Association (GSMA) in 2015 the number of cellular connections through mobile phones, smartphones and tablets increased to more than 7.5 billion and is expected to increase to over 9 billion by 2020. Additionally, smartphone penetration will allow non-bank institutions to expand access to more user friendly interfaces such as mobile financial services. However, for several reasons, feature (or “dumb”) phones will remain the preferred option in many developing community contexts (i.e., poor villages in Africa) for a while still.

[THREE] Geography generally matters less than policy, legal, and regulatory changes.

With this said, there are some regional trends in terms of financial services provision, however. Regulatory and policy changes will likely accelerate financial inclusion outcomes, but in order to promote digital financial services — which, as we explain above, is important for accelerating financial inclusion — countries need a robust digital ecosystem that promotes innovation.

[FOUR] There are many important actors with major roles and they need to coordinate closely.

Central banks, ministries of finance and communication, regulated banks and non-bank financial providers, and mobile network operators each have a major role in achieving financial inclusion. They should closely coordinate with respect to advances in policy, regulation, and technology to ensure a vibrant and inclusive financial ecosystem.

The Microcredit Summit Campaign organized a Field Learning Program last year for ministers and directors of social protection programs in Africa who were interested to learn how to replicate and scale up important, accessible, and affordable financial services to the extreme poor. They observed how flagship programs like Ethiopia’s Productive Safety Net Program are combating extreme poverty pairing financial services with social protection programs. In Mexico, they examined how the government and regulatory authorities coordinate with financial entities and technology companies to deliver a conditional cash transfer (CCT) program. The national development bank, BANSEFI, plays an integral role as a facilitator of cash transfers and an accounting hub for the social protection program.

[FIVE] Tackle the gender gap and address diverse cultural contexts with respect to financial services.

Solving these two problems will help achieve global financial inclusion. For example, formal financial service providers encounter mistrust and a lack of awareness. Public and private sector leaders need to educate the public about these services and mobilize their efforts to improve the efficiency and reliability of communication networks.

The FDIP Scorecard

The FDIP Scorecard provides us an overall ranking for each country on the rate of financial inclusion, a country’s commitment, the mobile capacity, the regulatory environment, and adoption of traditional and digital financial services.

The FDIP Report and Scorecard are instructive to us as we pursue our advocacy on uptake of the six pathways (mobile money, integrated health and microfinance). The FDIP report and scorecard hold valuable information that can provide positive guidance to the design and delivery of financial inclusion interventions. This report strengthens the growing body of evidence demonstrating effective ways of reaching the hardest to reach and poorest individuals with programs that support their sustained progress out of poverty.

The scorecard offers an easy-to-understand progress report on financial inclusion commitments. How can we assess, in the future, progress made on Campaign Commitments?

Here is an example of one of the 21 scorecards in the report:

We hope this report provides strength to the growing body of evidence demonstrating effective ways of reaching the hardest to reach and poorest individuals with programs that support their sustained progress out of poverty.


Footnote

[1] The 21 countries are Afghanistan, Bangladesh, Brazil, Chile, Colombia, Ethiopia, India, Indonesia, Kenya, Malawi, Mexico, Nigeria, Pakistan, Peru, the Philippines, Rwanda, South Africa, Tanzania, Turkey, Uganda, and Zambia.

[2] John D. Villasenor,West, Darrell M., and Lewis, Robin J. The 2015 Brookings Financial And Digital Inclusion Project Report. Pg.3: http://www.brookings.edu/~/media/Research/Files/Reports/2015/08/financial-digital-inclusion-2015-villasenor-west-lewis/fdip2015.pdf?la=en


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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

Addressing the financial needs of the most excluded

Anowara Begoum lives in Kazipara village. Anowara received a cow and goat to from BRAC through its STUP Special Targeting Ultra Poor. AusAID funds BRAC's work in Bangladesh, its estimated that BRAC works within 70,000 of Bangladesh's 86,000 villages. Photo: Conor Ashleigh for AusAID.

Anowara Begoum lives in Kazipara village. Anowara received a cow and goat to from BRAC through its STUP Special Targeting Ultra Poor. AusAID funds BRAC’s work in Bangladesh, its estimated that BRAC works within 70,000 of Bangladesh’s 86,000 villages. Photo: Conor Ashleigh for AusAID.

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The following blog post was originally published
by the Center for Financial Inclusion at Accion

>> Authored by Larry Reed, Director, the Microcredit Summit Campaign, and Jesse Marsden, Research and Operations Manager, the Microcredit Summit Campaign

In collaboration with the CFI’s process to develop the Financial Inclusion 2020 Progress Report (to be released October 1, 2015), the Microcredit Summit Campaign recently conducted interviews with microfinance leaders* around the world committed to reaching the most excluded. In this post, we share some of the insights from these conversations about how to ensure that the most invisible clients are financially included, directly drawn from the experiences of those who are doing it.

To set the stage, Luis Fernando Sanabria, general manager of Fundación Paraguaya, made this central point: “Our clients need to be the protagonists of their own development stories. Our products should be the tools they use to meet their needs and empower their aspirations.” With that reminder of the purpose of financial inclusion, we begin the discussion by asking who are the most excluded.

In each country, people living in extreme poverty (below US$1.25 a day) make up the largest segment of those excluded from the financial system. We spoke with leaders from organizations that make intentional efforts to reach this large excluded market: Fundación Paraguaya, Pro Mujer, Fonkoze, Plan Paraguay, Equitas, Grama Vidiyal, and TMSS. These organizations not only address poverty, but also a host of other dimensions that lead to exclusion, including literacy, race, gender, physical disabilities, and age. Less frequently-discussed reasons for exclusion include sexual orientation, language barriers (especially among indigenous populations), and mental or emotional health issues. In India and Bangladesh, for example, those interviewed noted that the lack of personal identification often drove exclusion, especially among women, persons with disabilities, and the socially excluded, such as transgender individuals.

In order to reach the most excluded, you have to know who they are. “Often the poorest families are invisible in their own communities,” said Steve Werlin of Fonkoze in Haiti. “When we do the wealth rankings in a community, they aren’t even mentioned.” Fonkoze takes steps to make sure that all households get included in their surveys so that the community can see who they have left out. Creating this visibility is essential. On a wider scale, in government statistics on economic activity, data on people over 65 is simply discarded or never collected.

Everyone, and every client, is unique. One of the messages of the FI2020 Progress Report is that the base of the pyramid (BoP) is not a monolithic bloc. Arjun Muralidharan of Grama Vidiyal in India noted, “You need to have a particular and unique strategy to seek out and serve these groups. This begins with deciding who you are going after. Different populations have very different problems.”

Two key elements for including the most excluded populations are building trust and overcoming prejudice. Not only do the financially excluded need to become confident in their services providers’ ability to responsibly manage their money, but they often have to become comfortable participating in a society that has regularly closed its doors to them.

“Working with disenfranchised groups is hard. We need to provide extra training and services to help overcome their self-exclusion,” said Muralidharan. Grama Vidiyal provides health services and legal rights training to members of the Dalit group (formerly known as untouchables) before including them in savings and lending groups.

On the other side of the equation are financial services staff attitudes. “In order to include people with disabilities, we need to train our staff first, to get them to overcome their prejudice,” said John Alex of Equitas in India. Equitas provides disability awareness training for its staff and clients and encourages them to find people with disabilities in their communities to include in the institution’s borrowing groups. Equitas also adapted its training and application systems to be accessible for people who are blind, deaf, mute, or face other physical limitations.

Excluded groups may have financial needs that do not fit the typical cash flows of other clients. TMSS asked rural farmers in northern Bangladesh what programs the farmers felt would be best to introduce. This client-first approach led to new programs that combined loans and savings in sync with the growing season. TMSS also changed its policies and products to meet the needs of an aging population — eliminating its age limit for borrowers. The institution also provides savings services for these clients and training for the next generation of family members to make sure they will be cared for as they age.

Those excluded from financial services often face many other types of exclusion as well, leaving them with a range of constraints that they need to address:

  • Both Fonkoze and Plan Paraguay employ the Ultra Poor Graduation Model developed by BRAC that provides a combination of cash transfers, training, savings, an asset, mentoring, and access to credit.
  • Equitas works with homeless people and provides housing and financial capacity training before providing loans.
  • TMSS provides health services, financial capability training, and vocational training.

These organizations often partner with the government and others to make sure their clients have access to the range of services they need. Fundación Paraguaya uses its Poverty Stoplight monitoring system to assess its clients on a checklist of 50 items related to poverty, health, education, and employment. It uses this data to bring in government services for common areas of need. Equitas partners with local hospitals, and Grama Vidiyal works with the government health insurance system to provide for the health needs of clients.

Achieving financial inclusion requires consistent energy to attain, maintain, and measure progress. Fundación Paraguaya uses its Stoplight system to enable clients to define and measure their own achievements over time, and provides incentives to its staff based on these clients’ achievements. Equitas provides incentives to its account officers for including persons with disabilities and measures the progress of its clients along consumption and health indicators. Plan Paraguay and Fonkoze measure the success of their ultra-poor graduation programs based on the numbers of clients who “graduate,” having met a comprehensive set of indicators related to food security, income security, asset ownership, school enrollment, housing quality, etc., and having reached a level at which they can use unsubsidized financial services.

Financial inclusion has always been about going where others wouldn’t go, addressing the needs of people who were excluded because it was too hard to serve them, or too risky, or too unsustainable. The people we spoke with represent the many financial pioneers who use innovation to expand the boundaries of inclusion, reaching those assumed to be impossible to reach.

For more on addressing client needs, check out the interactive FI2020 Progress Report, launching on Thursday (10/1).

Persons interviewed for this post: Luis Fernando Sanabria, Fundación Paraguaya; Carmen Velasco, co-founder of Pro Mujer; Steve Werlin, Fonkoze, Haiti; Mariella Greco, Plan Paraguay; John Alex, Equitas, India; Arjun Muralidharan, Grama Vidiyal, India; and Munnawar Reza, TMSS, Bangladesh.

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.

Learn more

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.

###

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

graph_MDG5

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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integrated health and microfinance news mailing list.


Take part in the social media buzz around the Global Goals this week!

  1. Sign up for the #GlobalGoalsLive Daily Delivery
  2. Share your stories and find out what others are doing on the #GlobalGoalsLive hub
  3. Engage with us on Twitter, Facebook, and wherever you are using the hashtag #GlobalGoalsLive

Campaign to host workshop with World Bank Annual Meeting in Peru

Attending the World Bank meeting in Peru? Join our workshop, “6 Financial Inclusion Pathways to End Extreme Poverty – What Role Can You Play?”

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Are you attending the 2015 Annual Meetings of the World Bank Group and the International Monetary Fund in Lima, Peru? Join us at the Civil Society Policy Forum* for a workshop to explore how microfinance and financial inclusion can contribute to the fight against extreme poverty.

The Microcredit Summit Campaign will host a workshop at the Forum at the World Bank Annual Meeting in Lima from October 6-9. The Forum promotes substantive dialogue and an exchange of views between Bank/Fund staff, civil society organizations (CSO), government officials, academics, and other stakeholders.

6 Financial Inclusion Pathways to End Extreme Poverty

What Role Can You Play?

As the 2014 Global Findex has shown, important progress toward universal financial access is evident. However, there has been much less progress for groups commonly considered to be among the most excluded or hardest-to-reach. Ensuring that these groups are not left out of the march toward universal financial access in the coming four years, intentionality in our approach will be essential as will be a clear framework for actors to coordinate their efforts.

The Campaign is highlighting six pathways that have shown positive outcomes for reaching and including the hardest-to-reach groups especially when delivered in an integrated manner. This lens can offer helpful ways to view opportunities where investment can accelerate progress in including the most excluded, hardest-to-reach populations by 2020.

Session Objective

We will show how the Universal Financial Access by 2020 (UFA2020) campaign links with ending extreme poverty by 2030. In breakout groups, participants will brainstorm how organizations like theirs (CSOs, in Bank-speak) can contribute to financial inclusion pathways to end extreme poverty.

Speakers

  • Larry Reed, Director, Microcredit Summit Campaign
  • Susy Cheston, Senior Advisor for the Center for Financial Inclusion at Accion and leads the Financial Inclusion 2020 campaign
  • Martin Spahr, Senior Operations Officer at the International Finance Corporation
  • Carolina Trivelli, Economist, CGAP

Date

October 8, 4-5:30 PM

Contact Jesse Marsden for more information.

* Note that registration for the Forum is closed. You can see the full Forum agenda here.


The 2015 Annual Meetings of the World Bank Group (WBG) and International Monetary Fund (IMF) will be held on October 9 – 11 in Lima, Peru. The Civil Society Policy Forum, a program of events including policy sessions for civil society organizations (CSOs), will be held from October 6 – 9, 2015.

Imprimir

Some Annual Meeting sessions will be livestreamed. Find out how to watch.

The registration platform for CSO representatives interested in attending the Civil Society Policy Forum is now closed. We will be processing registration requests that were received within the last few days and will be notifying applicants on the status of their request. This process can take a couple of weeks and so we ask for your patience. As previously published, no new registration request will be entertained.

#tbt: Affordable Transactions for the Poor

#Tbt_10

Photo courtesy of Jeffrey Ashe

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We are pleased to bring you this #ThrowbackThursday blog post, which was originally published in Resilience: The State of the Microcredit Summit Campaign Report, 2014, under the chapter “Mobile Network Operators Can Build Systems that Reach the Poorest and Most Remote.” The section excerpted below describes how important mobile technology and digital financial services are for reducing the cost of doing business with the poor and hard-to-reach — both for the provider and the client. Read also Ian Radcliffe’s blog post from Tuesday in which he describes WSBI’s progress achieved so far toward a related Campaign Commitment.


Transaction costs pose a significant challenge to those seeking to provide financial services to people transacting in very small amounts or living in remote areas. The cost of providing the service often exceeds the price that the client can afford to pay. People living in poverty must manage daily transactions with incomes that are small, inconsistent, and often unpredictable.

Ian Radcliffe, of the World Savings Bank Institute (WSBI) reported its research that calculates that people living in poverty can only afford to pay about USD 0.60 a month for financial transactions, an amount far lower than the cost to employ staff to manage the transactions. Moving transactions to mobile platforms can drastically reduce many of these costs.


An interview with Ian Radcliffe, Director of World Savings Bank Institute. Download a transcript of the video [PDF].

Low-income clients have shown the ability to adopt new technology when it provides them with essential services at much lower cost or with much easier accessibility than the alternative. A study by William Jack and Tavneet Suri of the M-PESA mobile payment system in Kenya describes how their system grew from its launch in 2007 to cover 70 percent of the Kenyan population today. The study stated that “while M-PESA use was originally limited to the wealthiest groups, it is slowly being adopted by a broader share of the population,” including those in the bottom quartile of household expenditure. [1] Compared to the option of receiving money from relatives far away only on their sporadic visits home, or through a USD 5 bus ride into the city, low-income people in rural areas quickly found out how to get access to a mobile phone, receive a funds transfer on it, and travel to the nearest agent to turn the digital funds into cash.

In addition, access to mobile payments can play a key role in reducing vulnerability and building resilience. Jack and Suri studied low-income families in rural Kenya who experienced economic shocks. Those with access to M-PESA received a greater number of remittances and more money from friends and family than those who did not have access to M-PESA. Access to mobile money gave them the ability to tap into a larger network and weather the economic crisis.


[1] William Jack and Tavneet Suri, 2011, “Mobile Money: The Economics of M-PESA,” http://www9.georgetown.edu/faculty/wgj/papers/Jack_Suri-Economics-of-M-PESA.pdf.

WSBI’s journey in making small-scale savings work

WSBI_Mobile Popote product Tanzania_605

Mobile banking service, Popote, in Tanzania, allows savings banks clients to access their account information anywhere. Photo courtesy of WSBI

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>>Authored by Ian Radcliffe, Director, WSBI-ESBG, Belgium

WSBI has long been a supporter of the Microcredit Summit Campaign and its goal of helping 100 million families lift themselves out of extreme poverty. As an organisation that represents the interests of approximately 6,000 savings and retail banking institutions across 80 countries, advancing financial access and financial usage for everyone is core to our members’ missions.

In fact, it is part of a heritage that can be traced back to our members’ roots that in some cases go back to the late 18th and early 19th centuries in promoting self-help among poor communities. And, since it has nowadays become broadly accepted that financial inclusion brings material economic and societal benefits including lifting people out of poverty, the Microcredit Summit Campaign’s mission is entirely congruent with WSBI and its members’ values.

Our Commitment to the Microcredit Summit Campaign was announced during the 2013 Microcredit Summit in the Philippines and renewed again at last year’s Summit in Mexico. Our commitment focuses on two elements:

  1. Identifying successful inclusive finance strategies for youth markets.
  2. Holding events with our partners and member banks to share knowledge about pricing research and the implications on offering savings products for the poor.

Both Commitments have been pursued under the auspices of WSBI’s major financial inclusion program that started in 2008 and that will come to an end later this year. The program’s aim was to significantly increase the number of savings accounts among the poor, working with savings and retail banks primarily in 10 countries [1]. We were developing new business models and distribution channels and, in many cases, taking advantage of mobile technology.

At the end of this particular journey, we are delighted that six of the banks that sustained projects throughout the life of the program doubled savings accounts, and their growth continues. They have developed business models based on lower-income populations and in so doing, these six banks have undergone significant internal cultural shifts, leading to strengthened identities by clarifying their market positioning. One bank even managed to turn a 75 percent dormant customer base into a 75 percent active one with almost all improvement coming from modest-turnover, low-balance savings accounts.

WSBI_agent with mobile money El Salvador_285

Making small-scale savings work in a digitized world
September 23, 2015
Four Seasons Hotel | Washington, D.C.
8:15 AM to 2 PM
Learn more

The banks’ projects were inevitably supported by a great deal of research and analysis performed by WSBI (including the youth research referred to in our Campaign Commitment), which is available on our website. And, apart from project implementation, the core goals of the program included articulating and disseminating lessons learned to a variety of stakeholders, which is where the Campaign Commitment of holding events with partners and member banks comes in.

On September 23rd, WSBI will run its final major event under this program: a workshop in Washington, D.C., entitled Making small-scale savings work in a digitized world.” We will showcase the successes and challenges faced by the banks that participated with us in our journey. Panel sessions and debates will address how banks and their projects have evolved to adapt to changing environments and competitive pressures. We will explore how strategies, institutional cultures, and practices have adapted as a consequence of program lessons. We will also examine what remains to be done and how the banks and others see the way forward.

The accumulated learning on display at “Making small-scale savings work in a digitized world” will be of clear interest to savings and retail banks, policymakers, and other practitioners involved in the financial inclusion world. The program and registration may be found here; participation is free and we really encourage anyone interested to join us at this workshop.

As we all work together in progressing our journey towards full financial inclusion, WSBI remains committed to continuing its work in this field, as witnessed by its commitment to the Universal Financial Access 2020 goal announced at the World Bank Group’s 2015 Spring Meetings. We are actively forging new partnerships aimed at addressing critical legal and regulatory reforms needed to facilitate WSBI members’ activities in improving financial access. We will continue to support the development of financial infrastructures that are tailored to individual environments. We will draw on the wealth of experience generated by our savings program to support savings and retail banks by way of advisory services aimed at overcoming technical or capacity shortcomings and promoting cultural or behavioral change. And finally, more than ever these days, we will support banks in adapting to the digitized world in which we all now exist to stimulate innovation so as to reach out to new customers, in particular those who currently have little or no access to financial services.

Footnote

[1] Mainly Burkina Faso, El Salvador, Indonesia, Kenya, Lesotho, Morocco, South Africa, Tanzania, Uganda, and Vietnam. Initiatives have also been pursued during 2015 in Ghana and Sri Lanka.


Related reading

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

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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

Colombia, a “Pathways” poster child

cct-grad-model_infographic_final_en1_Medium

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>>Authored by Paul Gostomski, Microcredit Summit Campaign Program Intern

The 100 Million Project, an initiative of the Microcredit Summit Campaign, aims galvanize and support work that helps advance industry toward the goal of helping 100 million families lift themselves out extreme poverty. To do so, the Microcredit Summit Campaign advocates adoption of “Six Pathways,” which are financial inclusion strategies that can reach the extreme poor and facilitate their movement out of extreme poverty.

The Consultative Group to Assist the Poor (CGAP), a global partnership of 34 leading organizations that seek to advance financial inclusion, recently published a paper that does an excellent job highlighting two pathways that are currently being implemented in Colombia: conditional cash transfers and an initiative to link mobile banking services with agent networks.

Conditional Cash Transfers

The Más Familias en Acción program began in 2001 and aims to supplement the income of families who live below the poverty line and have children under 18. Mothers receive the cash transfer conditioned on their child’s regular attendance at school. This condition also qualifies the family for a health subsidy if their child receives regular health check-ups. In 2012, Más Familias en Acción was reaching 2.7 million families throughout the country. Between 2001 and 2012, malnutrition among children in Colombia aged two and under in rural areas decreased by 10 percent. Also in this time, school attendance for children between 12 and 17 increased by 12 percent.

The Campaign advocates for the use of conditional cash transfers (CCTs) within our six-pathways framework due to evidence such as is seen from programs like Más Familias en Acción. An array of positive externalities are also associated with CCTs, including income smoothing. Stabilizing income through CCTs help families better plan for the future as the immediate risks of today are somewhat mitigated.

Conditioned cash transfers are also incentivizing beneficiaries to make investments in themselves, often through participation in programs to increase health or education for the family. During last year’s Innovations in Social Protection program led by the Campaign, participants in PROGRESA (then called Oportunidades) indicated that while they appreciated and valued the security the transfer brought, they found that the greatest positive change was understanding the significance of the education and health investments they were making in their families.

Another positive externality of conditional cash transfer, and one we find significant, is its effect on women in poor communities. Almost all conditional cash transfers are administered to the mother of the household and this in turn increases women’s bargaining power, something that’s all too often neglected in poor communities.

 Mobile Money with Agent Networks

The second of the two pathways currently being implemented in Colombia is mobile money linked with agent networks in low-income communities through the mobile banking service DaviPlata. DaviPlata, launched as a private mobile service in 2011, was able to garner 500,000 customers in its first year of operation. Taking notice of this success, the government of Colombia contracted DaviPlata in 2012 to deliver the conditional cash transfers of Más Familias en Acción to its 937,000 beneficiaries.

After being contracted, the paper noted, DaviPlata as an organization began a new focus on how to serve the poorest in the country. DaviPlata, working solely through mobile phones, makes financial inclusion easier by making transferring, receiving, and withdrawing money less costly to the recipient of the conditional cash transfer. The recipient now spends less time traveling to the bank or post office and takes less risk as he or she has less cash on their person.

The World Bank reports that of the poorest two quintiles of those living in developing countries, only 30 percent have access to a savings account, whether formal or informal. The Campaign is looking at mobile money within its six-pathways framework because of how digital financial tools are decreasing the cost of transacting and, when linked with savings, increasing the ease with which the poor can access accounts, begin to develop savings, and more easily transfer money when needed.

Although many of the poor do not have savings accounts, many do have mobile devices. Mobile money linked with agent networks like DaviPlata helps link those living in more rural and remote areas to the mobile platforms where traditional financial institutions are less easy to find.

However, DaviPlata has room for improvement as a payments facility. The CGAP paper reports that DaviPlata faces an illiterate customer base and also issues with customers that do not understand the technology. DaviPlata must also deal with dormant accounts, where customers signed up for the service but their accounts have not been used in more than 30 days. Overcoming these challenges will be critical to moving forward.

Colombia’s Next Step

Colombia’s Más Familias en Acción, is a global leader in the use of CCTs to support increased health standards and school attendance among the poor. Now, work needs to be focused on decreasing the inefficiencies around the mobile banking service DaviPlata. In the CGAP paper on Colombia, it was made clear that Colombia’s greatest development challenge was in regard to DaviPlata and increasing its financial stability. This includes taking fuller advantage of the product while making the processes and channels more efficient. With a more effective method on distributing funds, the intended effects of Más Familias en Acción can then be multiplied.


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Community-based financial inclusion: Sarah’s story

Sarah Chikuse standing in front of her pigsty

Sarah Chikuse standing in front of her pigsty. She is proud to be one of the few women encroaching into this previously male dominated agricultural territory. Photo courtesy of Alex Dalitso Kaomba.

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>>Authored by Alex Dalitso Kaomba, development consultant and freelance writer

At 39 years of age, Sarah Chikuse’s health is visibly better than the other women in her village. A single mother of two, she lives in Kang’oma village on the outskirts of Lilongwe’s Area 23 in Malawi. Her day starts at 4:00 AM when she usually wakes up to the din of her neighbors’ jerry cans and water tins at the only borehole in the village.

Sarah starts by lighting up her charcoal burner so that it gathers heat while she fetches water at the borehole. Next on the routine (if it’s during school term) is preparing her daughters for school. Once she bids her daughters goodbye, she tends to her newly acquired livestock.

Sarah Chikuse_with pigsty

Sarah in front of her pigsty. Acquiring a pig is one highlight on her growing list of achievements. Photo courtesy of Alex Dalitso Kaomba.

Owning livestock is not only a symbol of status for the privileged but also an envied source of income in Malawi, which has one of the lowest livestock herds per family in Southern Africa. Sarah is proud to be one of the few women encroaching into this previously male dominated agricultural territory.

Acquiring a pig is one highlight on her growing list of achievements. Sarah counts herself a success in being able to afford three meals a day for her family and providing her children with a basic education. She has paid their school fees and provides their books, uniforms, and lighting for evening homework.

Two months ago, her daughter contracted malaria, and for the first time, Sarah managed to hire a car and take her to a private clinic where she got rapid, quality care. The hospital bill was US $12, and she managed to pay it in full.

Life before inclusion

Life has not always been so comfortable for Sarah and her family. After a bruising divorce, she was left with less than $4 tied up in her wrapped skirt, and she struggled to make ends meet. She could hardly afford a single meal for her children. She started selling vegetables at a local market, but her family’s daily expenses were much higher than her profits and the business did not grow.

Sarah desperately wanted to get a loan but did not possess any tangible property except the roofing sheets on her two bedroom house. One institution agreed to use the roofing sheets as collateral for a micro business loan, but after careful consideration, she could not accept the offer. She had seen people in her village having roofing sheets confiscated after defaulting on payments, and she was not ready to risk such humiliating consequences.

In January 2015, she joined a self-help group (SHG), a concept championed by a local NGO, Global Hope Mobilization (GHM), which is supported by a $150,000 two-year grant from Vibrant Village Foundation. The doors of opportunity for Sarah started opening then. (GHM’s self-help groups are basically savings groups.)

As a vegetables vendor, Sarah could make $2 a day from which she would have to provide for her family daily needs. However, the SHG she joined required that she contribute $0.20 a week into the pooled funds. She struggled to keep up for two months until her turn to borrow the funds came up. She used all the money she borrowed to buy a variety of vegetables for her fresh produce business.

Photo courtesy of Alex Dalitso Kaomba.

Sarah feeding her livestock. Photo courtesy of Alex Dalitso Kaomba.

Life after inclusion

Sarah showed me a tiny pigsty with one mother pig and eleven piglets, the first time in her whole life that she has owned livestock. In a few months, she expects to sell and collect over $500. This was possible because she joined an SHG from where she accessed loans totaling a little under $100 over a 3-month period. She pumped this money into her fresh farm produce business by ordering a wide variety of vegetables and fruits which her customers had always asked her to stock. Her business revenues increased rapidly.

I asked her what her most outstanding benefit from the SHG was. With a very wide smile and beaming face, Sarah had this to say:

“I was a pauper with no hope, but the SHGs taught me the importance of saving from the little I get and how to access low interest loans. Today I can feed my family good meals every day, I have a piggery project that will soon start bringing me revenues. I intend to diversify into selling kitchenware which brings me higher profits than vegetables and even if I stock more kitchenware it is not perishable.”

Anne Chiudza from Global Hope Mobilization says, “We are aware that the marginalized, poor, and unbanked population has its own means of survival, and from the little they get they can change their lot in life by using their numbers to pool funds together. Our organization believes in facilitating improvement of livelihoods through community owned strategies and the self-help group concept is one such strategy.”

A measure of how these groups can advance community development is a borehole which the women are planning to have drilled in a year’s time at a cost of $4,000 without any donor funding.

Sarah’s story is just one among many in her 20-member group. They have managed to improve the lot of their families by building or improving their homes, by improving their families’ nutrition, and by consolidating their economic independence through self-help groups. There are 15 more groups in surrounding villages, and evidence is clear that the women’s hard work and commitment is bearing fruit for the betterment of Kang’oma community’s standard of living.


More about Global Hope Mobilization’s self-help group model

Global Hope Mobilization’s (GHM’s) self-help groups are savings groups whose sole aim is to provide a low-interest pool fund from which members (and only members) of the group can borrow to inject into their businesses. Members can save through loaning out the savings over a period of four weeks.

The groups loan out the money from the very first meeting. No funds are kept in a box of any sort because soon after contributions have been made, a borrower must take the money immediately. The funds are only deposited in the bank when they have multiplied and no members are ready to borrow that week.

Question: How does GHM create the groups?

Answer: At the beginning of the project last year, Global Hope Mobilization trained four Community Facilitators who were all drawn from the catchment community. Their role is to spearhead the formation of the groups and act as resource persons for the groups on behalf of Global Hope Mobilization.

The SHGs are self-replicating because the roof limit for each group membership is 20 members only. To date GHM, is supporting 100 groups with a total of 2000 members, all of whom are women. There is, however, an emerging demand from men in some villages to join the groups.

Q: Are the SHGs self-sustaining or are they reliant on GHM for ongoing support / hand-holding?

A: The SHGs are self-reliant. GHM only facilitates their financial literacy training and monitors their early growth stages, providing guidance and advisory [services] where needed.

Q: What training does GHM provide to the SHG members? Do they offer other sorts of capacity building like financial literacy, health, women’s empowerment, etc.? Do they try to link SHGs to other services like government social protection services?

A: The flip side of [GHM’s] concept is to provide women with a platform and confidence to identify and demand social services from government departments like water, health, etc. Every group meeting ends with a social discussions segment. All issues are recorded for future reference and actioning. Using the SHG as a nucleus for change, GHM facilitates health talks and [sexual and reproductive health] SRH awareness campaigns.

Q: Do all SHG members take out a loan? Or, do some just use the SHG to save? What is the interest rate on loans (if there is interest) and what is the savings interest rate (if there is one)?

A: Around 75 percent of members take out loans at an average interest rate of 10 percent per month. The loans period is 4 weeks maximum, depending on the loan size and specific group by-laws. Interest [on] savings is 10 percent.


About the author

Alex KaombaAlex Dalitso Kaomba is a 35 year old Malawian rural development consultant and freelance writer. He lives in a village on the outskirts of Lilongwe the capital city of Malawi. He works with International and local NGO’s in Malawian villages in the areas of access to energy for maternal health and education, HIV and Aids, education and environmental interventions. Alex has a passion for development work and the African stories of self-sufficiency and sustainable rural development. His favorite pastime is reading, watching sport and playing cricket.

alex.kaomba[at]gmail.com | @AlexKaomba | https://www.facebook.com/kaomba


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