New database tool can help you define and refine client outcomes

Gallery

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.

Español | Français | Continue reading

4 interventions to help victims of trauma find hope and dignity

Josh Goldstein_keynote speech

Josh Goldstein (CFI) gives a keynote speech at the 8th Annual PCAF Pan-African Psychotrauma Conference in Nairobi, Kenya, a multidisciplinary event that focuses on psychological trauma in Africa’s war-affected societies. Photo: Josh Goldstein

Lea en español *** Lisez en français


The Center for Financial Inclusion at Accion has made a Campaign Commitment to bring greater attention to the issue of aging and financial services and further support the inclusion of those with disabilities. Learn how you can join the global coalition of organizations working to help 100 million families lift themselves out of extreme poverty.

Read the full text of Josh Goldstein’s keynote speech.


>>Josh Goldstein, Vice President, Economic Citizenship & Disability Inclusion, The Center for Financial Inclusion at Accion

“Over a sixth of the world’s population has directly experienced armed conflict, torture, terrorism, sexual and gender-based violence, ethnic cleansing or genocide.”
— The Peter C. Alderman Foundation (PCAF) website

I recently attended the 8th Annual PCAF Pan-African Psychotrauma Conference in Nairobi, Kenya, a multidisciplinary event that focuses on psychological trauma in Africa’s war-affected societies. PCAF operates mental health clinics in Cambodia, Kenya, Liberia, and Uganda and conducts trainings for mental health professionals. At the conference,I was surrounded by global leaders from health care, academia, and a litany of organizations working in the mental health space.

At first blush, my placement at such an event might seem odd as my work focuses on disability inclusion for microfinance. But, I’d argue that’s more of a reflection of how society, and our industry, views mental disabilities — with reductive biases — rather than how they fit within microfinance.

I had the privilege of presenting a keynote to the attendees. I discussed whether it’s possible for trauma patients who have gone through a successful course treatment that includes counseling, medication, and livelihood trainings to become clients of microfinance institutions (MFI) and build small-sized enterprises. Immediately below is an abridged version of my speech, with the complete text linked at the end.

Can MFIs help victims of trauma find hope and dignity through self-employment?

Josh Goldstein_keynote speech_portAs a post-traumatic stress disorder (PTSD) survivor myself from the U.S., who received treatment, I believe with all my heart that in a just society poor people with mental health challenges should get the help they need so they can flourish as human beings. Unfortunately, in the international development world I come from, this great cause is barely on the radar — in spite of the fact that reaching the most destitute is at the urgent core of all international development work. Indeed, I share your outrage at the paucity of funding and support for community mental health from governments and foundations.

But, why self-employment for those with mental health issues like PTSD? Why not go find a job and work for a business that provides a regular paycheck? Isn’t that easier and more secure? Of course it is. Most clients of MFIs are what we call “necessity entrepreneurs” and would rather have such jobs than start their own businesses. But, the sobering reality of limited formal sector employment opportunities across Africa makes finding such jobs for persons with physical disabilities, let alone psychosocial disabilities, even more challenging than it would be otherwise. Even in my country, the United States, unemployment of persons with disabilities in the formal workplace remains unconscionably high.

But are such financial products like credit or savings a good idea for someone with PTSD? For example, would the effort to save or borrow money bring greater stress? There is no easy answer based on my cursory review of the very limited research studies to date — the results are ambiguous and prove nothing conclusive one way or the other. What we do know, thanks to PCAF Uganda Program Director Dorothy Kizza, is that relapsing back into mental illness is often caused by a lack of employment. So, on balance, the stress of not working may be equally or more stressful than paying back a working capital loan which at least holds the promise of a more hopeful future. My own hunch is that the answer will only be decided on a case-by-case basis and so no generalization is really possible.

What seems beyond doubt, as Crick Lund, a professor at the University of South Africa and CEO of PRIME, a consortium of research institutions and ministries of health, has written, “is [the] growing international evidence that mental ill health and poverty interact in a negative cycle. This cycle increases the risk of mental illness among people who live in poverty and increases the likelihood that those living with mental illness will drift into or remain in poverty.” A big-picture study from the Harvard School of Public Health and the World Economic Forum estimates that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$16.3 trillion between 2011 and 2030.

I am happy to say that the Center for Financial Inclusion (CFI) and its allied partners working on disability inclusion have begun to demonstrate significant success in including persons with physical disabilities in microfinance in Bangladesh, Ecuador, India, Nigeria, Paraguay, and Uganda, and I hope we can expand this initiative to include persons with mental health issues.

However, achieving the progress needed to financially include people with physical disabilities is not the same as that of including people with mental health issues. Persons with psychosocial disabilities in Africa and in many other places in the world are, in the words of Nigerian healthcare advocate Ifesinanchi Sam-Emurwa, “doubly stigmatized” for having a disability and for that disability being a mental one.

And, to paraphrase remarks by Columbia University psychiatrist Dr. Evaristo Akerele, who spoke this past June at the only mental health session on psychosocial disabilities at the U.N. Conference of State Parties annual disability conference: The person with mental health issues is blamed for bringing what psychiatrists call depression, or anxiety, on themselves. Beliefs such as that God is upset with them, that drug use is to blame, that witchcraft is at work, are all common. In most places, the term “depression” is not culturally acceptable or even understood; there is not an accepted and shared nomenclature for describing mental suffering.

An interesting example of how this “double stigma” plays out also comes from Nigeria, in the financial services arena. The Central Bank of Nigeria recently earmarked US$20 million to financial service providers to make loans to persons with disabilities — a great step forward. But, it explicitly excluded persons with mental health disabilities as recipients of these loans.

So, what can be done to improve the situation? I want to suggest five of the biggest challenges we face and interventions that I believe we can undertake together to answer these challenges and improve the livelihood possibilities of persons with psychosocial disabilities. I hope this will form the beginning of an action plan.

Challenge 1: How can the staff of an MFI with no training in psychology even begin to identify clients with mental health issues if there are no common, agreed on terms of reference for describing distressed states of mind? How do we sensitize staff to work with this client segment?

It is relatively easy to determine a baseline of the numbers of persons with physical disabilities who are clients, by asking medically non-invasive questions (or just through observation) about their state of wellness. Unless a person with mental health issues self-discloses, it is impossible to know if they are suffering from a depressive, anxiety, or other disorder.

Intervention: Volunteers from the mental disability space, like attendees of these annual PCAF Conferences,can help financial service providers design survey questions that allow MFI staff to get a better count of current clients with mental health issues. These volunteers along with PTSD survivors themselves can help sensitize MFI staff on how to best reach out to persons with mental health disabilities. They can connect MFIs with community mental health leaders and, in particular, patient advocates. These learnings can then be incorporated into the Framework for Disability Inclusion so that a set of best practices can be developed and shared with MFIs from around the world.

Challenge 2: Access and support for basic capital and business training for persons with psychosocial disabilities is largely lacking.

Intervention: Connect PCAF graduates, and those of other mental health clinics that include business training, to microfinance providers, credit unions, self-help savings groups, and otherproviders offering group-based financial services as well as enterprise-building support to professionalize the business training and operations of the clinic patients. The natural intermediary to make first contact with the MFI or other provider might be the PCAF social worker, during their weekly or monthly follow up outreach to former PCAF patients in their villages, homes,and workplaces.

Just as CFI identified two or three institutions in India that were eager to do a pilot to include persons with disabilities in their programs, we can work to identify two or three MFIs in the PCAF countries of Cambodia, Kenya, Liberia, and Uganda who want to be leaders in including persons with psychosocial disabilities in credit and/or savings groups. Success is promising here since a portion of PCAF livelihood trainings are done in groups,suggesting that the transition to group lending methodologies could prove to be quite natural and comfortable.

Challenge 3: The United Nations (U.N.) does not do enough to recognize the importance of mental health disabilities — when it comes to collecting good statistics, when it comes to prioritizing it as a Sustainable Development Goal to reduce extreme poverty, when it comes to seeing therapeutic intervention as a significant part of the Constitution on the Rights of Persons with Disabilities treaty.

Intervention: Those working in this field and other interested parties should lobby the Washington Group on Disability Statistics (the U.N. body charged with disability statistics) to include a specific question on mental health in its so-called “short set” of questions that it provides to governments that do censuses and disability surveys. Similarly, while they’re still being shaped, pressure should be applied to modify the Sustainable Development Goals to include much stronger language on mental health.

Finally, there must be concerted lobbying by PCAF, and others, to ensure that in implementing the articles of the U.N. Convention on the Rights of Persons with Disabilities, the right to receive treatment for mental health ills gets equal billing with assuring the right to vote and enjoy equal protection before the law. If this does not happen, it will be much harder for mental health practitioners to obtain funding from governments and foundations to expand their community mental health programs — something critically important in countries like Burundi that have only one psychiatrist in the whole country!

Challenge 4: To create a new set of global standards and indicators for microfinance institutions and other financial service providers to follow that will establish the importance of and offer guidance on serving PTSD survivors and other persons with psychosocial disabilities.

Intervention: The CFI will work collaboratively to push the microfinance industry-wide standard-setters to add mental health indicators. With the help of key industry standard-setting groups, I believe that we can help to break down the attitudinal barriers that keep persons with psychosocial disabilities in extreme poverty unbanked and stigmatized. For example, I am delighted to announce that the Poverty Stoplight has offered to take the lead in creating a mental health indicator for its assessment tool. The Poverty Stoplight set of indicators, pioneered by Fundación Paraguaya and now used around the world, sees poverty as multidimensional and have developed a tool that allows the poor to measure their own poverty, broken down into different categories. Adding a mental health indicator could be a source of data that could be used not only by MFIs but by local community mental health leaders and other public health providers.

Freedom from Hunger in conjunction with the Microcredit Summit Campaign has just published a new guide called “Healthy, Wealthy, and Wise: How Microfinance Can Track the Health of Clients,” in which they share experiences in selecting and pilot-testing health indicators among four MFIs. The researchers asked questions around six health indicators: food security and nutrition, preventive health care, poverty, curative health care, sanitation and safe water, and attitudes. The results demonstrated the added value of health indicators when combined with poverty measurement in helping MFIs understand client well-being. Their “theory of change” is that with greater financial resources, the clients will be able to meet their essential needs as outlined above — like having cleaning water or improved nutrition. I have consulted with the guide’s author, Bobbi Gray, and she is very willing to work with us to see if we can help her develop a seventh indicator around mental health — which is great news.

My conclusion is that self-employment can offer dignity and hope to persons recovering from mental illness. And, that like persons with physical disabilities, many can make excellent clients. I think it is worth exploring how we can do more to connect to PTSD survivors with MFIs and other financial service providers to open their doors to PCAF clients and those of other clinics. At the very least, this initiative will help fight stigma and bring down attitudinal barriers. Let us see what works and what sticks. It is certainly worth a try.

Read the full text of Josh Goldstein’s keynote speech.


Related reading

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.

Lea en español *** Lisez en français


>>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.

Lea en español *** Lisez en français


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

#tbt: Microfinance as a Platform for Health Education

KNOWLEDGE ABOUT HIV VIRUS

Knowledge about HIV

Lea en español *** Lisez en français


We are pleased to bring you this #ThursdayThrowback blog post, which was originally published in The State of the Microcredit Summit Campaign Report 2011.


Microfinance as a Platform for Health Education

>>Authored by D.S.K. Rao, Regional Director; and Anna Awimbo

<img class="size-thumbnail wp-image-4303" src="https://mcsummit.files.wordpress.com/2014/04/momf.jpg?w=150" alt="April is the Month of Microfinance
Learn more” width=”150″ height=”150″ />
April is the Month of Microfinance
Learn more

The Microcredit Summit Campaign launched its Financing Healthier Lives Project in 2002. The project aims to build a global group of microfinance institutions capable of providing health education trainings to their clients in a sustainable manner and reach over half a million clients affecting some 2.5 million family members.

In March 2009, the Campaign released an updated version of its report outlining how microfinance can be used as a platform for health education. This strategy has proven effective at enhancing clients’ movement out of poverty, especially in situations where microfinance alone is insufficient. The document, titled Financing Healthier Lives, makes the case for a global expansion in the use of microfinance as a platform for health education and other health services.

Much of the initial work on this project has been centered in South India where The Campaign has trained in-country trainers and partnered with four organizations to reach more than 30,000 microfinance clients with health education. The four organizations are Star Microfin Service Society (SMSS), People’s Multipurpose Development Society (PMD), Pioneer Trad and McLevy Institute of Development Services (MIDS). SMSS is an MFI operating in Andhra Pradesh, whereas the remaining three are NGOs based in Tamil Nadu. The clients have received education in the following six topics in their local language 1) HIV and AIDS prevention; 2) Integrated Management of Childhood Illnesses (IMCI); 3) Women’s Health; 4) Infant and Child Feeding; 5) Healthy Habits and Planning for Better Health and Using Health Care Services; and 6) Malaria Prevention and Treatment.

In early 2010, the Campaign expanded its work to North India, where it is working with CASHPOR Microfinance to implement a pilot project covering 9,000 clients with education in IMCI and Women’s Health. Encouraged by the extremely positive feedback from its field workers and clients, CASHPOR is planning to triple its outreach to 30,000 clients.

The following graphs illustrate the Campaign’s findings from the work in India and demonstrate that important client-level outcomes are achieved when MFIs integrate health education. For example, data showed improved knowledge of malaria and HIV and AIDS as well as positive behavior change to mitigate the risks associated with these illnesses. Similar positive results were shown with respect to pre- and post-natal medical check-ups of pregnant women. Clients have also shown improved confidence in preparing for future health expenses [1].

Knowledge about HIV

KNOWLEDGE ABOUT HIV VIRUS

Knowledge about critical danger signs in children

figure2_danger signs

A team of UCLA Executive MBA students recently evaluated this project and published a 2010 report that recommended expansion of the initiative because of its benefits to clients and the partner institutions. The report also underscored the need to deepen its work on measuring knowledge gains and behavioral changes in clients and their families. The Campaign has begun laying the groundwork for a more in-depth study of these changes and hopes the additional data will go a long way in convincing many more MFIs worldwide to introduce and scale up health integration.


Source: Financing Healthier Lives, Microcredit Summit Campaign, 2009.

[1] The project’s independent third-party evaluators randomly surveyed 400 members from all project participants across all four organizations. The selected members were given a questionnaire prior to and at the conclusion of both the HIV and AIDS and IMCI education modules. Incomplete or illegible surveys were excluded from the final tally.

Partnership building to reduce the Philippines’ maternal mortality rate

health-education_HMHB-PH_Oct2014_Courtesy-of-CARD-MRI

Women learn about family planning techniques while they wait for their exams at October’s community health fair.

Lea en español *** Lisez en français


Pathway

Microfinance savings and/or borrowing groups linked with health education, health financing, and health product delivery


>>Authored by Camille Rivera, Senior Program Associate, and Sabina Rogers, Communications & Relationships Manager

HMHB_CMYK_English_BeveledWith the 2013 Partnerships against Poverty Summit in the Philippines, we wrote a new chapter in the evolution of the Microcredit Summit Campaign. The 16th Microcredit Summit focused on how public-private partnerships could combine expertise from the field of microfinance with other areas to develop more efficient and sustainable services for the extreme poor.

We have since created one such collaboration in order to address the problem of stubbornly high maternal mortality rates in the Philippines. While the country has experienced strong economic growth in recent years and the government has instituted a national hospital insurance scheme, PhilHealth, maternal mortality is at 221 per 100,000 live births. The Philippines are far off track of their maternal mortality MDG of 52 deaths per 100,000 live births.

It is a long way to go from 221 to 52 in the next few months, but when offered the opportunity to scale up in a short period of time our integrated health and microfinance methodology, we (with Freedom from Hunger) jumped at the chance. In partnership with a local partner CARD MRI (the largest social development organization providing micro-financial services in the Philippines) and with the financial and strategic support of Johnson & Johnson, we are implementing the Healthy Mothers, Healthy Babies project (HMHB, or “Kalinga Kay Inay” by its name in Tagalog).

Photo credit: Cassie Chandler

Photo credit: Cassie Chandler

How it works

The idea is simple: offer free health check-ups and behavior change education on health topics to pregnant and lactating women to create positive health outcomes. By the end of 2015, CARD and other MFIs will educate 600,000 women to improve maternal health and safe deliveries of infants, birth outcomes, and reduce preventable maternal death; and 8,000 pregnant or lactating women will be directly connected to relevant services and products. CARD and partners have held two community health fairs so far, and for many of these women, it was their very first gynecological exam.

At these health fairs, CARD sets up tents to give shade to those waiting outside. Inside the building, as the women wait for their preliminary exams (and, if necessary, ultrasounds), they learn about family planning. The volunteer health providers (doctors, OB-GYN, midwives, and others) write prescriptions for those who need medications, and BotiCARD (a CARD MRI institution) fill them for free in a tent set up outside.

CARD has found their collaboration with local government and public health units to be vital in getting higher-than-expected turnout to the fairs as well as for identifying local health providers for CARD members. Local administrators of PhilHealth have joined our January health fair and provided services to 179 health fair patients ranging from members’ renewal enrollment, new enrollment, membership updating, and printing of members’ data information.

Making these changes lasting changes

More importantly to us, through this endeavor, we are working to improve the scalability and sustainability of delivery of health education and related services to millions of women and children in the Philippines. Inspired by the 2013 Partnerships against Poverty Summit, the Campaign’s role in the HMHB project is to reach beyond the traditional microfinance actors and facilitate a partnership-building process for the “MFIs for Health” consortium, a group of 18 MFIs who are banding together to increase access for their communities to health-related products and services.

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

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

We are talking with several foundations, corporations, and associations to identify specific ways that they can work with us and MFIs for Health to increase access to and improve delivery of healthcare services. The Zuellig Family Foundation (ZFF) and JPHIEGO in the Philippines are two organizations that have joined forces with our alliance — whether formally or informally. They have facilitated introductions to local government units (LGUs) and the Integrated Midwives Association of the Philippines to recruit healthcare providers as volunteers for the health fair and get their help spreading the word to their patients. In fact, ZFF and CARD are working with the Rural Health Unit (RHU) in the Visayas to coincide the RHU’s “Buntis Congress” (Pregnant Women’s Congress) with CARD’s April community health fair. Through this coordination, we are pooling resources and thus gain a larger potential impact for the community.

April is the Month of MicrofinanceLearn more

April is the Month of Microfinance
Learn more

This strategy behind HMHB, to facilitate partnerships between microfinance actors and players in other sectors, parallels efforts to create more integrated approaches to solve the most pressing needs of the extreme poor. In this case, we are addressing maternal and child health; in Ethiopia, it could be fistula and, in India, it could be non-communicable diseases.

Because MFIs meet regularly with large numbers of clients, they serve as an ideal platform to convey health information and services to clients who often build relationships of trust with their loan officers, as well as other members in their group. These exchanges can also have a replicator effect as clients are encouraged to share the information with their family members and others in their community.

By forging partnerships across sectors and bringing in non-traditional actors to microfinance, the Campaign is maximizing the best aspects of each player and (hopefully) helping the Philippines reduce their maternal mortality rate to 52 deaths per 100,000 live births.

Relevant resources

Millennium Development Goal 5: Progress and challenges in maternal mortalitySource: The Institute for Health Metrics and Evaluation

Millennium Development Goal 5: Progress and challenges in maternal mortality
Source: The Institute for Health Metrics and Evaluation

Health Outcome Performance Indicators will help us “understand clients”

PMD clients and health providers

Microfinance clients are linked with local healthcare providers by PMD in India.
RESOURCES: 
– Check out the recording of the webinar and review the PPT presentation.
– Read the SEEP Network’s blog post recapping the webinar.

Lea en español *** Lisez en français


On March 4, 2015, in collaboration with the SEEP Network‘s HAMED working group, we co-hosted a webinar called “Healthy, Wealthy, and Wise: How MFIs Can Track the Health of Clients,” to discuss how microfinance institutions and their partners can measure client health and well-being. Our regional director for Asia-Pacific, Dr. D.S.K. Rao moderated the webinar. Joining us in the webinar were Bobbi Gray (Freedom from Hunger), Sandhya Suresh (ESAF Microfinance and Investments Pvt Ltd in India), and John Alex (Equitas Group and Equitas Development Initiatives Trust in India).

Choosing Health Indicators. Click the image to see it enlarged.

The webinar was focused on addressing questions of application and use of tracking health outcomes and how MFIs benefit from collecting data on client health. The HOPI will help institutions to know who their clients are and understand their needs — a defining theme, according to Dean Karlan, of the World Bank’s forum on microcredit at the end of February, and one that we have written extensively on as well.

And, of course, there were many questions posed by the audience, and we have made and effort to collect and answer those questions in this blog post.

Our work with partners ESAF, Equitas, and other financial service providers in India as well as the development of the HOPI is made possible with the generous support of Johnson & Johnson.

Comment

Tom Shaw (Catholic Relief Services):

Please note that [adding health onto microfinance] is not unique to microfinance institutions (MFIs); it is also applicable and being applied through the savings group platform.

Bobbi Gray:

Agreed. While this discussion has focused on MFIs, there are a growing number of savings groups who have been adding health to their activities as well. We’ve also seen some health sector actors find that savings groups have been organically forming within their programs, so they’ve tried to formalize this process such that the savings group structure becomes a significant part of the program. John Snow International has an example of this in Nigeria.

I think it’s important to add that even within health programs, tracking health outcomes at the “patient” level is just as a significant activity as it is for financial service providers (MFIs and savings groups, alike). While there are population-based surveys that inform the work of the health sector, tracking health outcomes at a more programmatic level is not a simple task for them either because of the cost and time implications of collecting this data.

That’s why I think there is an important opportunity for finding ways to collaborate with health sector actors by using the data that MFIs are able to collect, since it could also be informative data that local health sector actors can also use. This data can be a vehicle for strengthening relationships across these two sectors.

Question 1

Vanina Gacioppo:

How is the health entrepreneur accepted by the community? (As there may be old “quacks” that may not be well prepared but the community have relied on them for years.)

Answers

Bobbi Gray:

Our experiences so far have shown that the health entrepreneurs become advocates for the members of their community. They are the link between the role that the MFI plays as well as the local health clinic. There is always the ongoing concern about developing a cadre of “quacks” but so far, we’ve seen existing midwives and community health workers take on these roles since it seems to be a natural fit.

DSK Rao:

In the particular case of ESAF’s Arogya Mithra (community health entrepreneurs) project, they are well accepted mainly because of the door step service (house-calls) a health entrepreneur provides. She comes to the villagers. In these villages, “quacks” are not common, but one finds less-qualified medical practitioners who do not provide door step services as the health entrepreneurs do.

Sandhya Suresh:

The health entrepreneurs are getting good acceptance in the community even though there are existence of other traditional practitioners, or even “quacks,” as the health entrepreneurs are community women and those who seek their services are known to them and hence they trust them.

ESAF has provided the health entrepreneurs with certificate and ID cards, which they can always produce in case people want to know about the authenticity.

Question 2

Stuart Coupe, Hand in Hand International, London:

I am very interested in the ESAF self-employed microentrepreneurs in the health sector. What services are community members willing to pay them for?

This question was posed and answered in the event, which was recorded and is available here: https://vimeo.com/121303535.

Answers

Bobbi Gray:

I thought Sandhya’s answer during the webinar likely was enough, but it is important to point out that often, people are supposed to have access to many of the health products and services for free as they are provided by the local health clinic; however, the health clinics are often poorly or not consistently staffed and often poorly stocked with the items they should be getting for free.

Therefore, the market for the health entrepreneurs is to provide the products, at the market price, to their community members for the convenience of them being able to access the products when they need them. Plus, for some items, like sanitary napkins, they can purchase items in privacy.

DSK Rao:

The community may be willing to pay for multiple services, such as monitoring hemoglobin levels, cholesterol, etc., but ESAF has focused on monitoring hypertension and diabetes, the two most common and dangerous non-communicable diseases (NCDs). The two parameters which require frequent measurement and which could be easily measured in the field.

Sandhya Suresh:

At present, community members are willing to pay for checking the blood sugar and blood pressure. In addition, they are even willing to pay for cholesterol or thyroid checking; however, these are complicated processes and cannot have a quick result, so we are not doing it at present. We can train the health entrepreneurs to collect the blood samples for these tests, but they can be very risky considering their semi-literate status.

theories of change

Click the image to see it enlarged.

Question 3

Amy Petrocy, Health Program Coordinator at Friendship Bridge, Guatemala:

I’m interested in any experience you all may have with measuring changes in health beliefs/attitudes as a result of health education offered by MFIs and then the correlation with utilization rates of health services.

Answers

Bobbi Gray:

Freedom from Hunger has been designing short mini-surveys that align with our health education. However, we only look at utilization of health services, if this particular aspect is actually part of the module.

For example, the integrated management of childhood illnesses (ICMI) teaches women about the danger signs a caregiver should know that would signal the need to visit a clinic immediately and then it teaches them what they should expect when they are there for the checkup.

Part of the effort here, in the HOPI, comes as a result of the years of measuring changes from pre-tests to post-tests directly related to particular education efforts. While there may be some directly related attitude questions for certain education topics — for example, for water and sanitation, there might be an attitude about whether they agree it’s important to provide safe water to their family or whether they feel confident they can provide safe water — there is growing interest in the field to look more at attitudes as very strong indicators for tracking change.

We found, for example, in our youth financial services work that a young person’s satisfaction with their savings level or their confidence they could cover their typical daily expenses using their savings, was likely a stronger indicator of their financial capability than trying to detect this through a long series of questions to understand how much money they actually had. I think understanding whether a person feels prepared for future health expenses is likely indicative of their real ability — given they know what resources they have at hand to cover those expenses.

When it comes to utilization of health services, I also think it’s important to understand why people do not use the services — in the same way we have to understand why clients might not use a particular financial product — there may be attributes we can change in the short-term and those we can’t. For example, “I feel ashamed” of going to the doctor is a different intervention from “I can’t afford to go.”

DSK Rao:

There are numerous incidents of behavior change such as women ceasing to chew tobacco and reducing oil, salt, and sugar intake in one’s diet. Impressive changes have come in terms of distributing food equally to all family members, including adolescent girls and pregnant and lactating women.

John Alex:

Equitas has a 5-day skill training program on a not-for-profit basis through the Equitas Trust, where the women skill trainer trains 10-15 women for 3 hrs a day in select skills. At the end of each day, she delivers a lesson on non-communicable diseases (NCDs) namely blood pressure (BP), diabetes, cancer, types of tests in a year, and healthy eating habits.

We measure the knowledge level on a sample basis pre- and post-training, and the results showed that the knowledge improved and that they also learned ways to detect early warning symptoms.

Furthermore, feedback showed that many started going for mammogram test and pap smear test and wanted the trainers to also check their BP, sugar levels, and body mass index (BMI); this made us launch a pilot recently to test sugar levels at random at the end of the training, and they are ready to pay the cost. We are working to make this pilot be self-sustaining. Based on the success and pending getting funding, we will roll it across India, which could be a great health indicator.

Question 4

Do you think you can you measure the impact of your health program in a 6 – 8 months period? Don’t you think the time is too short… What do you think?

Answers

Bobbi Gray:

I think it depends on the health intervention. Some are meant to spur immediate changes, and others aren’t. For example, if we can convince a mother to give a child with diarrhea more to drink, she should immediately be able to put this behavior into practice. However, facilitating a household’s ability to install a new sanitation facility might take longer, particularly if households are facing competing financial obligations.

DSK Rao:

As it pertains to the affect on knowledge and awareness as well as the behavior change in improvement in diet, yes, 6-8 months is sufficient. We have seen changes in health seeking behaviors in that period; however, it may not be possible to see an improvement in health parameters.

Sandhya Suresh:

Well, if you have given a health education session, people will try to practice it as soon as possible if they remember it and are convinced about it. We can therefore see the change in the awareness levels and behavior change in them even after 6 to 8 months. But, if you want to measure the impact of a changed health practice, you will definitely need more time.

John Alex:

Equitas has two loan products with a tenure of 18 months and 24 months and option to repay in either fortnightly or monthly installments. I think 6-8 months is too short, and it should be on a continuous basis during every loan cycle.

Question 5

Pierre Claver NKUNZABAGENZI:

Which country in Africa is model now in developing financial health products?

Answers

Bobbi Gray:

We’ve worked with RCPB in Burkina Faso to develop a health savings and loan product. This is a commitment savings device that clients can use to save an established amount of money on a regular basis. Once they hit the minimum, they can use the savings as long as they have receipts showing that the money will be used to cover a health expense.

If the health expense is greater than the amount they have in savings, they can access a health loan, if desired, to make up the difference. There are also savings groups in Benin that also save for health. They save their normal amount with their group, and they save an additional amount on top of this for health expenses, using the same savings group mechanism for collecting and accounting for their funds.

There has also been a study by Pascaline Dupas looking at various savings strategies for health in Kenya that included products where clients simply earmarked their money, put money in a lockbox that was easily accessible, lock boxes that were more secure, etc. She found that most of the mechanisms worked to improve savings for health simply because they provided a safe place to keep their money that they wanted to earmark for health purposes.

While I don’t have the data at hand, I know there have also been some significant efforts in improving access to health insurance products as well, which should not be overlooked when thinking about financial services with a health objective.

Health indicators selected

Click the image to see it enlarged.

Question 6

Tessa Joy P., Research and Evaluation Specialist at Community Economic Ventures, Inc. (CEVI), Philippines:

Are the health indicators set of questions country-specific?

Answers

Bobbi Gray:

Some of them are, and some of them aren’t. Our original aim was to see whether we could find indicators that could work across most contexts and some of them seem to do this well.

For example, the question about whether a person has forgone seeking medical treatment because of the cost works well in all the contexts. For the water and sanitation questions, these questions are often fairly standardized, particularly if you rely on how the national demographic and health surveys articulate the questions and answer options.

However, depending on the key health problems in a country, one might tailor the questions more specifically to the context. For example, while we’ve yet to pilot these questions in West Africa, you could imagine asking about the use of insecticide treated bed nets. Whereas in Latin America, malaria and other infectious diseases might not be as common, and you might look more at chronic illnesses as well as the need for annual checkups to get one’s blood sugar or blood pressure checked.

This is not to say that chronic illnesses are not equally as frequent in places like West Africa; it simply means that an organization needs to think about which of these issues seems to affect their clients the most and where an MFI’s products and services might most directly influence improvements (i.e., improving financial access to mosquito nets, preventive care medical services, etc.)

Question 7

Joy May, branch accountant, CEVI, Philippines:

Can you please differentiate between key health indicator and additional indicator?

Answers

Bobbi Gray:

After the pilot-test MFIs (ESAF, Equitas, and others) completed their first assessments, we have discussed which of the indicators they might want to keep for further implementation of the surveys. While we tested up to 11 different indicators, we recognize that not all of these will feel really compelling to the MFI.

So, we’ve discussed which few they might choose to track over time. In ESAF’s case, they’ve talked about perhaps keeping water treatment as a variable that they’ll track with their poverty measurement efforts for every new loan cycle, but they might follow a sample of clients with a broader number of indicators every five years.

At the end of the day, we want MFIs to choose the smallest number of indicators they’ll track and actually use—over a longer period of time, since larger evaluations and studies have the flexibility to track a larger number of indicators. Which indicators are useful to track at every loan cycle for monitoring purposes vs. which indicators might you track for a broader picture of client outcome for more evaluation purposes (where you’d conduct more analysis, etc.)?

Research Results Equitas India

Click the image to see it enlarged.

Question 8

Joy May, branch accountant, CEVI, Philippines:

What are the health indicators Equitas is planning to finalize for health survey both in rural and urban areas?

Answers

John Alex:

We plan to ask about different types of water filters, and we will ask both men and women. In addition, we will also compare this data with a control sample of non-clients. And, finally, we plan to expand our data collection to more areas on a pan-India scale.

Question 9

Joy May, branch accountant, CEVI, Philippines:

Why is Equitas emphasizing low cost fruits? Can you please elaborate the relationship between fruit and nutrition? What about childhood nutrition specially children below 2 years?

Answers

John Alex:

When we say “fruits,” very often, clients would mistakenly imagine it as costly fruits like apple and oranges, etc., which may be a bit costly for these low income households. We would like to also add questions on the type of locally available fruits like bananas, ber, custard apple, papaya, sapota, and guava.

We also plan to add questions to find out if they have low-cost millets, which are very healthy, and add the same questions about child nutrition and a line on breast feeding.

Question 10

Joy May, branch accountant, CEVI, Philippines:

What would be your sustainability plan on your clients’ health indicator project?

Answers

Sandhya Suresh:

We have already incorporated two health indicators, which we will track for all the clients; for other relevant indicators, we shall conduct an annual Client Change Assessment.

Question 11

Joy May, branch accountant, CEVI, Philippines:

Do you have any plan to integrate your health program with government’s health program under National Rural Health Mission (NRHM)?

Answers

Sandhya Suresh:

Most of our health entrepreneurs are Asha Workers, or health workers appointed under the NRHM, so they are already known in the community. By offering the service that we have promoted, they get an extra income. They have received permission from their NRHM supervisor to charge the user fee for the services they are offering.

Research Results ESAF India

Click the image to see it enlarged.

The PPT presentation

Relevant resources

The SEEP Network | Mar 4, 2015

By Patrick Fine, Leith Greenslade | 26 February 2015

Cassie Chandler | Huffington Post Global Motherhood |

Hosted by FHI 360, Women Thrive, Johnson & Johnson
Wednesday, March 11, 2015 from 5:30 PM to 8:00 PM (EDT)
New York, NY

The importance of measuring client outcomes

Outcomes process

Lea en español *** Lisez en français


The World Bank is hosting a day-long event today (as I write this, actually) presenting lessons and implications of the latest research on microcredit. Based on the swiftness of my Twitter feed, the event, “Financial Services for the Poor: Lessons and Implications of the Latest Research on Credit,” is very popular and timely. (You can follow it using the hashtags #WBlive and #Microcredit2015.) Much of the evidence shared this morning (when they had a live video feed of the event), confirmed our understanding that microcredit alone is not enough.[1]

Indeed, the speakers in the 10 AM session (agenda), in response to an audience question, “If you had $1 million, how much of it would you put toward microfinance?”, recommended that we should invest our money in human capitol, namely early childhood education and conditional cash transfers (CCTs).

We would add health-related products and services: from health education for positive behavior change to healthcare delivery, and everything in between. We also believe that it is essential to measure and track the client outcomes of our interventions over time — be they microcredit, savings, insurance, or non-financial products and services.

On February 4th, the Social Performance Task Force (SPTF) Outcomes Working Group hosted a virtual meeting on the “Selection of Outcomes Indicators.” The purpose of this working group is to develop practical guidelines for credible measurement of and reporting on outcomes, drawing on experience with different approaches and tools.

Frances Sinha of EDA Rural Systems introduced the session and explain how theory of change connects to indicators. Bobbi Gray of Freedom from Hunger explained the criteria applied to developing outcomes indicators — including a new set of Health Outcome Performance Indicators (HOPI) in partnership with the Microcredit Summit Campaign — and lessons learned. Anne Hastings of the Microfinance CEO Working Group discussed their plans for laying the groundwork for a common measurement and monitoring system.

Feb 5th meeting resources

If you would like to learn more about the pros and cons of the Health Outcomes Performance Indicators, join us on March 4th with the SEEP Network’s HAMED Working Group for the webinar, “Healthy, Wealthy, and Wise: How MFIs Can Track the Health of Clients.”


SPTF’s Outcomes Working Group will host a repeat of their December 14th virtual meeting on Tuesday, March 3rd at 4 AM (EST) // 9 AM (GMT) // 12 PM (East Africa) // 2:30 PM (India). Panelists will discuss the Theory of Change and how it helps us think about what to measure and when.

Recordings and materials from the original meeting (December 14th) are available online.

Speakers:

  • Frances Sinha, EDA Rural Systems
  • Anton Simanowitz, Independent consultant

The idea of a Theory of Change is now increasingly applied to strategic planning. It is beginning to be applied to measurement of change. This webinar will review the framework of a Theory of Change and to discuss how it can help an institution think through the ways in which it aims to achieve change, what inputs lead to what outcomes, and the time frame for expected change to take place. These are questions that are fundamental to appropriate research design and help in identifying relevant outcome indicators (short-term and long-term) and in analyzing the data to reflect a relevant sequence of inputs, outputs and outcomes.

About the Outcomes Working Group

  • Facilitator: Frances Sinha, director of EDA Rural Systems (India) and SPTF Board member.
  • Purpose: Develop practical guidelines for credible measurement of and reporting on outcomes, drawing on experience with different approaches and tools.
  • Introductory presentation

[1] Social Performance Task Force (SPTF) “Repeat session of the Outcomes Work Group: Theory of Change” WebEx meeting.

Tuesday, March 3, 2015 at 4:00 am | Eastern Standard Time (New York, GMT-05:00)

Click to join WebEx meeting
Meeting number: 315 311 993
Meeting password: sptf

Join by phone
1-877-668-4493 Call-in toll-free number (US/Canada)
1-650-479-3208 Call-in toll number (US/Canada)
Access code: 315 311 993

Global call-in numbers
Toll-free calling restrictions
Add this meeting to your calendar.

Healthy, Wealthy, and Wise: How MFIs Can Track the Health of Clients

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

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

Lea en español (traducido por Google) *** Lisez en français (traduit par Google)


Join us on Wednesday, March 4th at 9:30 AM (ET / GMT – 5) for “Healthy, Wealthy, and Wise: How MFIs Can Track the Health of Clients,” a webinar co-hosted by the SEEP Network to discuss how you and your partners can measure client health and well-being.

Register 2

Wednesday, March 4th at 9:30 AM (ET / GMT – 5)
What time in your country?

The webinar will feature presentations from two of India’s leading microfinance institutions, ESAF Microfinance and Equitas Micro Finance Pvt Ltd. They will share the results of the “Empowering Poor Women through Integrated Health and Financial Services in India: Measuring Impact of Health and Microfinance” project led by Freedom from Hunger and the Microcredit Summit Campaign.

With funding support from Johnson & Johnson, these two organizations set out in 2014 to develop and test a standardized set of “Health Outcome Performance Indicators” (HOPI) that can be used by microfinance institutions (MFIs), self-help promotion institutions (SHPIs), and other financial service providers (FSPs) to monitor the health outcomes of clients over time. The HOPI relied on a cross-sectoral collaborative process, including the involvement of the SEEP Network’s HAMED Working Group members, health sector experts, investors, and practitioners who provided input during the indicator selection process as well as the analysis and interpretation of the data.

The webinar will focus on the following questions:

  • Do the benefits of tracking health outcomes outweigh the costs of the ongoing client data collection?
  • You may be asking yourself, why do we care? If MFIs don’t have health programs, what do they get out of collecting data on client health?
  • Why not just collect the PPI data? Did this give MFIs a better picture of their clients’ vulnerability than what the PPI alone can tell them?

Why the Health Outcome Performance Indicators are important:

  • They are practical for FSPs to measure and monitor client health over time (annually or as part of other monitoring tools such as the PPI).
  • They can be reported by clients in a monitoring survey.
  • They can be benchmarked to other regional, national, and global health goals and data.
  • They are reliable and are subject to change over time.
  • They will be relevant and useful for FSPs to measure and improve measures of program impact on client health and well-being.
  • They will provide donors, investors, government, health actors, and others with important information to guide decisions about support and social investment.

Speakers:

Bobbi Gray, Research & Evaluation Specialist, Freedom from Hunger, USA; and Facilitator, SEEP Network HAMED Working Group
Sandhya Suresh, Senior Manager, ESAF Microfinance and Investments Pvt Ltd, India
John Alex, Vice President and Head of Social Initiatives, Equitas Group; and Program Director, Equitas Development Initiatives Trust, India

Moderator:

Dr. DSK Rao, Regional Director for Asia Pacific, Microcredit Summit Campaign, USA


This webinar is hosted by SEEP’s Health and Market Development Working Group (HAMED), in partnership with the Microcredit Summit Campaign.


Bobbi Gray, Research & Evaluation Specialist, Freedom from Hunger, USA

Bobbi joined Freedom from Hunger in 2004. She leads research and evaluation efforts and works closely with the organization’s partners to determine solutions for assessing and measuring the social performance and impacts of integrated financial and non-financial services for adults and youth, including feedback of this information to stakeholders for decision-making. She has experience with both quantitative and qualitative methodologies, including sampling and analysis methodologies such as Lot Quality Assurance Sampling, financial diaries, qualitative “impact stories,” and Randomized Control Trial evaluations. In the past year, Bobbi has focused on working with a cross-sectoral team of experts to design a short-list of client outcome indicators focused on client health. She is also the Facilitator of the Health and Market Development (HAMED) working group at the Small Enterprise Education and Promotion Network (SEEP). She holds a Master of Public Administration degree in International Management from the Monterey Institute of International Studies, a Bachelor of Arts degree in French and Spanish from Texas Tech University, and speaks both languages.

Sandhya Suresh, Senior Manager, ESAF Microfinance and Investments Pvt Ltd, India

Sandhya Suresh works as senior manager with ESAF Microfinance and Investments Pvt Ltd based in the southernmost part of India in the state of Kerala. Ms. Suresh is a development professional with over 16 years of experience in the social development sector. Her primary interest and work is in social research where she likes to engage with low income women who struggle both socially and economically to keep up to the expectations of her family and community. She has engaged with ESAF’s beneficiaries in various capacities as a trainer, strategy developer, project coordinator, and team leader managing social research (including impact assessments). As an SPM champion with ESAF Microfinance, she has tried to oversee and guide the operations towards adhering to responsible finance and client protection principles. Ms. Suresh possesses a Master’s in Development Communications and has actively participated in the working groups that developed the Universal Standards of Social Performance and also in the development of SPI4 the assessment tool to measure SPM.

Ms. Suresh remains fully committed to the cause of bringing positive change in the lives of poor women through the platform of microfinance where in women are in a position to reduce the vulnerability attached to insufficient finances to meet the food, education, and housing expenses that are fundamental to every human being.

John Alex, Vice President and Head of Social Initiatives at Equitas Group and Program Director, Equitas Development Initiatives Trust, India

John Alex, after graduating in agriculture and rural development, started his career as a Group II Gazetted Officer in Tamil Nadu State Government and served as an extension officer (agriculture) and block development officer in North Arcot District, Tamil Nadu from 1979 to 1983. Mr. Alex joined the Indian Overseas Bank as a probationary officer and served as agriculture field officer, branch manager, regional assistant chief officer, senior manager, and chief manager in various branches in Tamil Nadu and Andhra Pradesh from 1983 to 2008. Mr. Alex joined the Management Team of Equitas in 2008 and conceptualized and set up the team for social initiatives with a clear focus to address a larger spectrum of requirements of clients in the field of health, education, skill development, food security, and placement for unemployed youth.

Dr. DSK Rao, Regional Director for Asia Pacific, Microcredit Summit Campaign, USA

Dr. D.S.K. Rao is the regional director of the Microcredit Summit Campaign and is based in Hyderabad, India. The Campaign draws heavily on his wide experience and familiarity with the microfinance sector in Asia.

Dr. Rao is a certified trainer of poverty measurement tools, including the Cashpor House Index (CHI), Participatory Wealth Ranking (PWR), and the Progress out Of Poverty Index (PPI).

He is presently implementing, in collaboration with Freedom from Hunger, a project in India funded by Johnson & Johnson in which he is providing technical assistance to local microfinance partners to integrate health and microfinance. Dr. Rao is working on health integration with some of the largest and most reputed MFIs in India. He also coordinated with Equitas and ESAF in piloting the Health Outcome Performance Indicators (HOPI) project.

Twitter Chat on the social determinants for achieving MDGs 4, 5, and 6

Pregnant woman attending the first community health fair of "Healthy Mothers, Healthy Babies" program in the Philippines

Pregnant woman attending the first community health fair of “Healthy Mothers, Healthy Babies” program in the Philippines last October
MDG 4: reduce child mortality
MDG 5: improve maternal health
MDG6: combat HIV/AIDS, malaria, and other diseases

#SocialDeterminants Chat: Achieving MDGs 4, 5, and 6

Organized by Johnson & Johnson Worldwide Corporate Contributions

For many people, a new year signifies a new beginning—an opportunity to recommit to achieving big goals. As of January 15th, we have 350 days left to achieve the MDGs. As our community continues to pursue progress towards these goals, we know that we cannot realize the promise of #Action2015 (a campaign on post-2015 sustainable development goals) without prioritizing #SocialDeterminants of health.

Join us Thursday, January 15th to take a special look at the social determinants impacting success on MDGs 4 (reduce child mortality), 5 (improve maternal health), and 6 (combat HIV/AIDS, malaria, and other diseases).

Achieving MDGs 4, 5, and 6 is a monumental challenge, requiring a global effort. We will co-host a Twitter chat organized by Johnson & Johnson Worldwide Corporate Contributions on Thursday, January 15th at 3 pm ET (GMT – 5) for members of the global development community; join us to discuss the social determinants standing in the way of making MDGs 4, 5, and 6 a reality.

Economically empowered women can keep families healthy

Download these lovely graphics to post on social media: event announcement, information, microfinance, electricification (right click on the image then “save image as…”)

Moderator: Chun-Mei Li (@ChunMeiLi), Johnson & Johnson

Co-hosts:

Hashtag: #SocialDeterminants

Op-ed Published on Devex: Microfinance is the key for the Philippines to meet MDG 5

Gallery

This gallery contains 5 photos.

An op-ed by the heads of Freedom from Hunger, the Microcredit Summit Campaign, and CARD MRI. Continue reading

Domestic Violence and Microfinance: What Is Our Role as Financial Service Providers?

Gallery

Originally posted on Center for Financial Inclusion Blog:
> Posted by Bobbi Gray, Research and Evaluation Specialist, Freedom from Hunger Embed from Getty Images The day after the closing of the Microcredit Summit in Merida, Mexico, conference participants were also invited…

Microfinance communities working together to improve maternal health

Gallery

This gallery contains 18 photos.

1700+ women attended a two-day community health fair in the Philippines got a checkup, learned about pre- and post-natal care, and more! EspañolFrançais Continue reading

Improving Maternal Health in the Philippines Through Microfinance

Gallery

This gallery contains 5 photos.

Collaborating on a cross-sectoral program to help achieve MDG 5 in the Philippines EspañolFrançais Continue reading

New Report on Integrated Health and Microfinance in India Shows the Way Forward

Gallery

This gallery contains 4 photos.

Read it today! EspañolFrançais Continue reading