Colombia, a “Pathways” poster child

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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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The Truelift Indicators are now available in the SPI4

Photo courtesy of Carsey

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CERISE and SPTF have created, with the support of their membership, the SPI4, a universal social performance assessment tool that integrates emerging industry social performance standards. MFIs can use the SPI4 as a self-assessment tool, or with the assistance of someone trained in the SPI. This blog post was originally published by Truelift on July, 29 2015.


The Truelift Indicators Tool has been streamlined and incorporated into the SPI4 as the pro-poor module. The SPI4 is a universal social performance assessment tool that integrates emerging industry social performance standards (Read more about the SPI4).

The streamlined SPI4 Truelift pro-poor module not only significantly reduces the number of indicators that need to be answered, it also contains guidance and examples of compliance for each indicator, easing practitioner completion of the self-assessment.

Completed SPI4 Truelift pro-poor modules can be still be submitted to Truelift by emailing the Excel file to info[at]truelift.org with the subject “Institution Name: SPI4 Truelift pro-poor module” to get verified and recognized as an Aspirant Milestones institution.

Download and complete the Truelift pro-poor module in the SPI4.

CGAP’s take on household resilience in Burkina Faso

Marie and Child

“A resilient household is able to find solutions to the various crises it encounters by making good choices in their income-generating activities. A non-resilient home fails to solve crises encountered.” — Marie, a 35-year old first wife of a polygamous family who lives in the Passoré province of Burkina Faso

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>>Authored by Barakah Ibisomi, Microcredit Summit Campaign Program Intern

Landlocked Burkina Faso is one of the poorest countries in the world with 44.6 percent of its population living on $1.25 or less per day. A recent CGAP publication draws on “resilience diaries” of 46 women in rural households in the northeastern zones of the country to determine how different financial services contribute to and affect household resilience.

Twenty-five women are members of village banks with the Reseau des Caisses Populaires du Burkina Faso (RCPB) while 21 are members of savings groups with the Office de Développement des Eglises Evangéliques (ODE). The seven-month project was conducted by Freedom from Hunger.

The diaries were used to understand the following:

  1. The strategies poor households employ to manage economic, environmental and health shocks that disrupt their financial lives.
  2. The roles formal, non formal and informal financial products play in improving household resiliency and building assets.

Freedom from Hunger Resilience Framework

Burkinabé households are highly influenced by their country’s seasonal and agricultural calendar as it determines how they make a living — specifically, how land is put to use, the degree to which households depend on livestock, and other non-agricultural sources of income. The time just before harvest in September is financially difficult, with income and savings at a low point and borrowing and expenses at a high point. There is a need for additional or specialized financial services to help households better manage the season.

The most common coping strategies used to respond to shocks are first using savings at home, then reducing food consumption, selling grain, selling small livestock, purchasing on credit and lastly, borrowing from a savings group. Borrowing from financial institutions, family and friends is less preferred. As resources become available to them, the women re-prioritize the way they manage any particular shock. For example, after harvest, more sell grain and fewer reduce food consumption, make purchases on credit or borrow from friends and family.

Very few households in Burkina Faso have access to formal financial services so the women’s use of formal financial products is very limited and their demand for it is widely unmet. When asked whether they had all the financial products and services they need, only 17 percent felt they had. There is a strong demand for additional financial products and services, with an emphasis on microcredit, savings products and agricultural-related grants. However, when they do have access, they use formal services to cover costs incurred from shocks. The most common formal products or services used are RCPB loans and remittance services.

The more commonly used non formal services are savings groups which are used to save money for purchasing livestock, paying health expenses, school fees and for food and income generating activity (IGA) expenses. For informal services, the women borrow from friends and family, make purchases on credit from local merchants and, as mentioned earlier, receive remittances often by hand-to-hand transporters. The women reported using non formal and informal financial services significantly more than formal financial services.

All these services help improve cash flow but it is difficult to determine the extent to which they are helpful in building resiliency.

Other key findings from the studied households:

  1. The most common shocks encountered by those studied were illness and injury, loss of livestock, death of family members and poor harvest, all These shocks affected both income-generation as well as food supplies. Other semi-regular shocks included droughts and famine, political crisis, and health threats.
  2. Women play a significant role in the household economy, but are limited byResilience Quote gender norms, time, and resources to pursue more profitable IGAs. The most common IGAs for the participants were the growth and sale of cash crops and petty commerce.
  3. Food insecurity dominates all of the households’ lives.

The concept of resilience is in itself a work-in-progress because of its novelty and multi dimensionality. The RM-TWG defines resilience as “the capacity that ensures adverse stressors and shocks do not have long-lasting adverse development consequences.”

Based on this definition of resilience, it is difficult to consider many of these households resilient because when shocks occur, they use negative coping mechanisms that increase food insecurity, such as reducing daily food consumption and selling grain stocks and livestock meant to be. These strategies solve an immediate problem but can have long-term, long-lasting adverse development consequences.


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Ghana: What lies ahead

Representatives from REST Ethiopia lead a group discussion with a graduation program participant during the Innovations in Social Protection and Livelihoods Development program in 2014.

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

The Microcredit Summit Campaign recently spoke with Mawutor Ablo, director of Social Protection at Ghana’s Ministry of Gender, Children and Social Protection, and also a participant in the Campaign’s Field Learning Program last year, Innovations in Social Protection and Livelihoods Development.

The program invited representatives from Ghana, Malawi, and Mozambique on a trip to observe leading social protection programs in Ethiopia and Mexico. In our discussion with Mr. Mawutor, we spoke about the changes made to Ghana’s social protection programs since we last met and what changes may be made in the future to increase the reach of the programs and strengthen outcomes for Ghana’s poorest.

The Ghana National Household Registry

In May 2014, the World Bank continued its support to Ghana through a credit of US$50 million to Ghana’s Finance Ministry with payments dispersed annually from 2015 to 2017.

The funds are directed to the Ghana Social Opportunities Project, which aims to extend Ghana’s Labor-Intensive Public Works (LIPW) program from 49 to 60 of Ghana’s 216 districts. LIPW also aims to expand the reach of grants from 100,000 to 150,000 poor households through the Livelihood Empowerment against Poverty (LEAP) program.

In addition, the social protection systems will be strengthened through improved targeting and the establishment of the Ghana National Household Registry (GNHR).

Ato Berhanu Woldemichael in a meeting

Mr. Ato Berhanu Woldemichael, as acting State Minister with the Food Security Directorate, oversees much of the government’s role in LEAP and LIPW.

Before the implementation of the household registry system, both LIPW and LEAP screened candidate households in selected districts independently. This has not caused an overlap yet, but with the extension of the Ghana Social Opportunities Project and its intended scaling up of both programs, overlap is inevitable, leading to possible disbursement conflicts between the two programs.

The GNHR will create a database that optimizes methods used in finding and selecting program candidates through a universal survey useful for multiple social protection programs in selecting participating households. Simply put, the GNHR and its universal survey will represent a more efficient and comprehensive method for selecting households for inclusion in the national social protection programs.

Mr. Mawutor expects the registry to improve the ability to target and reach the poorest in Ghana. He compared the registry to that of the successful Cadastro Unico, the national registry of Brazil established in 2001. Three years after Cadastro Unico was created, a study showed that the poorest quartile of the population received 80 percent of all social protection programs’ benefits.

By way of comparison, the cash transfer programs in place prior to the unified registry together distributed only 64 percent of the total benefits to the poorest quartile. This improvement in targeting is something Mr. Mawutor hopes to see take place in GNHR by reducing what he termed inclusion error — the participation of households living above the targeted poverty level — in programs like LEAP and LIPW.

The Move to Mobile Money

Leaders in charge of implementing Ghana’s social protection programs are interested in finding the most efficient way to distribute the cash transfers that are at the center of these initiatives. Currently, the most common method of disbursement is through smart cards. Here, recipients of a cash transfer can go to the post office or another government entity with their smart card to have their payment added to their smart card.

Ghana would like to move from this strategy because of the high transaction costs associated with it. Also, this method does not allow recipients to transfer the money they receive to, for example, a family member in need. Instead, Ghana would like mobile money to be the primary form of receiving cash transfers.

Ghana has already partnered with MTN, a mobile network operator from South Africa, and has thus far reached a point where about 10 percent of its payments are disbursed through mobile systems.

Hoping to expand this number, Mr. Mawutor told us that Ghana would be increasing its total number of providers to four companies this year. With the expansion, Mr. Mawutor hopes to make mobile banking more accessible to poorer areas by increasing the overall number of local branches across the country.

The addition of three new operators would also produce significant returns from the added competition to the market, producing incentives for each company to provide the best service.

Mr. Mawutor Ablo during the Innovations in Social Protection, along with the Hon. Dela Sowa, Deputy Minister of Gender, Children, and Social Protection. Together they have great responsibility for the social protection programing in Ghana.

Growth by Efficiency

Social protection programs in Ghana have made many changes in the past few years and they all seem to focus on efficiency. Both the establishment of the Ghana National Household Registry and the move to mobile money aim to cut the costs associated with these programs. The registry intends to better target those among the poorest in Ghana for participation in the social protection program and reduce the costs to serve them by removing redundancies between the various initiatives.

The move to mobile money aims to make funds more accessible to beneficiaries, increasing the potential for positive outcomes resulting from the programs. With these changes, it is clear Ghana is dedicated to maximizing results.

We look forward to continuing to follow new developments from Ghana over time and continuing to be a close supporter of the work of Ghana’s Ministry of Gender, Children, and Social Protection.


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How you can influence global policy priorities at the World Bank (event)

RESULTS is hosting its 35th annual International Conference on Capitol Hill in Washington DC from July 18th to July 21st, featuring many leading poverty experts, activists. and policy makers.

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

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In just two weeks, RESULTS Educational Fund, the parent organization of the Microcredit Summit Campaign, will celebrate its 35th anniversary with the 2015 International Conference in Washington, D.C. We invite you to join in the festivities and attend our workshop called “Partnerships to End Poverty: Health, Government, and Financial Services” on Sunday, July 19th at 4:30 – 6:00 PM. The conference will be held at the Washington Court Hotel on Capitol Hill.

Only $85 a day!

RESULTS International Conference — only $85 a day!

Attendees of the International Conference will hear from leading experts, activists, and policymakers on the challenges and solutions to ending poverty. Join World Bank President Jim Yong Kim, Senator Sherrod Brown (D-Ohio), and Nobel Peace Prize laureate Muhammad Yunus (and, of course, founder of the Grameen Bank). Find out who else will be speaking here.

The conference agenda is designed to provide the information and tools to influence policymakers — so you can deliver the message directly to your representative on Capitol Hill and policymakers at the World Bank and USAID!

The Microcredit Summit Campaign’s role at RESULTS is to lift up financial inclusion solutions designed for the world’s extreme poor, creating economic opportunities to help lift themselves out of poverty. The Campaign will be leading a workshop at the International Conference about the future of financial inclusion.

Our session, entitled Partnerships to End Poverty: Health, Government, and Financial Services,” will focus on integrated health and microfinance and linking the graduation model and conditional cash transfers (CCTs). Learn why these are key pathways to help end extreme poverty and how you can influence the global development agenda. (Read more about the six pathways.)

Sonja Kelly of the Center for Financial Inclusion at Accion will moderate a panel discussion with Olumide Elegbe of FHI 360 and our own Dr. DSK Rao and Larry Reed. Join us to develop your message and advocacy strategy around financial inclusion to end extreme poverty, and take it directly to major financial inclusion funders like the World Bank and USAID to influence their programmatic priorities in the over coming years.

About the panelists


Sonja Kelly, Fellow, CFI

Sonja Kelly is a fellow at the Center for Financial Inclusion at ACCION (@CFI_ACCION). She conducts research on supply and demand side opportunities to advance financial inclusion around the world, including income growth, demographic change, and policy shifts. Ms. Kelly is finishing her PhD at the School of International Service at American University, writing her dissertation on financial inclusion policy and regulation in low and middle income economies. Her research articulates the ways that international organizations and internal politics influence financial sector policy. She is also a consultant at the World Bank and the president of the DC chapter of Women Advancing Microfinance. Prior to joining CFI, Ms. Kelly worked in microfinance at Opportunity International.

Olumide Elegbe Olumide Elegbe, senior relationship manager at FHI 360, is a health and development expert with demonstrated results of building successful partnerships across sectors and geographies. With a focus on forging trusted, long term partnerships between the government, nonprofit and private sectors, Mr. Elegbe has a track record of brokering collaborative partnerships that drive social change by addressing health, education, sustainability and/or other development challenges. This, while delivering results and outcomes tailored to suit the needs of stakeholder individuals and organizations including market access, efficiencies in supply chain, and contribution to local GDP.

Mr. Elegbe has extensive international and cultural experience, spanning sub-Saharan Africa, Eastern and Western Europe as well as the USA. Prior to joining FHI 360, he worked as a public health specialist and a visiting lecturer in population medicine in the United Kingdom, and as technical advisor on public health programs in Nigeria.

Mr. Elegbe holds a Master’s Degree in Public Health with a minor in Health Services Management from the London School of Hygiene & Tropical Medicine in the United Kingdom.

Dr. D.S.K. Rao, Regional Director for Asia-Pacific, Microcredit Summit Campaign

Dr. DSK Rao has been the regional director for the Asia-Pacific region with the Microcredit Summit Campaign since 2000. The Campaign draws heavily on his wide experience and familiarity with the sector while organizing the regional and global summits. Dr. Rao has conducted scores of workshops and trainings on tools for practitioners in Asia to track poverty and other social outcomes including the Cashpor Household Index, Poverty Wealth Ranking, and the Progress out of Poverty Index. Dr. Rao is presently implementing a Johnson & Johnson-funded project for integrating health with microfinance in India, in collaboration with Freedom from Hunger. He has co-authored two books on microfinance: The New Middlewomen and Development and Divinity and Dharma.

Larry Reed, Director, Microcredit Summit Campaign

Larry Reed has headed up the Microcredit Summit Campaign (@MicroCredSummit) since taking over the reins from founder, Sam Daley-Harris in 2011. Mr. Reed has co-authored the annual State of the Campaign Report for the last 5 years. He has worked for more than 25 years in designing, supporting, and leading activities and organizations that empower poor people to transform their lives and their communities. For the majority of that time, Reed worked with Opportunity International, including five years as their Africa regional director and eight years as the first CEO of the Opportunity International Network.


Our workshop will be held on Sunday, July 19th
from 4:30 – 6:00 PM
.

To attend the workshop and the International Conference, email IC2015[at]results.org
or register online

Daily registration is only $85.

RESULTS is an international movement of grassroots advocates raising their voices to end poverty. Through government program and policy advocacy, RESULTS staff and its massive network of grassroots activists help to address the root causes of poverty: lack of access to medical care, education, and opportunity to move up the economic ladder. Click here to read more about RESULTS.


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The Nepal microfinance sector’s earthquake response

“2015 Nepal depremi” by Hilmi Hacaloğlu.
Licensed under Public Domain via Wikimedia Commons.

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>>Authored by Sabina Rogers, Communications and Relationships Manager

In a country with poverty that is already among the highest in the world, the devastating earthquake in Nepal this April caused more destruction and destitution than could have been imagined. The Nepal earthquake, estimated to have been a magnitude of 7.8 to 8.1, caused more than 8,800 deaths and 23,000 injuries. You can read all about the subsequent aftershocks that, in any other situation, would be major events in and of themselves. There is also a great deal of coverage of the toll this has taken on Nepali families and the international response. (Watch this video from The Guardian.)

Major destruction identified using satellite imagery by the crowd-source platform Tomnod. Last updated April 29th, 2015. Source: AidData at the Center for Development Policy

Major destruction identified using satellite imagery by the crowd-source platform Tomnod. Last updated April 29th, 2015.
Source: AidData at the Center for Development Policy (http://labs.aiddata.org/aiddata/nepal)

Recent data shows that it will cost over $6.6 billion and at least five years to rebuild the country, according to Nepali government officials. More than one million people may be stranded in extreme hardship for quite a long time. Local microfinance institutions have been working hard to triage their clients’ needs and thinking longer-term about the best response to this disaster.

RMDC logo-no text

RMDC made a Campaign Commitment in 2014

We have been in communication with Jyoti Chandra Ojha, CEO of the Rural Microfinance Development Centre Ltd. (RMDC), which is a wholesale lending organization in Nepal. Ojha has provided us with the information below concerning the Nepal microfinance sector’s response to the disaster.

The earthquake seriously affected 14 districts in Nepal, and microfinance clients are among the hardest hit. From preliminary information collected by RMDC and its members, here are the statistics of those affected:

  1. No. of MFIs affected: 29 (only 4 are highly affected)
  2. No. of branches of the 29 MFIs: 142
  3. Members/clients affected: 129,000
  4. Member deaths: 126
  5. Homes of members destroyed: 163
  6. Branches of MFIs damaged: 7
  7. Houses of Staff damaged: 90
  8. Staff deaths: 1
  9. Portfolio affected: Rs 2.44 billion
  10. RMDC Portfolio affected with MFIs: Rs. 1.29 billion

These details provide a snapshot of the disaster caused to Nepal’s microfinance sector by the April earthquake. On the basis of preliminary analysis, RMDC and their members are in the process of finalizing the following action plan:

Settlement of the survivors affected from the disaster

  • Providing soft loans to rebuild homes: temporary for short-term needs and then planned homes for the long-term
  • Managing the livelihoods of the affected families
  • Managing daily necessities
  • Health and education

Creating conducive economic environment

  • Devising to revive the old economic and farm activities
  • Identifying appropriate local based microenterprises
  • Skill development trainings

Financial Resource management

  • Rescheduling/ writing off of the affected farm and microenterprise loans
  • Providing new loans at lower interest rates
  • Additional Rs. 2 billion will be required to finance in the affected districts

Technical Support

  • Disaster management training
  • Workshop on rehabilitation of affected MFI branches
  • Developing new microenterprises
  • Skill development trainings

RMDC welcomes your support and assistance in carrying out this action for the disaster affected families of Nepal. Contact RMDC today:

Rural Microfinance Development Centre Ltd.
Putalisadak, Kathmandu, Nepal
P.O.Box: 20789
Tel. No.: 977-01-4268019/4268020
Fax: 977-01-4247702
Email: rmdc@wlink.com.np
http://www.rmdcnepal.com/

“Collapsed buildings in earthquake-hit Chautara, Nepal” by DFID – UK Department for International Development
Licensed under CC BY 2.0 via Wikimedia Commons.

How you can donate to the ongoing response effort

You can send individual donations to GlobalGiving’s Nepal Earthquake Relief Fund. Additionally, Save the Children has a dedicated Nepal Earthquake Relief Fund. A list of organizations accepting donations for relief efforts is available from William & Mary’s Reves Center for International Studies.

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The Puzzle of Poverty: Embera Puru Edition

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>>Authored by Kristin Smith, Program Intern for the 100 Million Project

jjjjJust a few weeks before joining the Microcredit Summit Campaign team, I traveled with Global Brigades to teach financial literacy workshops and provide microenterprise consulting to small business owners in an indigenous community in Panama.

The program, founded in 2003, sends university students from the United States and select European countries on a series of brigades to Panama, Honduras, Nicaragua, and Ghana to “strengthen the health and economic development of communities” by meeting a certain aspect of their “holistic model.” Learn more.

Their holistic model attempts to assess and address the most dire needs of developing communities in an intentionally sequenced process to help them achieve a state of sustainable self-sufficiency.

Panama holistic model

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Under the holistic model developed specifically for Panama, the process begins with Global Brigades employees researching the region and evaluating the community through a process of “integrated community development” to understand its most pressing needs.

Initially, the program sends medical and dental brigades — passionate volunteers working to mobilize positive social change — to the communities to provide mobile medical and dental clinics. Community banks are then established by a group of community members with guidance from Global Brigades staff to encourage saving for health needs and emergencies. Once established, the community banks begin distributing loans to community members for environmental projects and new business developments.

My brigade, composed of my colleagues from the University of California-Berkeley and others from Arizona State University, was excited to complete the Global Brigades puzzle (that is, the holistic model). Our role was to teach financial literacy and perform business consultations in the community of Embera Puru.

Embera Puru is an indigenous community of some 250 individuals in the Darien Province. Located in Eastern Panama near the Colombian border. Embera Puru is an Embera community, one of the largest indigenous groups in Panama and Colombia. The community members’ main source of income is agriculture, producing crops such as plantains, yucca, rice, and otoe (a local root vegetable), and creating artisan handicrafts.

With guidance from Global Brigades, the community established a caja rural (community bank) to encourage savings and loan making within the community. Embera Peru’s caja now has 21 members with 21 active savings accounts, but there are still many among the 266 inhabitants without this means to save.

Comparable to a savings group, a caja rural is a group of men and women who pool their funds to create a solid financial base, providing savings and loan services for themselves and for the entire community. Despite the initial contributions of Global Brigades, the caja is entirely owned and operated by members of the community.

Because the indigenous communities of Panama are predominantly closed economies, community groups eschew money from the outside and make weekly savings deposits into the community bank to begin their work. Group members manage the fund themselves, make decisions about who can receive loans and under what terms, and hold each other accountable for loan repayment.

As part of our business consultation work, we met with representatives from the community’s “Environmental Committee,” a group of farmers producing beyond self-sufficiency for distribution within the community, to ask simple questions to best understand the level of business assistance they needed.

The president of this group, a man by the name of Marcelino, also happens to be the treasurer of the caja rural, as well as a community teacher. Through conversation with Marcelino, we learned that his bookkeeping records won their bank a prize for “Caja with the best bookkeeping management” at a board of directors microfinance workshop in Panama City.

Analyzing the business’s books and records, we found a very thorough system and were stumped on how else to proceed with our consultation. (Aside from our recommendation that they include an inventory management system in preparation for increased production.) Not long into our conversation with these experienced committee leaders about potential business obstacles, we found ourselves confronted with an irritated committee leader and community elder who expressed his frustration with the focus of our questions and our work.

He argued that the group’s record-keeping strategies were highly insignificant in comparison to the group’s utter lack of inventory. It turns out that there was a community water shortage resulting from a collapsed well and a series of unfinished agricultural projects throughout the farm.

“Money,” he said. “We need your help on the farm, we need more crops, and we need money.” My observation was that the present infrastructure severely lacked sufficient capital to support a self-interacting and self-sustaining community.

As I sit now at my desk here in Washington, D.C., far removed from this man and his community, I face the internal debate of whether our work and efforts in microfinance are indeed meeting the direst needs of these people. My short time in Panama reinforced my understanding that development is a puzzle that we do not always equip ourselves to solve. Regardless of the practicality of the services we were working to provide, if other pieces of the complex puzzle are not fully in place, the outcomes in general are undermined.

Increased financial access serves as the window of opportunity for many entrepreneurs throughout the developing world, but without the proper environment and sufficient infrastructure, access to money is rather trivial.

Prioritizing the views, aspirations, and goals of clients or other program beneficiaries is critical as well. As economist William Easterly often argues, no matter how well-intentioned our efforts, without proper feedback from those receiving the assistance, how are we to measure the effectiveness and progress of our efforts? Under my interpretation, Global Brigades was not responsive to the needs and aspirations of its clients.

While the Embera Puru puzzle remains unsolved because the other pieces were never correctly and fully placed, I am glad to know that the industry and many of its institutions are making great strides towards increased attention to feedback from clients and beneficiaries as well as accountability of institutions to deliver on their objectives. Despite the puzzle’s sheer complexity, we have all the pieces and the ability to work with the poor to solve it.

I encourage Global Brigades to join the Microcredit Summit Campaign in making a specific, measurable, and time-bound Commitment on their efforts to end extreme poverty.

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Equitas commits to improve focus on clients and service coverage

Read the press release announcing Equitas’ Campaign Commitment
Read their Commitment letter
Photo courtesy of Equitas

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The Microcredit Summit Campaign welcomes Equitas, a major Indian microfinance institution (MFI), as the 56th organization to make a Campaign Commitment, joining a global coalition working to help 100 million families lift themselves out of extreme poverty.

Equitas is committing to expand its financial services and non-financial services to the following number of clients in the financial year 2015-2016 :

  • Provide 1.5 million clients with financial services.
  • Cover 70,000 clients under the food security program.
  • Cover 50,000 clients under the health education program.
  • Screen the health of 850,000 clients.
  • Partner hospitals will provide 3,000 Equitas clients discounted consultation/ treatment.
  • Use the Progress out of Poverty Index to measure the poverty level of 1.5 million clients.
  • Provide financial support to 3,000 disabled women.
  • Rehabilitate 200 homeless pavement dwellers.
  • Screen, educate, and track the health of 3,500 students in the 6 schools run by Equitas Trust.
  • Provide gainful employment to 15,000 unemployed youth.
  • Train 50,000 women in new skills to increase their income.

P.N. Vasudevan, founder and managing director of Equitas Micro Finance India P. Ltd., explains their mission and how they support the well-being of their clients:

“When we founded Equitas in 2007, we wanted to create an MFI which would be a global benchmark in fairness and transparency, two facets sadly missing from most of the MFIs globally.  Equitas is a Latin word meaning ‘Equitable,’ which means fair and transparent, and this philosophy is woven into every action of Equitas.  Equitas had started lending at 25.5% in 2007 (at a time when the other MFI rates were in the high thirties) and after 4 years, Reserve Bank of India capped the lending rate for MFIs in India at 26%! The Equitas Ecosystem Model is designed to support the well-being of our clients by providing financial and non financial services with a clear focus to address a large spectrum of their requirements in the field of health, education, skill development, food security during emergencies, placement for unemployed youth and many more.”

Equitas is an NBFC MFI with headquarters at Chennai, India, and operations in eight states, namely Tamil Nadu, Pondy, Karnataka, Maharashtra, Gujarat, Rajasthan, Madhya Pradesh, and Chattisgarh. Equitas has about 2.8 million active borrowers as of 31st March, 2015. Along with financial services, Equitas is also promoting several non-financial services aiming at holistic development of their clients and their families.

Read Commitment Letter from Equitas.

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 Equitas and…

Get Inspired. Set a Goal. Make a Commitment.

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

Grama Vidiyal commits to expanding health services to clients

Read the press release announcing Grama Vidiyal’s Campaign Commitment
Read their Commitment letter
Photo courtesy of Grama Vidiyal

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The Microcredit Summit Campaign welcomes Grama Vidiyal, a major Indian microfinance institution (MFI), as the 55th organization to make a Campaign Commitment, joining a global coalition working to help 100 million families lift themselves out of extreme poverty.

Grama Vidiyal commits to expand its financial and non-financial services to the following number of clients in the financial year 2015-2016:

  • Provide an additional 150,000 clients with financial services in FY15
  • Help 1,050,000 community members through Grama Vidiyal’s empowerment program.
  • Organize 720 health camps for clients, screening 300,000 members.
  • Provide 10,000 clients with discounted consultation/treatment in partner hospitals.
  • Provide health education to 80,000 client families (or community).
  • Give access to health related products and medicines to 150,000 clients.
  • Help 800,000 clients with the Free Meals program.
  • Install 1,000 household toilet connections and 4,000 water tap connections.
  • Establish 80 Community Knowledge Centers, engaging 30 poor students each (a total of 2,400 students), to motivate learning basic math and English.
  • Help 500,000 clients with the Health Service and Development Program that provides sanitary napkins for women.
  • Use the Progress out of Poverty Index to measure the poverty level of 35,000 clients.

Sathianathan Devaraj, chairman and managing director of Grama Vidiyal, explains the importance of microfinance as a means to financial inclusionhealth:

“Microfinance is a very important tool for financial inclusion, which provides financial services for poor entrepreneurs and small businesses lacking access to formal banking and related services. Microfinance creates a window for the poor where they can access quality financial services such as credit, savings, insurance etc., without inhibition. A double bottom line approach with the right balance of fiscal performance and positive social impact is key to the microfinance’s success. Formal banks identified and promoted bankable people, but microfinance introduced and proved that even the poor are trustworthy and bankable.”

Grama Vidiyal is one of the largest Indian microfinance institutions, serving one million clients over 5 Indian states. Their objective is to focus on eradication of poverty and improving the standard of living of downtrodden women.

Read Campaign Commitment letter from Grama Vidiyal.

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 Grama Vidiyal and…

Get Inspired. Set a Goal. Make a Commitment.

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

Measuring client health outcomes using simple indicators

A local community health volunteer trained and supervised by Bandhan, an Indian MFI, meets with members of a local self-help group and their families. (Photo courtesy of Johnson & Johnson)

A local community health volunteer trained and supervised by Bandhan, an Indian MFI, meets with members of a local self-help group and their families. (Photo courtesy of Johnson & Johnson)

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>>Authored by Sabina Rogers, Communications and Relationships Manager

More than two years ago, we set out with Freedom from Hunger to develop and test a standardized set of health indicators as part of a Campaign Commitment we co-launched in 2013. This has culminated with the release of Healthy, Wealthy and Wise: How Microfinance Institutions Can Track the Health of Clients. The report describes our experience in selecting and pilot-testing a set of indicators. It will help you choose the right indicators for monitoring client health outcomes over time. And finally, the report summarizes key recommendations for developing “standardized” client outcome monitoring indicators.

We hope financial services providers and others will use our “health outcome performance indicators” (HOPI) to assess the health and well-being of clients and their families. We believe that wide usage of the HOPI would create short- and long-term value for practitioners (both health and financial services), social investors and donors, raters, and other actors. “Health” is a basic need that crosses all borders and all demographics, making the HOPI compelling measures for understanding client outcomes for financial service providers.

Four MFIs pilot tested the HOPI in 2014 (see below), and we shared results from ESAF’s and Equitas’ experiences in India in a webinar in March.

Financial Service Provider Country No. of Clients being served by FSP No. of clients participating in health indicators survey
ESAF India 450,000 700
Equitas India 1,344,361 551*
CARD Philippines 1,828,052 472
ADRA Peru 17,039 95

*Equitas had completed 234 surveys by the time we began data analysis. Therefore, the HOPI report only covers analysis for the first 234 data points

The HOPI measure 6 dimensions: poverty, food security and nutrition, preventive health care, curative health care, water and sanitation, and attitudes. The results from these four MFIs highlighted the added value of health indicators when combined with poverty measurement in helping MFIs understand client well-being. For example, the food security measure was useful to detect vulnerability; while very few clients in Peru fell under any of the poverty lines, 40 percent of them scored as food insecure.

We also found that whether clients treat their water was most frequently associated with poverty levels. However, to correctly interpret this measure, this dimension should not be used without assessing household drinking-water sources as well.

The curative health care dimension results were particularly informative and the questions have broad applicability across contexts. Results from the four MFIs showed that up to 60 percent of clients didn’t seek treatment because of costs. In Peru and the Philippines, we also learned that clients were not very confident in their ability to cover future health costs or to receive adequate medical care.

Because it’s so context-specific, the preventive health care dimension is the most complicated, yet it is also very important to include because it could be predictive of future health outcomes. As we look at adapting to new countries, national health surveys will be the most useful source for indicators.

While collecting the data was fairly simple, the bigger test will come from an organization’s ability to analyze and interpret the data so that action can be taken. In the pilots, we provided technical support to the four MFIs to analyze the data, but that level of input is not likely to be sustainable. Therefore, we are now developing an easy-to-use, Excel-based data collection and analysis tool for distribution later this year. If you are curious, then, about the health outcome performance indicators, here is what you should know:

  • They are practical to measure and monitor client health over time (annually or as part of other monitoring tools such as the Progress out of Poverty Index®).
  • 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.

If you would like to learn how you can adapt the HOPI to your institution’s needs, contact Bobbi Gray (email) or DSK Rao (email).

Related reading

Ecuadorian Government commits to support entrepreneurs with disabilities

The Technical Secretariat provides financial inclusion support to entrepreneurial projects led by persons with disabilities. Says Alex Camacho Vásconez, Technical Secretary, “This commitment will allow us to take part in an international movement that seeks to reduce extreme poverty all over the world.” Read the full press release.

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The Microcredit Summit Campaign welcomes the Government of Ecuador as the first government to make a Campaign Commitment, joining a global coalition of 54 partner organizations working to help 100 million families lift themselves out of extreme poverty.

The Technical Secretariat for the Inclusive Management on Disabilities (Secretaría Técnica de Discapacidades) of the Vice-presidency of the Republic of Ecuador is developing the “Productive & Financial Inclusion Model” through public-private partnerships. The model provides financial capacity building and training in support of enterprises run by persons with disabilities, and the Technical Secretariat has supported 257 enterprises to date. The Technical Secretariat commits to support 500 entrepreneurial projects led by persons with disabilities through the Productive & Financial Inclusion Network by December 31, 2015.

Furthermore, the Technical Secretariat understands the vital importance of measurement indicators to assess progress in meeting its objectives in serving persons with disabilities. It is currently working with partners to identify and assess the relative strengths of available poverty measurement and other indicators. The Technical Secretariat commits to implement a set of measurement indicators, including indicators to assess poverty levels, during the first half of 2015.

Alex Camacho Vásconez, explains why they have joined the Microcredit Summit Campaign and this global coalition:

“Our commitment to advise more than 500 entrepreneurs with disabilities in 2015 and to implement tools for the assessment of poverty levels of the members of this priority group directly supports the objectives of the 100 Million Project,” said Alex Camacho Vásconez, Technical Secretary. “The signature of this commitment will allow us to take part in an international movement that seeks to reduce extreme poverty all over the world. This strategic partnership with a global actor such as the Microcredit Summit Campaign is of great value as it constitutes a guarantee for the beneficiaries of the Productive Inclusion model and international recognition as a good practice for the global eradication of poverty.”

Read the Government of Ecuador’s Campaign Commitment letter.

The Microcredit Summit Campaign looks forward to welcoming our new partners to the global coalition and sharing their progress towards achievement of their Commitment 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.

The Technical Secretariat for the Inclusive Management on Disabilities was created in 2013 to coordinate the transfer of programs and projects from the Misión Solidaria Manuela Espejo to the guiding ministries; following Executive Directive No. 547, enacted January 14, 2015, this was transformed into the Technical Secretariat forthe Inclusive Management on Disabilities.

Among its roles are the coordination of  cross-sector implementation of public policy in matters concerning disabilities such as development and enactment of policy, plans, and programs to raise awareness about persons with disabilities within the initiative of Participatory and Productive Inclusion and Universal Access under the national program Ecuador Lives Inclusion (Programa Ecuador Vive la Inclusion).


We invite you to join the Government of Ecuador and…

Get Inspired. Set a Goal. Make a Commitment.

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

CRECER Commitment focuses on women and movement above national poverty line

A female client from CRECER is managing her financial assets. Read the press release about CRECER’s Commitment, which focuses on women and movement above national poverty line
Photo courtesy of CRECER Bolivia

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The Microcredit Summit Campaign welcomes CRECER Bolivia as the 53rd Campaign Commitment maker, joining a global coalition working to help 100 million families lift themselves out of extreme poverty. A press release was issued on the Campaign website. CRECER was one of some 200 attendees that visited the Commitment Café during the 17th Microcredit Summit in Mexico last September to write on the Commitment Wall. (Read more about that.)

In their Commitment, Crédito con Educación Rural (CRECER) commits to support the Campaign’s goal in the following ways:

  • Continue to prioritize services for female clients: CRECER has 152,000 clients and will grow 3 percent per year to reach 166,000 clients by the end of 2017 while maintaining a rate of 80 percent women clients.
  • Clients in rural areas: Maintain a rate of 56 percent of total clients living in rural areas.
  • Strengthen financial education targeted towards women: By the end of 2015, have 75,000 female clients attend financial education events.
  • Support cervical cancer prevention: By the end of 2015, 25 percent of female clients will be receiving preventive screening each year, and it is expected that approximately 32,000 will benefit from this screening by the end of 2015.
  • Improve the quality of life: Of CRECER’s 152,000 clients, at least 65 percent live on less than double Bolivia’s poverty line ($2 per person per day), which is to say they live on less than $4 per day per person, while 41 percent are below the national poverty line. Our goal is that 10 percent of clients who are currently below the national poverty line raise their incomes from less than $2 to at least $4 per day, thus surpassing the poverty line. This process will be monitored with the Progress out of Poverty Index (PPI).

José Auad, CEO of CRECER, explains why they have joined the Microcredit Summit Campaign and this global coalition:

“Being a part of the Campaign…coincides with CRECER’s institutional philosophy. We are mindful of the responsibility that this signifies, as well as the responsibility we take on through the Commitment, for our fight against poverty began more than 25 years ago. We focus on a very vulnerable population, such as women in rural areas who, while truly experiencing poverty, are heroines in their daily struggle. We are convinced that by joining efforts and taking action…, we will reach the great goal of helping 100 million families around the world.”

CRECER is a development financial institution that provides financial and educational services to low-income women in Peru, in order to improve their quality of life and their families. It was founded in 1999 and its mission is to provide excellence and warmth with integrated financial products development services to improve the quality of life preferably women and their families. Read CRECER’s Campaign Commitment letter.

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 CRECER and…

Get Inspired. Set a Goal. Make a Commitment.

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

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.

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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

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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

How deep is your outreach?

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We are still collecting the 2014 Institutional Action Plan (IAP) forms in preparation for The State of the Microcredit Summit Campaign Report, 2015.

Submit your IAP_193x92

Submit your Institutional Action Plan today!
DEADLINE FEBRUARY 15

By filling out an Institutional Action Plan (IAP), members of the Council of Microfinance Practitioners and Associations report on the progress they have made over the past year in providing financial and non-financial services to the most vulnerable and poorest populations.

Please complete the appropriate form below, and email it to info[at]microcrocreditsummit.org by February 15, 2015 to be included in the 2015 State of the Campaign Report.

If your institution operates in multiple countries and you would like to fill out a single IAP form, please contact us at info[at]microcreditsummit.org. Note that this year we are only asking for information on borrowers.

If you have any questions, please contact the Secretariat at info@microcrocreditsummit.org.


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Nous recueille toujours les formulaires de Plan d’Action Institutionnel (PAI) 2014 pour le Rapport de l’État de la Campagne du Sommet du Microcrédit, 2015.

Envoyer votre PAI_193x92

Envoyez votre Plan d’Action Institutionnel (PAI) dès aujourd’hui !
DATE LIMITE : LE 15 FÉVRIER

En remplissant un PAI, les membres du Conseil des Agents et des Associations rendrent compte du progrès qu’ils ont fait pendant la dernière année en occtroyant des services financières et non financiers aux populations les plus vulnerables et plus pauvres et le nombre de clients qui sont sortis de la pauvreté.

Veuillez remplir le formulaire approprié ci-dessous, et envoyer-le a info[à]microcreditsummit.org au plus tard le 15 de février 2015 afin d’être inclus dans le Rapport de l’état de la Campagne.

Si votre institution travaille dans plusieurs pays et vous voulez remplir un seul Plan d’Action, veuillez nous contacter à info[à]microcrocreditsummit.org. Notez bien que cette année nous demandons seulement des informations à propos des emprunteurs.

Si vous avez des questions, veuillez contacter le Sécrétariat en écrivant à info@microcrocreditsummit.org.


ENGLISH   ~   FRANÇAIS  ~  ESPAÑOL

La Campaña de la Cumbre de Microcrédito le complace anunciar que está recolectando los formularios del Plan de Acción Institucional para el 2014 (PAI) para el Informe del Estado de la Campaña de la Cumbre de Microcrédito, 2015.

¡Entregue su Plan de Acción Institucional hoy! FECHA LÍMITE: EL 12 DE DICIEMBRE

¡Entregue su Plan de Acción Institucional hoy!
FECHA LÍMITE: EL 15 DE FEBRERO

Al completar un Plan de Acción Institucional (PAI), los miembros del Consejo de Agentes y Asociaciones de Microfinanzas están reportando los progresos realizados durante el último año en el suministro de servicios financieros y no financieros a las poblaciones más vulnerables y pobres.

Por favor llene el formulario apropiado que se encuentra a continuación y envíelo por correo electrónico a info[a]microcreditsummit.org a más tardar el 15 de febrero de 2015 para poder incluir sus datos en el Informe del estado de la Campaña 2015.

Si su institución trabaja en varios países y desea llenar un solo Plan de Acción, favor de comunicarse con nosotros al enviar un correo a info[a]microcrocreditsummit.org. Por favor tome en cuenta que este año sólo estamos pidiendo información sobre sus prestatarios.

De tener cualquier pregunta, por favor comuníquese con el Secretariado enviando un correo a info@microcreditsummit.org.

Truelift’s progress and what the future holds

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A message from the Truelift Steering Committee was posted on the Center for Financial Inclusion blog on January 21st, “Truelift’s Progress and Future in Pursuit of Transparency and Accountability in Poverty Alleviation Efforts.” The message opens with the pronouncement that defines what Truelift is all about: “Institutions built upon a promise of poverty alleviation must be motivated and supported to make good on that promise.”

Formerly known by the name of The Seal of Excellence for for Poverty Outreach and Transformation in Microfinance, Truelift officially launched in 2011. It emerged through the coordinated action of leaders in the global microfinance community who were catalyzed the Microcredit Summit Campaign early in 2010. We have been and will continued to be strong supporters of Truelift.

Now, however, Truelift’s resources have diminished to the point where they must depend on volunteer staff and committee members to maintain access to the Truelift information, tool, and services. The Microcredit Summit Campaign is committed to helping maintain what Truelift has already built, and together, we seeking new funding to regain momentum.

In the meantime, practitioners and others can continue to access the Truelift information and tool through our website and to receive responses to questions/queries about use of the tool and interpretation of results. Self-assessments as well as external assessments by rating agencies remain viable options.

We invite you to read the entire message from the Steering Committee and learn more about Truelift’s progress and future in pursuit of transparency and accountability in poverty alleviation efforts.

www.truelift.org