5 lessons on expanding financial inclusion and usage

Source

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

Lea en español *** Lisez en français


>>Authored by Mbaye Niane, 100 Million Project intern

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

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

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

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

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

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

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

Achieving financial inclusion: Five critical conclusions

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

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

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

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

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

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

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

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

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

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

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

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

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

The FDIP Scorecard

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

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

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

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

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


Footnote

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

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


Get Inspired. Set a Goal. Make a Commitment.

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

Swedes, chimps, and you and me on sustainable development

Hans Rosling shows how the child mortality rate declined at a phenomenal rate across the globe between 1964 and 2012.

Lea en español *** Lisez en français


>>Authored by Sabina Rogers

Earlier this year at the World Economic Forum (WEF), Hans Rosling opened his presentation, “Sustainable Development: Demystifying the Facts,” with three questions for the audience about the state of global development (about extreme poverty, measles vaccination, and population in 2100). He was testing their knowledge in order to illustrate how preconceived ideas will do us wrong.

He had done this test before. Rosling conducted studies with Swedes, Americans, and chimps about the state of global development. The chimps were asked to choose a banana that is associated with 1 of 3 possible answers, and they got the answer correct 33 percent of the time. In essence, they were bound to be right 1 time in 3; the humans were not as lucky. Basically, according to his study, chimps in a zoo have a better chance of choosing the right answers at random to questions about the state of the world than the average Swede and American does.

It is detrimental when we underestimate the progress that has been made just in the last 15 years. In 1964 (the date he starts with his child mortality chart), the world was clearly divided into two worlds: the developing world with large families and high child mortality and the developed world with the opposite. Today, there really is just one world, with a few outlying countries, mainly in Africa.

It’s also a world of inequality within countries. Take India, for example. “If someone comes from outer space and wants to see the world,” says Rosling, “and [they] have only one day to visit, they should go to India. Because they can see everything in India: the most fantastic success [and] progress being made, but also remote, rural areas where still, extreme poverty is rampant — but decreasing.”

This is where the post-2015 agenda has to focus the world’s energy and money: the still marginalized, the remote and hard-to-reach areas. This is why we at the Microcredit Summit Campaign are championing six financial inclusion strategies (our “six pathways“) that we believe hold the greatest promise in helping to end extreme poverty at the frontiers — at the margins of society in economic, social, and geographic terms. The six pathways offer a means to reduce the cost of delivery (mobile money), help the poor build assets (cash transfers linked with savings), tackle the challenge of a weak health infrastructure, and more.

But, this isn’t just about practitioners and donors. With the launch of the Global Goals for Sustainable Development, we are seeing a massive media campaign targeted at you and me. It is a media campaign designed to get people excited and believe in the possibility of achieving the SDGs. Each goal has been reworded to express greatly simplified concepts. No numbers. No percentage signs. Just simple framing: No poverty, no hunger, good health, and so on.

It is also is designed to put “we the people” in the driver’s seat of this “next generation” of development. This is good because we are going to need everyone behind this agenda to fund it and traditional “aid” funding will not suffice. Tax revenue must contribute to the estimated $172.5 trillion price tag (over 15 years). The MDGs cost $915 billion in total. That’s $114 billion per goal compared to more than $10 trillion per goal for our post-2015 agenda.

In an interview on NPR’s Goats and Soda blog, Paul O’Brien of Oxfam America said, “It’s not just about more aid and donors doing more. This is going to be about sustained political will by governments to use their own money to tax corporations more effectively and make sure the money from their natural resources goes to poverty reduction.” This is the same conclusion in Who Pays for Progress?, a report from RESULTS UK about how to finance healthcare in new middle income countries. And, we can only do this if we understand what Rosling is trying to show us with his charts: “We can make the world much better. The long-term trend is going in the right direction.”

I would add, don’t underestimate what a world united by a set of global goals can achieve.

Watch Hans Rosling’s presentation at the World Economic Forum

Here is Rosling’s first question for WEF attendees:

In the last 20 years, the proportion of people living in extreme poverty has…? A. almost doubled, B. remained more or less the same, C. almost halved.

The answer was C (though the numbers of extreme poor may not have decreased in absolute terms). How many got it right? 61 percent of respondents from the WEF were right; in an online survey he conducted, 23 percent from Sweden and 5 percent from the US answered C.

How many of the world’s one-year-old children are vaccinated against measles? A. 2 in 10, B. 5 in 10, C. 8 in 10.

Again, the answer was C, and 23 percent of WEF got it, 8 percent of Swedes, and 17 percent of Americans.

How many children will there be in the world in 2100? A. almost 4 billion, B. 3 billion, C. 2 billion (with no increase from 2000).

26 percent of the WEF audience answered the correct answer, C, 11 percent of Swedes, and 7 percent of Americans. Rosling’s chimps surveyed answered correctly 33 percent of the time.

What does this mean? When you answer worse than random, it means that the problem is not lack of knowledge, the problem is that you carry preconceived ideas, which makes your score worse than chimps.

The whole point of this exercise queued up his presentation (starting at 6:33) on the state of child mortality between 1964 and 2012 (hint: the vast majority of countries are doing amazingly well). He showed how child mortality today in Bangladesh (8:52) is better than the state of child mortality in Italy in 1964 and that even the worst off families (women with absolutely no education) are, today, where the better-off and most-educated Bangladeshis were in 2001.

Hans Rosling shows why the concept of “developing countries” (those with less than US$12,000 per capita) doesn’t have much meaning anymore — for a happy reason. We have great reason to be optimistic about ending extreme poverty by 2030.

The main reason for optimism is the evidence of the past…the long term trend is going in the right direction.

Better health for every woman and every child in the Philippines

Lea en español *** Lisez en français


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

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

Learn more

Re-strategizing with the SDGs…Inspiration from MDG 6

Lea en español *** Lisez en français


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


>>Authored by Ifesinachi Sam-Emuwa, an Atlas Corps Fellow and the U.S Department of State fellowship Alumni

The launch of the new Global Goals for Sustainable Development (also called “SDGs”) this month during the U.N. General Assembly will focus world attention once again on the global development framework. Countries and the global community must use this opportunity to focus not only on the future, but also on the unfinished work of the MDGs.

The MDGs came as a global development framework to drive the global fight against poverty; to improve education, health, and the environment; and also to boost partnerships among member nations to tackle these issues.

World leaders from 189 United Nations member states signed this global framework, agreeing to achieve its goals, targets, and indicators between 2000 and 2015. As that period comes to an end by September, 2015, it is important to understand how well the different countries performed against the goals. Knowing this will allow the global community to re-position strategically in bid to achieve the SDGs, which 193 member states of the U.N. will adopt by September 2015.

Proportion of children under age five sleeping under insecticide-treated mosquito nets for selected countries in sub-Saharan Africa, around 2001 and 2013 (percentage)

The proportion of children under age five sleeping under insecticide-treated mosquito nets for selected countries in sub-Saharan Africa has grown exponentially since 2001.
Source: The Millennium Development Goals Report, 2015

MDG 6: Combat HIV/AIDS, malaria and other diseases

Besides other issues like eradication of extreme poverty and achieving universal primary education being tackled by the MDGs, the achievement of the health MDGs has been of great concern. Much focus was particularly put on achieving MDG 6 to fight HIV/AIDS, tuberculosis, and malaria (ATM) — deadly diseases that kill millions of people every year.

graph_MDG6

From The Millennium Development Goals Report, 2015

In fact, according to the World Health Organization, these are the latest statistics of the ATM:

  • In 2014, approximately 1.2 million people died from HIV-related causes globally (fact sheet).
  • In 2013, 9 million people fell ill with TB and 1.5 million died from the disease (fact sheet).
  • In 2013, malaria caused an estimated 584,000 deaths, mostly among African children (fact sheet).

The MDG agenda helped to focus both energy and awareness on the fight against ATM, and progress to reach these targets and were driven by funding from partners like the Global Fund to Fight AIDS, TB and Malaria, and other donor funding to implementing countries. Awareness about these diseases has increased, stigma and discrimination have been reduced, and people are learning how to avoid contracting these diseases. In that regard, MDG 6 has had huge global success, especially around treatment and management of the ATM.

For example, according to the World Health Organization (WHO), 40 percent of people living with HIV received anti-retroviral treatment (ART) in 2014. New advancements in malaria treatment have been achieved, with WHO now recommending the use of ACT (artemisinin-based combination therapy) antimalarial drug used in the treatment of malaria. Controlling the spread of tuberculosis (TB) has also improved through the DOTS (directly observed treatment, short-course) centers, these are centers that provides TB patients with treatments while directly observing them. These are all steps in the right direction for the eradication of the ATM.

Nigeria’s strategy for MDG 6

Nigeria made its own efforts to implement programs geared towards eradicating ATM by establishing agencies to oversee the implementation of interventions. The National Agency for the Control of AIDS (NACA), the National Malaria Control Programme (NMCP), and the National TB and Leprosy Control Programme (NTBLCP) were established in a bid to contribute to the global fight against ATM in Nigeria.

Nigeria has made a lot of progress towards achieving MDG 6 and other MDGs — but isn’t there yet[1]. Like many other countries (Kenya, for example), Nigeria needs to focus on domestic resource mobilization and also to use the new opportunity presented by the SDGS to refocus its national strategy. Nigeria’s government should focus interventions on equity; using the equity lens, Nigeria could ensure that the poorest and most vulnerable people are reached with the various health interventions.

The question of whether or not Nigeria has achieved the MDGs should not impede the country from focusing on stamping out HIV/AIDS, tuberculosis, and malaria. Nigeria successfully rallied against Ebola in 2014 and has now reached a one year polio-free milestone. With effort, resources, and political will, Nigeria can meet its agreed-to milestones on HIV/AIDS, tuberculosis, and malaria and save lives.


About the Author

Ifesinachi Sam-EmuwaMs. Ifesinachi Sam-Emuwa is a Professional Fellow for the U.S Department of State Bureau of Educational and Cultural Affairs. She is also an Atlas Corps Fellow and a USAID CIDI volunteer. She has over eight years of professional experience in the nonprofit sector working with Treasureland Health Builders Initiative; she earned a Bachelor’s of Science in Health Education from the Nnamdi Azikiwe University and a Master Degree in Community Development and Social Work from University of Lagos. She has Certifications in Global Health and International women’s health & human rights from the USAID and Johns Hopkins Bloomberg School of Public Health eLearning Center and Stanford University Online respectively. While working as a Project Coordinator and Community Development Specialist with Treasureland Health Builders Initiative under the Global Fund Malaria and HIV/AIDS Project, she helped improve the health of rural dwellers reducing the incidence of malaria and HIV/AIDS in Western Nigeria.

Ms. Ifesinachi is passionate about reproductive health of young people and women, and has trained over 3,800 women and girls on becoming community volunteers in that area. She has authored three books and has received several awards for her outstanding contributions to youth, women & community development in Nigeria. Through these experiences, she developed strong project coordination and implementation skills.

Other writing:


Footnotes

[1] According to a research study conducted by Adedokun A. & Ololade, B.M (2014), “Nigeria in the Eve of MDGs Final: A Progressive Analysis,” in Developing Country Studies, http://www.academia.edu/7538837/Nigeria_in_the_Eve_of_MDGs_Final_A_Progressive_Analysis

Insufficient and greatly uneven progress on the maternal health MDG

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

Lea en español *** Lisez en français


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


>>Authored by Marion Cosquer and Sabina Rogers

MDG 5: Improve maternal health

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

graph_MDG5

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

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

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

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

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

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

From The Millennium Development Goals Report, 2015

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

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

From The Millennium Development Goals Report, 2015

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

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

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

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

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

Maternal health in the post-2015 development agenda

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

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

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


Footnote

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

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

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

Lea en español *** Lisez en français


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


>>Authored by Carley Tucker and Sabina Rogers

MDG 4: Reduce child mortality

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

From The Millennium Development Goals Report, 2015

From The Millennium Development Goals Report, 2015

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

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

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

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

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

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

Where do we go from here?

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

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

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

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

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

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

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

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

Free ultrasounds draw thousands to community health fairs

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

Lea en español *** Lisez en français


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

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


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

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

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

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

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

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

HMHB_CMYK_English_Beveled

What else is in the newsletter?

Increasing Healthcare Access

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

What’s in the Mother and Baby Kit?

health-kit_HMHB-PH_Oct2014_Courtesy-of-CARD-MRI

Building Capacity to Provide Health Education

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

“MFIs for Health” Provide Health Services to Poor Communities

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

To receive the full newsletter, please sign up for our
integrated health and microfinance news mailing list.


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

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

Post-MDG 3: Achieve gender equality to tackle the root causes of poverty

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

Lea en español *** Lisez en français


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

MDG 3 is focused on gender equality and empowering women. Many MFIs are actively working to address gender inequality and to empower women in their own corner of the world. A dozen organizations have so far made a Campaign Commitment specifically targeting women. For example, Grama Vidiyal launched a Commitment will help 500,000 clients in India with their Health Service and Development Program that provides sanitary napkins for women. Crecer (Bolivia) committed to 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.


>>Kristin Smith, former intern for the 100 Million Project

MDG 3: Promote gender equality and empower women

From The Millennium Development Goals Report, 2015

From The Millennium Development Goals Report, 2015

As the deadline of the Millennium Development Goals (MDGs) rapidly approaches, we are called to evaluate the significant and substantial progress made across the board in addressing the root causes of global poverty. The final MDG report, recently released by the United Nations (U.N.), documents the global 15-year effort to achieve the aspirational goals set out in the Millennium Declaration, highlighting the vast successes while acknowledging the substantial gaps that remain.

The number of people living in extreme poverty, the proportion of undernourished people in developing regions, and the global under-five mortality rate have all decreased by more than half; however, despite these remarkable statistics, millions are still being left behind due to their sex, age, disability, ethnicity, or geographic location.

As we aim to continue substantial advances in reducing global poverty through the Sustainable Development Goals (SDGs, or “Global Goals”), we must renew our efforts to focus on the most vulnerable populations.

Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015

The importance of achieving gender equality arguably extends into every facet of society. MDG 3 aimed to address parity in education, political participation, and economic empowerment and emphasized the crucial role of women in achieving the other seven MDGs as well.

At the Council on Foreign Relations in 2004, economist Gene Sperling noted that “girls’ education is an integral part to virtually every aspect of development, and what is just striking is the amount of hard, rigorous academic data that is not only about what girls’ education does in terms of returns for income and for growth, but in terms of health, AIDS prevention, the empowerment of women, and prevention of violence against women.”

Women are proven to be key contributors to large development payoffs such as increased economic productivity and reduced maternal and infant mortality. This final report reiterates that “the education of women and girls has a positive multiplier effect on progress across all development areas.”

MDG-infographic-3

Indicator 3.1 Ratios of girls to boys in primary, secondary and tertiary education

In reviewing key statistics highlighted in the report, progress towards MDG 3 seems promising, yet further analysis paints a rather dreary picture. While the developing regions as a whole have eliminated gender disparity in primary, secondary, and tertiary education, this comes only as a result of averaging progress with the few prosperous regions. In South Asia, for example, female primary school enrollment has surpassed boys’: from 74 girls for every 100 boys in 1990 to 103 girls for every 100 boys today.

However, looking at the Gender Parity Index (GPI), defined as the ratio of the female gross enrollment ratio to the male gross enrollment ratio for each level of education, certain regions have backtracked on progress since 2000. GPI has decreased at the primary level in East Asia, at the secondary level in Oceania, and at the tertiary level in Sub-Saharan Africa.

Indicator 3.2 Share of women in wage employment in the non-agricultural sector

Women still face discrimination in access to work and economic assets, and they lack sufficient representation in public and private decision-making roles. The most prevalent barriers to women’s employment, as noted in the report, are household responsibilities and cultural constraints.

Distribution of working-age women and men (aged 15 and above) by labour force participation and employed women and men by status in employment, 2015 (percentage)

From The Millennium Development Goals Report, 2015

Indicator 3.3 Proportion of seats held by women in national parliament

Since the launch of the MDGs, women have gained significant ground in political representation. The average proportion of women in parliament has nearly doubled over the past 20 years; however, there remains significant work to be done with only one in five members being women. Organizations like UN Women help focus future development efforts on including women as a key demographic in global development, as poverty remains a heavily feminized condition.

Distribution of countries* in the developing regions by status of gender parity target achievement in primary, secondary and tertiary education, 2000 and 2012 (percentage)

From The Millennium Development Goals Report, 2015

Onward with the Global Goals for Sustainable Development

Despite uneven progress and persistent inequalities, the MDGs helped to lay an ambitious framework for the long-term effort of tackling the root causes of global poverty.

The Global Goals for Sustainable Development, or SDGs, are intended to build on the successes of the MDGs and tackling problems where they fell short. While some people complain that there are too many goals, they have been designed with an eye toward promoting concise and reasonable actions. Perhaps that requires 17 goals and 169 indicators. In analyzing the draft language of the successor Global Goals, it is important to note the widespread presence of important phrasings such as “inclusive” and “for all.”

UN Women advocated for a stand-alone goal to achieve gender equality, similar to the MDGs. SDG 5 is “Achieve gender equality and empower all women and girls;” this means tackling violence against women as well as ensuring equal economic and leadership opportunities, property rights, equal policies, social protection, and more. This singularly focused goal is crucial to creating a ripple effect for the integration of gender equality throughout the other goals.

Reaching full equality and empowerment for women and girls remains a crucial requirement to achieving full and sustainable development.


Continue reading