Better health for every woman and every child in the Philippines

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

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

Learn more

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

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

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


>>Authored by Carley Tucker and Sabina Rogers

MDG 4: Reduce child mortality

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

From The Millennium Development Goals Report, 2015

From The Millennium Development Goals Report, 2015

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

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

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

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

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

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

Where do we go from here?

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

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

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

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

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

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

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

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

ESAF Microfinance commits to comprehensive services for clients

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

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

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

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

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

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

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

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

Read the Commitment Letter from ESAF Microfinance.

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


We invite you to join ESAF Microfinance and…

Get Inspired. Set a Goal. Make a Commitment.

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

Financing healthcare in new middle income countries: Lessons from Kenya

Release of "Who Pays for Progress?"

Report authors Steve Lewis and Evelyn Kibuchi presented their findings on the report, Who Pays for Progress? at the Third Financing for Development Conference in July. They were joined by representatives from the World Bank and other global organizations as well as Yvonne Chaka Chaka, UNICEF Ambassador and Princess of Africa Foundation. Photo credit: Steve Lewis/RESULTS UK

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>>Authored by Theo Fievet, State of the Campaign Report Intern

A step to climb

Despite economic growth over the last decade, healthcare outcomes in Kenya remain weak. Rates of maternal mortality and stunting among children have barely changed…

— World Bank, Financial Report (Kenya), June 2014

Is a vibrant, fast-growing economy enough to improve the performance of the public health sector? A case study in Kenya published recently by RESULTS UK and partners KANCO and WACI shows that the correlation between economic growth and public health is not simple, nor automatic. Even though Kenya’s growth in recent years averaged 6 percent per annum, 25 percent of the population still lacks quality healthcare.

Kenya’s improved economic performance helped the country cross the line separating low-income countries (LIC) from lower-middle-income countries (LMIC), and this shift in status has a considerable impact on Kenya’s situation on the international stage. Kenya’s new standing as a MIC threatens its income from international aid and donations. The country faces a contradictory situation: while its economic position has improved, the country’s health sector remains typical of an LIC. For example, only 28 percent of infants are fully immunized.

The Government of Kenya is working to on a plan for universal health coverage (UHC), providing all citizens with the health services they need and saving them from financial hardship. According to the World Bank, Kenya’s rate of “out-of-pocket” expenditures (the amount paid by the patient’s household) was greater than 50 percent. For poor families, this often means selling business assets or pulling their children out of school. Kenya’s challenge is to figure out how to revolutionize a health system to include even the poorest Kenyans, while international aid possibly decreases in the coming years.

In the report, Who Pays for Progress?, the authors (Steve Lewis and Evelyn Kibuchi) suggest that a balance between domestic resource mobilization (DRM, otherwise known as taxes) and official development assistance (ODA) will be the way toward a sustainable and independent healthcare system.

Alliance of public funders

RESULTS UK argues in the report that cooperation between internal (domestic) and external (international) actors is necessary since both solutions have inconveniences that the other can counterbalance.

ODA could and has declined and follows unpredictable trends. Australia, for example, decided to cut 70 percent of its aid for developing countries. International aid institutions such as the World Bank and GAVI (the Vaccine Alliance) have a variety of complex criteria from which it is difficult to determine what will be the final aid amount disbursed. Furthermore, relying on DRM instead of ODA provides greater maneuverability for countries because ODA is often conditional and subject to donor priorities. Kenya cannot risk being totally dependent on the varying ODA and its requirements.

On the other hand, ODA that is earmarked for healthcare comes with direction on how to be spent; it is thus a way to assure funding is provided for health services. Tax income, meanwhile, may be siphoned off for debt repayment or subject to a lack of political will or a lack of trust in health sector efficiency. Furthermore, while DRM currently accounts for 55 percent of Kenya’s budget, it covers only a fraction of many of the country’s healthcare needs.

Finding the most sustainable way to finance UHC

In the medium-term, ODA may fall faster than Kenya is able to increase tax revenue. In 2012, Kenya collected 15.9 percent of their GDP in tax revenue (World Bank data). According to the UNDP, this number needs to increase to 20 percent to smooth the transition from a donor- and tax revenue-financed health sector to a tax revenue- and loan-financed health sector. This is a sustainably financed health sector.

The report recommends tax reforms that combat illicit financial flows in order to a) facilitate predictability of tax income and prioritization; b) create a sense of participation to appear responsible to donor nations, which will then be obligated and/or encouraged to continue their aid; and c) gain recognition in the international finance markets for replacing grants with loans.

In the shorter term, responsible health spending (regarding the implementation of UHC) requires that ODA has to be invested in a profitable way. Investment could occur directly in some key aspect of the health sector regarding maternal health, delivery or child nutrition, as “every dollar invested in nutrition to reduce stunting yields a benefit of more than $16” [1]. Investment could also take place indirectly, for example, to reform and modernize Kenya’s tax system, as “an OECD pilot project in Kenya found that every $1 invested in tax administration, $1,650 was returned” [2].

The report concludes that Kenya should work toward a tax system suitable to an LMIC country. Kenya is not unique in its transition from an LIC to an LMIC, and this report can easily be adapted to other countries that fall in between these two categories. A close look at this group of countries would benefit other countries who are on the way to being in the same position between LIC and MIC.

Read the full report.

Footnotes

[1] “Who Pays for Progress?” page 13

[2] Page 30


Related reading

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.


Get Inspired. Set a Goal. Make a Commitment.

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

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:

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:

Accessible and affordable microinsurance with Afua Donkor

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We are pleased to bring you this #ThursdayThrowback blog post, which was originally published in Resilience: The State of the Microcredit Summit Campaign Report, 2014. Afua Boahemaa Donkor, executive director of Star Microinsurance in Ghana, explains how they have developed microinsurance products that are simple and affordable for the poor.


>>Authored by Ana Hecton, former intern, and Sabina Rogers, Communications and Relationships Manager

SOCR 2014_front-cover_EN_270x348

You can read a transcript of her interview here.
Read the full report here.

The 2014 State of the Campaign Report features various actors in the microfinance sector that are taking steps to help their clients lift themselves out of poverty. In this interview Afua Boahemaa Donkor, executive director of Star Microinsurance in Ghana, talks to DSK Rao from the Microcredit Summit Campaign about how microinsurance works and how it can benefit the poorest. Ms. Donkor also discusses the challenges in providing coverage for the poorest.

Star Microinsurance in Ghana started in 2008 as a specialized microinsurance subsidiary of the Star Insurance Group. Star Microinsurance works to design microinsurance products, looks for distribution channels, and provides the back office administration of the products.

“Microinsurance is supposed to be suave. When I say that, it means that it has to be simple, accessible, understandable, fundable, and efficient.”

— Afua Boahemaa Donkor

Star Microinsurance aims to make their insurance accessible to all people, those living in the city and those living in remote areas. The microinsurance products that are offered by Star Microinsurance are “made very simple, the premiums are set to be very cheap, affordable, so that the informal person, in the rural sector, can afford to have insurance products.”

Star Microinsurance collaborates with rural banks, MFIs, and post offices where the product is located. The rural banks and post offices are spread all throughout Ghana, therefore being highly accessible to all people no matter their location.

The challenges that face microinsurance

When talking about microinsurance and selling it to those living in poverty, Ms. Donkor says that it is hard for people to grasp the concept that they are paying for a possibility that may or may not occur. For those living in extreme poverty, possibilities of the future or what could happen is not a high priority. The demand is for what they need right here, right now. Thus, trying to sell microinsurance to people whose concern is focused solely on getting through that day is very difficult. In fact, “insurance in general is a very difficult thing to sell whether to an educated person or an uneducated person because it is an intangible good we are selling.”

What we know of the impact of microinsurance

ei76 infographic en

A systematic review of the impact of microinsurance (2013) produced by the ILO’s Microinsurance Innovation Facility. Source: http://www.impactinsurance.org/emerging-insights/ei76

Measuring what’s important: client transformation

Research Results ESAF India

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Published on the Center for Financial Inclusion’s blog April 15th.

Measuring Transformation

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

While recent research indicates that access to and use of microcredit alone is not transformative for the average client served (see “Where Credit Is Due“), there has been very little discussion about the types of indicators being used to measure “transformation” in the ongoing debates. In fact, it seems that we all have accepted the general findings that microcredit has only had modest impacts on, along with other indicators of poverty and well-being, education, health, and social capital because the randomized controlled trials (RCTs) have said so. There needs to be greater thought and debate about the choices of indicators used to support these conclusions.

Freedom from Hunger over the past 20-plus years has integrated health with microfinance and helped build a body of knowledge indicating that microfinance plus health services can enhance health outcomes. In an ongoing partnership with the Microcredit Summit Campaign, supported by Johnson & Johnson, we have pilot-tested a series of health indicators that financial service providers (FSPs) can use to track client health outcomes. This pilot test was built on years of experience of evaluating health outcomes with our FSP partners, as well as on similar experiences of developing common tracking indicators in the health sector. We created a list of criteria to assess the types of indicators we felt would be meaningful to track—for individuals with and without health services – which included dimensions of feasibility, usability, and reliability. Initial results have been shared in several webinars with SEEP and the Social Performance Task Force.

It’s important to note that this pilot test effort was not about “proving” impact, but rather developing common techniques for monitoring client outcomes that FSPs could use over time. However, this experience has shown how difficult it is to identify indicators that best measure certain health outcomes. What initially might appear as an intuitive indicator to use — for example, how often a person reports being ill or seeking medical treatment — is found to be more difficult than expected. Morbidity — or reports of illness — is not an easy measure for health sector actors or those who directly work to improve health outcomes because it is influenced by the seasons, by specific efforts, and other factors, so care has to be taken when interpreting results. Reports of seeking medical treatment are complicated by whether people are satisfied with the services they can seek and may not always reflect financial capability but preferences or lack of available health services.

Read the rest of the article

Relevant resources

Partnership building to reduce the Philippines’ maternal mortality rate

health-education_HMHB-PH_Oct2014_Courtesy-of-CARD-MRI

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

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Pathway

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


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

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

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

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

Photo credit: Cassie Chandler

Photo credit: Cassie Chandler

How it works

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

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

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

Making these changes lasting changes

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

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

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

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

April is the Month of MicrofinanceLearn more

April is the Month of Microfinance
Learn more

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

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

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

Relevant resources

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

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

Health Outcome Performance Indicators will help us “understand clients”

PMD clients and health providers

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

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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

Click the image to see it enlarged.

The PPT presentation

Relevant resources

The SEEP Network | Mar 4, 2015

By Patrick Fine, Leith Greenslade | 26 February 2015

Cassie Chandler | Huffington Post Global Motherhood |

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

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

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

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

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Join the Google+ Hangout on “Women Who Inspire” — Wednesday @ 1 PM

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