Celebrate improving maternal and child health in the Philippines

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Over the past 20 years, the Philippines has enjoyed an increase in life expectancy, improved access to education and economic opportunity, and a decrease in communicable diseases. However, maternal health has lagged behind, and as 2015 draws to a close, the world will be reflecting on the Millennium Development Goals like #5, “Improve maternal health.” Three development organizations took action in 2014 to tackle this challenge and are now celebrating what has been achieved, new partnerships that have been formed, and plans for moving forward.

Freedom from Hunger and the Microcredit Summit Campaign partnered with CARD Mutually Reinforcing Institutions (CARD MRI) to implement a project called “Healthy Mothers, Healthy Babies: Kalinga kay Inay.” The project is supported by an educational grant from Johnson & Johnson and will conclude at the end of 2015.

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Philippines program provided 800,000+ women maternal health education and care

Summary:
CARD Mutually Reinforcing Institutions (CARD MRI), the Microcredit Summit Campaign, and Freedom from Hunger announced that under the “Healthy Mothers, Healthy Babies” program, some 800,000 women have received maternal health education in the past 5 months and 3600 women have received healthcare in the past 12 months. The project aims to improve maternal health alongside their microfinance services in the Philippines, accelerating achievement of UN Millennium Development Goal 5.


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WASHINGTON, D.C. [September 24]—Partners in a joint-program aiming to improve maternal health in the Philippines announced today that they provided more than 800,000 women with maternal health services in the past year. CARD Mutually Reinforcing Institutions (CARD MRI), the Microcredit Summit Campaign, and Freedom from Hunger began rolling out health education in April to poor and rural communities in Luzon, Mindanao, and, notably, the Visayas, which had catastrophic destruction in the wake of Typhoon Haiyan.

With the support of program partners, CARD MRI trained more than 1,000 account officers (AOs) in 14,650 centers to deliver the health education to CARD members. The AOs educated an average of 5,000 women per day over the last five months on important maternal health issues. Each woman received two hours of instruction on simple but important lessons like the food and nutritional supplements that pregnant and young women need and the importance of giving birth in a health facility.

“Helping poor communities through financial access is undeniably important in poverty eradication,” said Marilyn M. Manila, director of the Community Development Group at CARD MRI (a Filipino microfinance institution), “but this is insufficient to reach our goal. Poor health and having no access to health care service are a big part of continuous poverty in many countries. We realize the importance of good health of microfinance institutions’ (MFIs’) clients to help them continue improve their quality of life.” Ms. Manila also chairs the MFIs for Health, a consortium of 21 Filipino MFIs committed to providing access to health care services to poor communities.

At 30 years old, CARD MRI client Barrera is eight months pregnant with her fourth child. Barrera is one of the 3,634 women who received routine gynecological examinations and 2,222 mother and baby kits at four community health fairs over the last 12 months. Berrera attend the fair in Davao this July “for the ultrasound—to be able to see my baby. It was my first time.” More than 100 healthcare providers have participated in the four health fairs, and many more will. The next health fair will take place in very rural areas of Mindanao October 2nd and 3rd.

Community health fairs are important for improving maternal health in poor, rural communities where accessing health services is a challenge. Program partners organize health fairs with support from local foundations and professional associations like the Philippines OB/GYN Society, community health workers and private health providers, as well as the government: the Department of Health, local government units, and PhilHealth (the national insurance program).

Over the last 15 years, the Philippines has improved in many key indicators such as life expectancy, access to education, and infant mortality; however, maternal mortality has remained at unacceptably high levels. Delays in accessing medical care is a key bottleneck in achieving better results for mothers and babies. With 99 days to the end of the Millennium Development Goals and the Global Goals for Sustainable Development on the horizon, this collaboration to educate about and expand access to health services is critical for meeting the needs of poor communities. This project is supported by an educational grant from Johnson & Johnson.

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About CARD Mutually Reinforcing Institutions
The CARD MRI is a group of mutually reinforcing institutions with a common goal of alleviating poverty in the Philippines and improving the quality of lives of the socially-and-economically challenged women and families towards nation building. Based in San Pablo City in Laguna in the Philippines, CARD MRI has 1,845 offices located all over the country and has program/partnership offices in Cambodia, Vietnam, Laos, Myanmar, and Hong Kong. CARD MRI has 2.99 million members and clients as of July 2015 throughout the country, continuously providing them holistic and integrated financial and social services that help uplift their lives and eventually transform them into responsible citizens for their community and their environment.
www.cardmri.com

About Freedom from Hunger
Founded in 1946, Freedom from Hunger is a US-based international development organization that brings innovative and sustainable self-help solutions to the fight against chronic hunger and poverty. By partnering with local microfinance institutions (MFIs) and nongovernmental organizations (NGOs) throughout Asia, Africa and Latin America, Freedom from Hunger is reaching 5.7 million women, equipping them with resources they need to build futures of health, hope and dignity.
www.freedomfromhunger.org

About the Microcredit Summit Campaign
The Microcredit Summit Campaign (the “Campaign”), a project of RESULTS Educational Fund, is the largest global network of institutions and individuals involved in microfinance and is committed to two important goals: 1) reaching 175 million of the world’s poorest families with microfinance and 2) helping 100 million families lift themselves out of extreme poverty. The Campaign convenes a broad array of actors involved with microfinance to promote best practices in the field, to stimulate the exchange of knowledge and to work towards alleviating world poverty through microfinance. In early 2016, the Microcredit Summit Campaign will host the 18th Microcredit Summit in Abu Dhabi. The agenda will focus on “Mapping Pathways out of Poverty” and will feature innovations from the Africa-Middle East Region.
www.microcreditsummit.org

Media Contact Information
Microcredit Summit Campaign
Sabina Rogers
Manager, Communications and Relationships
+1 (202) 637-9600
rogers@microcreditsummit.org
Freedom from Hunger
Piper Gianola
Senior Director, Development and Communications
+1 (530) 758-6200 x 1018
piper@freedomfromhunger.org
CARD MRI
Cleofe Montemayor-Figuracion
Deputy Director, Corporate Communications
+63 (49) 562-4309 local 108
corpcomm@cardbankph.com; cardmri.corpcomm@gmail.com

Free ultrasounds draw thousands to community health fairs

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

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

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


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

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

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

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

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

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

HMHB_CMYK_English_Beveled

What else is in the newsletter?

Increasing Healthcare Access

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

What’s in the Mother and Baby Kit?

health-kit_HMHB-PH_Oct2014_Courtesy-of-CARD-MRI

Building Capacity to Provide Health Education

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

“MFIs for Health” Provide Health Services to Poor Communities

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

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

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Does your microfinance program improve newborn survival?

Products provided to microfinance clients through the “Healthy Mothers, Health Babies” project in the Philippines implemented by the Microcredit Summit Campaign, Freedom from Hunger, and CARD MRI. The products included are selected for their usefulness to women soon to give birth.

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>>Authored by Larry Reed, Director, Microcredit Summit Campaign

Research from the World Health Organization shows that half of the decline in under-5 child deaths is due to factors outside the health sector. In addition to health improvements, advancements in girls’ education, women’s economic status, water, sanitation and hygiene, energy, and infrastructure all make a vital difference. We believe that the microfinance sector has an important role to play in bringing child mortality down even further.

At the Microcredit Summit Campaign, we know how powerful integrating health programs can be. Microfinance institutions (MFIs) that offer health products and services to their clients help them to manage shocks and improve the health of clients and their families. In partnership with Freedom from Hunger and with the support of Johnson & Johnson, we are working with microfinance partners in India and the Philippines to provide health products and services to hundreds of thousands of families.

In the Philippines, our project focuses on improved health outcomes for pregnant women and their newborns. To date, CARD MRI (our local partner) has delivered the “Healthy Pregnancies Make Healthy Communities” education to nearly 300,000 women clients. The education is delivered using an innovative pictorial learning conversation (PLC) methodology developed by Freedom from Hunger. This PLC module distills important information about pre- and post-natal care into easily digested 15-minute segments.

An image from the “Healthy Pregnancies Make Healthy Communities” PLC. It teaches about the importance of visiting a health facility throughout the pregnancy.

An image from the “Healthy Pregnancies Make Healthy Communities” PLC. It teaches about the importance of visiting a health facility throughout the pregnancy. Contact Cassie Chandler at Freedom from Hunger to learn more about the education module.

At the Community Health Day events organized under the project, thousands of women (pregnant and with newborns) also get free consultations and medical checkups — many for the very first time. In addition, attendees have learned important information for ensuring healthy pregnancies and healthy newborns. Medical professionals have delivered lectures on family planning, signs and symptoms to be aware of during pregnancy, as well as prenatal care like nutrition during pregnancy and post-natal care like breastfeeding or caring for a newborn.

The Campaign is helping CARD and other members of the MFIs for Health consortium to leverage this small, one-time grant by building a strong, local resource base for their work. Through our Campaign Commitments, we are mobilizing microfinance actors around the world to take specific, measurable, and time-bound actions to address the multiple dimensions of poverty. We hope to do the same in the Philippines to improve the health of microfinance clients and their families.

Mapping integrated solutions

An effort is underway to develop a new online map to capture such programs around the world. Called the Newborn Survival Map, this initiative hopes to encourage the development of cross-sector partnerships delivering integrated solutions. In our experience, when an MFI hesitates to introduce health programs, it is often because they say that their job is to provide financial services, not health. In this case, partnering with health development organizations and other health sector actors is a viable alternative to offering health services in-house. The map could direct your organization to potential future partners in health.

The Newborn Survival Map will initially focus on 16 countries where newborn deaths are concentrated (see the map below). It will focus on programs with a total value of US$500,000 and above across 14 different sectors whose work greatly impacts newborn survival. Note that this threshold is for the life of the project and represents a total investment. Investments will also be tracked by sub-region, so it may be that an organization has a series of smaller investments in different locations or over a period of time, but the total current and planned investment for their work in a sub-region may equal or exceed the $500,000 threshold.

Priority countries (MDG 4, child mortality)

Priority countries are India, Nigeria, Pakistan, Democratic Republic of Congo, China, Ethiopia, Angola, Indonesia, Bangladesh, Kenya, Uganda, Afghanistan, Tanzania, Sudan, Sierra Leone, and Niger. Send in your program information by August 24th to be sure that you are included in the Newborn Survival Map.

The initiative is led by FHI 360, an international development organization, in partnership with the MDG Health Alliance and Johnson & Johnson. FHI 360 and partners invite actors in the microfinance sector to take part in this exciting initiative. We encourage you, our audience, to make sure that significant microfinance programs — especially those benefiting women of reproductive age — are represented on The Newborn Survival Map.

The Newborn Survival Map is in collaboration with the Every Newborn Action Plan and in support of the UN Secretary-General’s Every Woman Every Child movement.

Take action today!

Email Christina Blumel (cblumel[at]fhi360.org) with the name and email of a contact person in your organization who will be responsible for getting your microfinance program included on the map. Christina will guide your colleague through the necessary steps to an online form, which takes approximately 20 minutes to fill out.

Many thanks for your partnership as we enter the Sustainable Development Goal era where achievement of the ambitious new goals will require unprecedented levels of collaboration. Read the letter from Leith Greenslade of the MDG Health Alliance inviting your organization to be part of this exciting initiative (and en français).

About the organizations responsible for the map

The MDG Health Alliance is an initiative of the UN Special Envoy for Financing the Health Millennium Development Goals and for Malaria. The Alliance operates in support of Every Woman Every Child, an unprecedented global movement spearheaded by the Secretary-General to mobilize and intensify global action to improve the health of women and children.

FHI 360 is a nonprofit human development organization dedicated to improving lives in lasting ways by advancing integrated, locally driven solutions. Our staff includes experts in health, education, nutrition, environment, economic development, civil society, gender, youth, research and technology — creating a unique mix of capabilities to address today’s interrelated development challenges. FHI 360 serves more than 70 countries and all U.S. states and territories.

At Johnson & Johnson, our Credo inspires our strategic philanthropy to advance the health of communities in which we live and work, and the world community as well. We focus on saving and improving the lives of women and children, preventing disease among the most vulnerable, and strengthening the health care workforce. Together with our partners, we are making life-changing, long-term differences in human health.


Related reading

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

The importance of measuring client outcomes

Outcomes process

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

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

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

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

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

Feb 5th meeting resources

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


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

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

Speakers:

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

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

About the Outcomes Working Group

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

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

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

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Meeting number: 315 311 993
Meeting password: sptf

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

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

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

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

Register 2

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

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

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

The webinar will focus on the following questions:

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

Why the Health Outcome Performance Indicators are important:

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

Speakers:

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

Moderator:

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


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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Organized by Johnson & Johnson Worldwide Corporate Contributions

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

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

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

Economically empowered women can keep families healthy

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

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

Co-hosts:

Hashtag: #SocialDeterminants

The Campaign in 2014: Making Progress Toward Ending Extreme Poverty

Expokonool vendors being recognized in the closing ceremony for their hard work

At the 17th Microcredit Summit, Expokonool vendors were recognized in the closing ceremony for their hard work

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As we come to the end of the year, we reflect on 2014.

In 2014, we more than DOUBLED the number of Campaign Commitments, and in the past two years, 54 Commitments have been announced by 48 organizations, including AGFUND, the Food and Agriculture Organization (FAO) of the United Nations, the International Labour Organisation (ILO), BRAC, Grassroots Capital Management, Red Financiera Rural, Oikocredit, and Grameen Foundation. These organizations join a coalition to advance the industry toward helping 100 million families lift themselves out of extreme poverty.

With the first 5 installments of the Campaign’s new E-Workshop Series featuring Commitment-making organizations, more than 400 participants learned important practical lessons on innovations and tools that work to support those making the journey out of extreme poverty.

Organizations that made a Campaign Commitment are recognized on stage at the 17th Microcredit Summit in Mexico.

Organizations that made a Campaign Commitment were recognized on stage at the 17th Microcredit Summit in Mexico.

17th Microcredit Summit #17MCSummitIn September, 875 people from 60 countries joined us at the 17th Microcredit Summit in Mexico, including high-level dignitaries like Secretary of Economy Ildefonso Guajardo Villarreal, Yucatán Governor Rolando Zapata Bello, and Nobel laureate Muhammad Yunus. The agenda focused on the theme “Generation Next: Innovations in Microfinance.”

“The participation of global leaders in combating poverty. The cases that inspired partnership work in a joint effort to build a better future for generations.”
— a participant on what was best about the Summit

In the lead up to the Summit, the Campaign led 6 policy makers from Ghana, Mozambique, and Malawi on a 12 day intensive field visit to sites in Ethiopia and Mexico for a deep dive into successful strategies for implementing social protection and livelihood development programs. The policy makers developed innovation plans for implementing throughout 2015 the lessons learned from their trip on returning home.

Throughout the Summit, more than 160 presenters participated in 7 plenaries, 35 workshops, and 6 full-day trainings; the materials, including videos and presentations, can be viewed online. Together, we built a vision for the next generation of financial services that reach everyone and that provide even the poorest and most remote with the tools and resources they need to complete the journey to sustainable livelihoods.

To get an overview of the 17th Microcredit Summit and key topic areas discussed, you can read our article in the forthcoming winter edition of the Journal for Social Business to learn more about the financial and social services that are building pathways out of poverty.


In June, we launched Resilience: State of the Microcredit Summit Campaign Report, 2014. The report emphasizes the key role that actors in the financial ecosystem can play in helping end extreme poverty by promoting the frameworks, systems, partnerships and strategies that deliver the types of products and services that help build resilience.

In July, we published Integrated Health and Microfinance in India, Volume II with Freedom from Hunger and the Indian Institute of Public Health-Gandhinagar. It highlights the policy measures in the Indian microfinance sector since 2011, documents best practices towards integrating health and microfinance, and proposes an agenda for moving forward to expand access to healthcare.

We also launched a joint project in July called “Healthy Mothers, Healthy Babies: Partnering to improve maternal health in the Philippines” with Freedom from Hunger and CARD, the largest MFI in the Philippines. Together, we aim to improve health knowledge and promote behavior change for more than 600,000 women by December 2015 and strengthen “MFIs for Health,” a collaboration of health and microfinance practitioners in the Philippines.

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

Join us for a fantastic 2015!

Looking Back at 2014, the Year of Resilience

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>>By Larry Reed, Director, Microcredit Summit Campaign

Larry visits a CARD group in Tacloban

Larry visits a CARD group in Tacloban whose members are rebuilding with the help of CARD’s quick and appropriate response to the Typhoon Yolanda disaster.

I started 2014 in Tacloban, Philippines, where one of the worst storms of this century, Typhoon Yolanda (or Haiyan outside the Philippines), made landfall. I visited Tacloban 75 days after the Typhoon hit to see how the storm affected the lives of microfinance clients, and what role financial services could play in helping them get back on their feet.

In the Central Business District only a few shops had dared to reopen. The dangling power lines and intermittent electricity made regular operations a challenge.

When I traveled to the parts of town where people lived in poverty, I found something much worse. Yolanda struck these low lying areas the hardest, hit them first with her 100 mph winds and then with the storm surge that followed in her wake, uprooting everything that was not permanently attached to the ground and then carrying it out to sea as the waters receded.

Homes and everything in them had been taken away, so people rebuilt with scrap lumber and sheets of plastic. They established homes and businesses again, selling daily necessities from the side of their rebuilt houses.

A mix of charity and financial services played a key role in helping people get back on their feet. Aid organizations employed people to help clean their neighborhoods and the rest of the city, giving them daily cash wages.

Microfinance institutions like CARD and ASKI got back into the city as soon as they could, providing rice and medicines for their clients’ immediate needs, while also paying insurance claims, providing access to savings and issuing emergency rebuilding loans long before any commercial banks restarted operations.

I came away with great admiration for the strength and resilience developed by those that live with constant vulnerability and an appreciation that the role that fast and appropriate financial services, delivered with a human touch, can have in catalyzing that energy to rapidly rebuild destroyed neighborhoods.

In August of this year, I visited another great example of resilience, this one over a decade in the making. Several government ministries in Ethiopia banded together under the leadership of the Prime Minister to design a program that would build resiliency in the land and the people that regularly suffered from drought. International aid organizations united behind this plan that now covers over 5 million people.

With support from the MasterCard Foundation, the Campaign hosted a trip for government ministers and leaders of government anti-poverty programs from Ghana, Mozambique, and Malawi to visit this Productive Safety Net Program (PNSP) in Ethiopia.

Participants of the Innovations in Social Protection project

Participants of the Innovations in Social Protection project on a field visit in Ethiopia.

Under the PNSP, people living in poverty who are not able to work (the elderly, the disabled, and mothers with young children) receive regular cash payments in exchange for maintaining regular health checkups and keeping their children in school.

Those who can work participate in local public works programs decided on by the leadership of each village. These projects can include expanding school facilities and building health clinics; although, most of them involve work that improves the productive capacity of the land.

With technical support from NGOs with highly trained professional on staff, the villagers work together to build dams, retention ponds, irrigation channels and hillside terraces. They receive the payment for their work in accounts set up in local banks or microfinance institutions, which also provide loans to help them expand businesses that profit from the land’s increase productivity.

Those who started the program with the greatest poverty participate in an ultra-poor graduation programs that provides them with an asset transfer, a savings account, business training, mentoring, and access to credit.

We visited at the end of the rainy season, and we could easily see the transformation that the PNSP had brought to the land and its people. We looked down a valley filled with tall green plants, with every hillside terraced and water flowing into dams and ponds that would provide irrigation after the rains stopped. Land that used to struggle to provide one crop now provided two or three crops a year.

Almost a quarter of the people who had started with this public assistance program now no longer needed it. I tried to imagine what it must feel like for the men and women working together on the hillside, digging a retention pond together, to look down the hill and see every part of the valley filled with green plants that would provide food for their animals and income for their livelihoods and to know that, not only were they and their children better off, but their entire community was better off because of the work they had done.

In September, we helped to assemble almost 900 people from 60 different countries in Merida, Mexico, for the 17th Microcredit Summit. As we gathered in the land of the ancient Maya who envisaged a new world coming into being at this time, we imagined a world where all people have access to financial products and services they need to protect against vulnerability and invest in opportunity.

Opening Ceremony - Prof Yunus_453x604

“Poor people didn’t create poverty. It’s the system that created the poverty. And, if we want to end poverty, we have to change the system.”

Muhammad Yunus issued the challenge for the Summit in his opening talk. “Poor people didn’t create poverty. It’s the system that created the poverty,” he told us. “And, if we want to end poverty, we have to change the system.”

During our 5 plenary sessions and 40 workshops, we heard from innovative thinkers and doers who are working to change the system. We discussed ideas and formed partnerships to begin or expand innovative programs that link conditional cash transfers to savings groups; extend agricultural value chains to small scale producers; provide health education, financing, and services in group meetings of microfinance clients; and employ digital technology that delivers payments and other financial services at a fraction of the cost of moving cash.

Together we made Commitments for what we would do to help extend financial services to all and help speed the end of extreme poverty. Then we closed by celebrating the real heroes of this work: the men and women who employ these services in order to earn and save enough to provide for their families and build a better future for their children.

I just completed my last trip of the year to the Inclusive Finance India Summit and saw a different type of resilience on display. Microfinance institutions in India have been devastated by the Andhra Pradesh crisis, where rapid growth in lending led to over-borrowing, client defaults, and a harsh response from the state government that halted collection efforts.

The sector is now growing rapidly again, enough that a few observers are worried that there may be some areas of overheating in the state of Karnataka, where many MFIs have moved.

Almost all the delegates I spoke with expressed excitement about new regulations announced by the Reserve Bank of India, which create a category of Small Finance Bank that can take deposits and make loans. The regulations also create a new category of Payments Bank to allow for institutions that make money from payment transaction, rather than from intermediating savings and credit.

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

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

In a dinner session I had with leaders from MFIs, I heard a lot of discussion about how they might transform their operations under these new regulations to provide a broader ranges of services to their clients. It will be interesting to watch this period of creative destruction that will take place in India as MFIs, mobile phone operators, and banks all adapt to the new regulations. I was glad to hear in our dinner the creativity and passion of many leaders to use these new opportunities to expand the services they provide to those living in poverty.

And now, as the year comes to a close, so does news of another Super Typhoon hitting the Philippines. This time, people knew about the power of storm surges and moved to higher ground before the storm struck, resulting in a much lower loss of life.

But still, thousands of people will go back to where they lived and find their houses and businesses destroyed. The fortunate ones will find an officer of a microfinance institution waiting for them, asking them what they need to get back on their feet.

On behalf of everyone at the Microcredit Summit Campaign, thank you for taking an active role in this global movement to bring appropriate financial services to those who struggle against poverty and vulnerability. It is our great honor and privilege to be working with you as we join with others to help bring an end to extreme poverty in our towns, our countries and our world.

May you be filled this holiday season with joy as you share the love of your family and reflect on the new financial system that we are creating together.

Sincerely,

Larry Reed

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

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

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

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> Posted by Bobbi Gray, Research and Evaluation Specialist, Freedom from Hunger Embed from Getty Images The day after the closing of the Microcredit Summit in Merida, Mexico, conference participants were also invited…

Microfinance communities working together to improve maternal health

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