Webinar recap: Is it too late for microfinance to be pro poor?

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On April 21st, the Microcredit Summit Campaign co-hosted with Uplift a webinar discussion focusing on the promise that graduation holds for sustainably reaching the ultra-poor. Our featured speakers were Debasish Ray Chaudhuri, CEO of Bandhan Konnagar in India, Rachel Proefke, a research associate with BRAC Uganda, Mark Daniels, the Philippines director for Opportunity International, and Allison Duncan, CEO of Amplifier Strategies and founder of Uplift. Anne Hastings, a global advocate with Uplift, moderated the webinar.

The conversation looked closely at the experiences that each of the three practitioners on the panel have had in implementing the program as well as the global advocacy message supporting the graduation approach being delivered by Uplift and its allies.

We hope you will get engaged with this promising avenue for reaching those living in ultra-poverty and be inspired by the potential it holds for helping microfinance institutions to reconnect to their original purpose. Some final thoughts from speakers on the webinar follow.

Anne Hastings noted,

We weren’t really able to address in depth how a pro-poor MFI, struggling for sustainability in a competitive, regulated environment can attain sustainability while operating the graduation program. In the models we saw, the institution was either an NGO or a regulated MFI that had formed a non-profit foundation for the graduation program and perhaps the delivery of other non-financial services. We shouldn’t be surprised or embarrassed that donor funding may still be needed, but partnerships with government safety net programs and other NGOs can also be very helpful in paying for the program. As the 6 RCTs funded by the Ford Foundation concluded, “Although more can be learned about how to optimize the design and implementation of the program, we establish that a multifaceted approach to increasing income and well-being for the ultra-poor is sustainable and cost-effective.” (Science Magazine, 15 May 2015, Vol 348 Issue 6236, p. 772.)

Rachel Profke added,

I think the point that I would stress, which we begun to address in the discussion, is the importance of finding the right partner for the implementation of components that an MFI does not have the core capacity to implement. While BRAC is able to leverage both microfinance and additional programming in the areas that we operate all programs, this is not always the case for us or other MFIs that will be interested in implementing graduation programming. Often, MFIs can provide the scale in identifying communities and in providing financial services, but linkages with implementing partners providing similar programming is fundamental to ensuring best practices in programming — as Mark highlighted. However, aside from NGO implementers, governments are often running existing programming that can be leveraged not only in identifying beneficiaries through such channels as social protection programming but also in providing some components through existing service provision, in terms of health or extension services. We find it helpful to look at what is already at place — and at scale — through government programs is useful, as we have done in Tanzania. This is also useful as we think about scaling because, apart from donor buy-in, governments offer larger potential through larger budgets and capacity.

Thank you to all panelists for contributing to this important conversation about the importance of the graduation approach. We also wish to thank all participants who submitted thought-provoking questions and comments to help make the session a very lively and interactive discussion!

Couldn’t join us? Watch the session recording!

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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The 2015 State of the Campaign Report in a nutshell

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An African farmer is linked into the financial system via her mobile phone.
In his presentation today at the Inclusive Finance India Summit New Delhi, Larry Reed featured Mapping Pathways out of Poverty: The State of the Microcredit Summit Campaign Report, 2015. The report is now available online. We will also publish the full report in French, Spanish, and Arabic in early 2016. You can also read previous reports online, just select the year of interest from the drop-down menu “Previous Reports.”

At our 2013 Microcredit Summit in the Philippines, we focused on the partnerships required to deliver financial services to those living in poverty. At our 2014 Summit in Mexico, we focused on innovations in microfinance with a demonstrated capacity to reach those in extreme poverty. This year, we use the report to explore, in more detail, our six financial “pathways.” Each pathways has a chapter, and each chapter does the following:

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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

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

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.”

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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integrated health and microfinance news mailing list.


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

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

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

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

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

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

Improving Maternal Health in the Philippines Through Microfinance

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This gallery contains 5 photos.

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

Graduating Families out of Ultra-Poverty (E-Workshop Recap)

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Due to technical difficulties, the webinar recording function started late. We apologize for this inconvenience and have made a summary and the presenter’s slides available to you.

BRAC client

Image courtesy of BRAC


Webinar resources


Larry Reed, director of the Microcredit Summit Campaign, moderated an engaging discussion about the Graduation Model pioneered by BRAC, an international development organization based in Bangladesh, that included Sadna Samaranayake (Program Manager of the Ultra-Poor Graduation Program at BRAC USA), Carine Roenen (Executive Director of Fonkoze in Haiti) and Raymond Serios (Special Projects Manager at Negros Women for Tomorrow Foundation).

Sadna Samaranayake, BRAC Ultra-Poor Graduation Program

Sadna opened by describing BRAC’s Ultra-Poor Graduation Approach which targets ultra-poor households and follows a process of focused interventions carefully sequenced to “graduate” households out of ultra-poverty. While the World Bank uses the $1.25 per day income threshold to define extreme poverty, BRAC understands the ultra-poor as those in the bottom half of earnings among those below the $1.25 a day line.

Sadna explained that the first step in the process to graduating households from ultra-poverty is to carefully target and select families for program participation. This requires community mapping and wealth ranking exercises to determine which community members are in the most need.

Once chosen to participate in the program, clients receive a transfer of productive assets and a cash stipend. Sadna explained that productive assets can be livestock, seeds for planting, or small goods for enterprise. The cash stipend allows clients flexibility to start improving their livelihood while beginning to generate an income from the productive assets.

Next the clients receive training and they start to generate an income for themselves. As time progresses, clients are encouraged to save money and are given access to appropriate health care. Ultimately, the objective of the graduation approach is to ensure that all families are better integrated into the social fabric of the community and are generating enough sustainable income to conquer ultra-poverty.

Graduation occurs over a period of 24 months when households achieve set economic and social goals including not having a reported food deficit in the past year, having multiple sources of income, owning livestock/poultry, having a sanitary latrine and clean drinking water, having cash savings and school age children attending school. Over the past 12 years, BRAC has graduated 1.4 million people, mainly in Bangladesh and has committed to graduating 250,000 more families by the end of 2016.

Carine Roenen, Fonkoze

Carine followed by illustrating the challenges of implementing a graduation model in Haiti. The Fokonze approach is an adaptation of the BRAC model with slight changes for the context for working in Haiti. Fonkoze has reached 62,735 clients with loans, and graduated 2,900 clients from ultra-poverty. Currently, Fokonze is hoping to expand its outreach in Haiti to graduate more households out of ultra-poverty.

Raymond Serios, Negros Women for Tomorrow

Raymond used his opportunity to interview both Sadna and Carine about the process of implementing a graduation model in his context in the Philippines. Raymond inquired about how BRAC and Fonkoze choose productive assets with the households. Carine responded that it depends on the skills of the client and should be something that she is already familiar with or willing to learn.

Larry then moderated a discussion among the panelists based on questions submitted by webinar participants. Some of the questions focused on monitoring and evaluation processes to track progress toward graduation. Others touched similarly on impact in the long term. It was a lively discussion that included an optional time extension after the official schedule ended to continue discussions. (See all the questions and comments in the webinar chat.)


We would like to thank all of the panelists and all of the participants who attended the webinar and participated via the chat and Q&A functions. We invite you to comment on this post to continue the discussion about the graduation model and further share ideas.

We also invite you to explore the links below to the recording of the webinar, presentations from BRAC and Fokonze, as well as the Robin Burgess report about the impact of the graduation model program on employment choices.

We hope you will join us for our next e-workshop “Instilling Confidence in Poverty Measurement: The New PPI Certification” on Tuesday, June 24th at 10:00 AM (EDT/GMT-4) and featuring panelists Frank Ballard (Grameen Foundation), Analí Oda Salcedo (Planet Rating), and Chiara Pescatori (MicroFinanza Rating).

Webinar Resources:


E-Workshops are hosted by the 100 Million Project of the Microcredit Summit Campaign and strive to feature the work of organizations who have announced Campaign Commitments to take specific, measurable and time-bound actions that demonstrate their commitment to the end of extreme poverty. Are you Committed?  Find out how to share your Commitment to the end of extreme poverty.

A sneak peek of “Resilience: The State of the Microcredit Summit Campaign Report, 2014”

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Join us for the launch event of the 2014 State of the Campaign Report on Thursday, June 19 (3-5 PM) at Busboys and Poets on 14th Street. Click here to learn more. RSVP now!


CARD Bank member clients in Tacloban meet with CARD accounts officer 75 days after typhoon Yolanda tore through the Philippines, destroying homes, robbing businesses, and taking lives.

The Center meeting in Tacloban of member clients and the CARD accounts officer started promptly at 8:00 AM. The roll call, though, showed that this meeting was not the same as most of those that came before. One man attended to represent his wife, who had recently died. Several absent members had left the city and would not return for a while. A few had not yet moved back to the barangay from the evacuation center and, due to the limited transportation, had trouble getting to the meeting on time.

Seventy-five days after typhoon Yolanda tore through the Philippines, destroying homes, robbing businesses, and taking lives, CARD’s member clients at the Center meeting were not interested in talking about their savings or loan payments. They spoke of fleeing their homes as water rushed in, able only to grab their children as they fled with just the clothes on their backs. They talked of neighbors who thought that their stronger cement homes would protect them—neighbors who perished when the storm surge rose too fast for them to get out.

They recounted harrowing hours huddled on a hillside, shivering in the rain and hiding behind rocks, as the 300 kilometer-per-hour winds felled trees and turned debris into missiles. They shared the empty feeling of returning to their neighborhood eight hours later and finding everything gone, with massive tanker ships driven onto the land where their houses had stood. And so began their scramble to survive, to find shelter and food, and to hope that outsiders would bring help soon. “We need rice and water (and yams),” they wrote in large letters in English on one of the stranded ships for the international aid organizations to see. Below it they wrote in their own dialect, “Don’t put trash here, this is our neighborhood.”

For a few days, they survived in an abandoned cement home in their neighborhood that still had a few rooms standing until aid agencies reached them and told them where evacuation centers were set up, offering food and cash-for-work programs. Some moved to these centers, while others went to family living far enough away to not be so badly affected by the storm.

They worked together cleaning their city, removing debris and dead bodies from the streets so that emergency workers could do their jobs. And, they used the relief supplies and the money they earned to restart their businesses, knowing that they would need money to start rebuilding. Those with food shared with those who had little. Those with shelter provided housing for those with none.

All of the member clients mentioned their surprise that their accounts officer had looked for them and found them. He visited the evacuation centers and the homes of relatives to locate each client. He explained when the Center meetings would begin again and where they could get the emergency rice, sardines, and vaccines that CARD provided to help them survive until they could start providing for themselves again. To those who had lost a spouse or children, he reviewed the simplified process for making claims, reminding them that CARD would maintain its 1-3-5 day payment-processing system[1] once it could bring in cash to make the disbursements.

A CARD Bank client

Slowly, they began reestablishing their businesses, buying a few extra items at inflated prices to sell in their sari-sari stores[2]. They purchased rice seed to replant their fields because Yolanda hit just as the last crop had been harvested and set to dry. Many had started to rebuild their homes, while trying to run their business on the side. CARD also joined other microfinance organizations to provide teams of medical volunteers, nurses, doctors, and therapists to help clients with the physical and psychological traumas they sustained from the storm.

Today’s discussion at the Center meeting focused on the “calamity loans” that CARD offered to its clients who survived Yolanda. The accounts officer carefully explained the terms: 6- or 12-month repayment periods with a 1-month grace allowance, lower interest rate, and weekly payments. The women immediately probed for more details.

What if they did not have enough to make full payments at the end of the grace period?
Partial payments would be accepted.

Would they be required to maintain a savings balance with this loan?
No.

How much could they get?
Up to PHP 10,000 (Philippine pesos), or USD 220.

Could they use the loan for their businesses or was it only for rebuilding their homes?
They could use it for anything they needed to get back on their feet, including their businesses.

The women huddled together, calculating what they could afford and what they could do with the money. “We like this loan,” they told the accounts officer, “and most of us will take it. But we think you should call it a rebuilding loan rather than a calamity loan. We don’t want to be treated like victims.”[3]

Later that afternoon, a line of people filled the lobby of the CARD offices and continued out the door, doubling back on itself three or four times until it reached the street. People waited patiently to receive their calamity loans. The doors of the office officially closed at 2:00 PM, but the staff let all those still in line outside come inside. After 9:00 PM, the staff made the last disbursement for the day and then began to quickly total the sums and balance the books, hoping to finish and get home by 10:00 PM.

In the 2013 State of the Campaign Report, we wrote about the vulnerability of people living in poverty. Living with little margin, they often suffer most when the economy fails, war erupts, or disaster strikes. Yet this experience with calamity can build resilience, as CARD’s clients in Tacloban demonstrate so clearly. A few weeks after the most devastating storm to ever hit land, the people there are rebuilding, stocking up their store inventories, selling to and buying from their neighbors, and sharing what little they have with those still in need. They pool the relief that has made it to them, turning it into assets they can use to reconstruct their community.

This response to Typhoon Yolanda also shows the transformational impact that a financial institution can have when it focuses first on getting clients back on their feet, rather than concentrating on recoveries and write-offs. CARD was the first financial institution to bring cash back into Tacloban. By injecting a mix of capital and care, they helped give their clients the hope, energy, and resources to get moving again. And CARD was not alone in this. Microfinance institutions (MFIs) in other parts of the Philippines provided similar supportive programs that included loan moratoriums, food and medical aid, quick insurance payouts, and new capital for rebuilding. This type of assistance has sped the recovery of Tacloban, where every neighborhood is busy with people working to rebuild their homes and businesses, while also taking care of everyday tasks, like washing their clothes and cooking their food. They suffered unimaginable losses, but working together, they have found the strength to get back on their feet and start over.


Note: For the purpose of this report and the Summit’s 19-year fulfillment campaign, any mention of “microcredit” refers to programs that provide credit for self-employment and other financial and business services (including savings and technical assistance) to very poor persons

[1] CARD’s 1-3-5 payment policy is a pledge that guarantees payment for a claim within one day of the presentation of the required documentation, with payment provided no later than the fifth day from when a claim was filed.

[2] A sari-sari store, from the Tagalog word meaning “variety,” is a convenience store found in the Philippines.

[3] All interview excerpts and direct quotes not cited in the text are from interviews carried out by the Microcredit Summit Campaign.

Photo credits: Larry Reed for the Microcredit Summit Campaign