Why Add Health Services to Microfinance
             Freedom from Hunger
                 April 2010
Session 1




Welcome and Introductions




                            1
Social Performance Pathway




                             2
Introductions…

With others from your organization, interview another organization
asking the questions below. After a few...
Session 2




Workshop Purpose and Objectives




                                  4
Session 3




Discussion on Client Health Challenges
and How Microfinance and Health
Protection Addresses Them




       ...
A Quote to Consider…

In the 2002 World Bank study, Dying for Change, illness was the most
commonly cited reason for “a do...
A Perspective to Consider…

To confront health challenges Freedom from Hunger suggests that…
―Ideally the over 3,000 exist...
Microfinance and Health Protection

Definition:
 Microfinance and health protection is the use of the microfinance
 platfo...
Questions for Further Reflection:

You already discussed a bit some of what you have seen among your
clients concerning th...
Session 4




Four Health Protection Approaches




                                    10
Four Approaches to Health Protection
Developed by MFIs in Response to Clients’
                Needs




                 ...
Bandhan Case Study




                     12
Session 5




Health Protection Products and
Services Developed by MFIs




                                 13
Cohesive
Microfinance
     +
   Health
 Packages




               14
PADME (Benin)
 Cohesive      • Health education
Microfinance   • Health product
     +           distribution
   Health
 P...
PADME (Benin)
 Cohesive      • Health education
Microfinance   • Health product
     +           distribution
   Health
 P...
PADME (Benin)
 Cohesive             • Health education
Microfinance          • Health product
     +                  dist...
PADME (Benin)
 Cohesive             • Health education
Microfinance          • Health product
     +                  dist...
PADME (Benin)         CRECER (Bolivia)
 Cohesive             • Health education    • Health education
Microfinance        ...
Cohesive
Microfinance
     +
   Health
 Packages




               20
Four Approaches to Health Protection
Developed by MFIs in Response to Clients’
                Needs




                 ...
Four Approaches to Health Protection
Developed by MFIs in Response to Clients’
                Needs




                 ...
Session 6




Health Education – A Key Approach




                                    23
What Makes Freedom from Hunger’s
Education Unique?

• Relevant for clients
• Focused on Behavior Change
• Enjoyable
• Easy...
Key Characteristics of
           Freedom from Hunger’s Education

Delivery Channels      Field agents of MFIs or NGOs de...
Available Education Modules




                              26
Session 7




Costs and Benefits of Selected Health
Protection Services




                                        27
Savvy MFIs are adding health
services in order to improve
   their own profitability.




                               28
Health services can create Net Benefits for MFIs

Income-generating health services for MFIs:
    • Health education (in c...
Gallery Walk: Sample Cost-Benefit Description

                 Cost to MFI           Benefit to MFI        Cost to Client...
Reflection on the Cost and
Benefits of Health Protection Products/Services

With others from your organization (or, if you...
Session 8




Market Research – A Key First Step to
Developing Health Protection Products
and Services




               ...
Microfinance and Health Protection Services
    (Sample Development Process and Timeline)




                            ...
Purpose of Market Research in the Development
of Health Protection


To better understand the health care environment with...
Characteristics of Market Research


 It seeks to explain underlying reasons for behaviors and
  beliefs

 It utilizes d...
Types of Health Data Generated Through Market
 Research


Types of Market Research Data                  Uses of Market Re...
Market Research Tools

          Tools            Purpose of the Tools

                            Discuss impact of dis...
Session 9




Action Planning – Next Steps for
Developing Health Protection Products
and Services




                    ...
What are your reactions
to our discussions today and
    what do they mean for
       your institution?



               ...
Developing Next Steps for Your Organization

Health protection approaches to explore:_______________________
_____________...
Closing Remarks




                  41
“You know well that we are poor country
 people. Agriculture is not flourishing like
 before due to the capriciousness of ...
“ When you go to the market in the
  morning you never know what will
  happen, but when you have the
  health savings and...
“ I joined CARD because they
                                             have many benefits; my favorite
                ...
Microfinance and
Health Protection
    (MAHP)




                      Myka Reinsch, Special Advisor, MAHP
              ...
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AMERMS Course 6: Why Offer Integrated Microfinance and Health Services - PPT 1

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FULL TITLE:
Why Offer Integrated Microfinance and Health Services: An Introduction to Health Education, Health Financing, Healthcare Linkages and Health Microinsurance
ROOM: Lenana Hall
FACILITATED BY: Freedom from Hunger
Ms. Myka Reinsch Sinclair (USA)
Dr. Mahamadi Cissé (Burkina Faso)

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  • Intro to Cost-Benefit session (1)Although offering health-related can contribute to your organization’s social mission and improve the lives of your clients, most MFIs have to focus on their own institutional sustainability. The central message that we want to convey is that our experience and research are revealing that MFIs that are adding health services to their offerings are not only helping their clients, but very importantly are helping their own institution’s profitability as well. This next session will provide you with an opportunity to consider the costs and benefits associated with offering integrated microfinance and health services.
  • AMERMS Course 6: Why Offer Integrated Microfinance and Health Services - PPT 1

    1. 1. Why Add Health Services to Microfinance Freedom from Hunger April 2010
    2. 2. Session 1 Welcome and Introductions 1
    3. 3. Social Performance Pathway 2
    4. 4. Introductions… With others from your organization, interview another organization asking the questions below. After a few minutes the others will interview you. You will then have one minute to introduce them and their organization using what you have learned. Who are you reaching out to? What services are you providing to them? What are the ultimate changes you want to see in their lives? 3
    5. 5. Session 2 Workshop Purpose and Objectives 4
    6. 6. Session 3 Discussion on Client Health Challenges and How Microfinance and Health Protection Addresses Them 5
    7. 7. A Quote to Consider… In the 2002 World Bank study, Dying for Change, illness was the most commonly cited reason for “a downward slide into poverty… ahead of losing a job, which took second place”. Turn to someone near you and discuss this: Reflecting on this quote, what is your experience with the effects of illness in the lives of your clients? 6
    8. 8. A Perspective to Consider… To confront health challenges Freedom from Hunger suggests that… ―Ideally the over 3,000 existing microfinance institutions worldwide could provide and infrastructure or platform for reaching the poor through a coordinated combination of services. MFIs recognize the need, hear the demand and have a vested interest in cultivating a healthy, successful clientele with strong microenterprises.‖* Turn to the same person and discuss this:  What do you think about the proposed role of MFIs in this quote given the challenges you have identified?  What, if anything, has your organization done to deal with the health challenges of your clients? *Adapted from: How microfinance can work for the poor: The case for integrating microfinance with education and health services by Dunford et al. 7
    9. 9. Microfinance and Health Protection Definition: Microfinance and health protection is the use of the microfinance platform to provide MFI clients with access to crucial health- related information, financing, care and products. 8
    10. 10. Questions for Further Reflection: You already discussed a bit some of what you have seen among your clients concerning their health challenges and what you have done about them. Before discussing some ways that the MAHP program has worked with partners to deal with client health problems take a minute to think to yourself about the following: In addition to any information you have now about the health needs of your clients, what additional information would you want to know about their health needs to provide services or products to meet these needs? 9
    11. 11. Session 4 Four Health Protection Approaches 10
    12. 12. Four Approaches to Health Protection Developed by MFIs in Response to Clients’ Needs 11
    13. 13. Bandhan Case Study 12
    14. 14. Session 5 Health Protection Products and Services Developed by MFIs 13
    15. 15. Cohesive Microfinance + Health Packages 14
    16. 16. PADME (Benin) Cohesive • Health education Microfinance • Health product + distribution Health Packages 15
    17. 17. PADME (Benin) Cohesive • Health education Microfinance • Health product + distribution Health Packages Bandhan (India) •Health education •Health loans •Health product distribution •Informal linkages to health providers 16
    18. 18. PADME (Benin) Cohesive • Health education Microfinance • Health product + distribution Health Packages RCPB (Burkina Faso) Bandhan (India) • Health education •Health education • Health savings •Health loans • Health loans •Health product distribution •Informal linkages to health providers 17
    19. 19. PADME (Benin) Cohesive • Health education Microfinance • Health product + distribution Health Packages RCPB (Burkina Faso) CARD (Philippines) Bandhan (India) • Health education •Health education •Health education • Health savings •Health micro- •Health loans insurance loans • Health loans •Health product •Preferred provider distribution linkages •Informal linkages •Access to to health providers affordable drugs 18
    20. 20. PADME (Benin) CRECER (Bolivia) Cohesive • Health education • Health education Microfinance • Health product • Mobile doctors + distribution • Health loans Health Packages RCPB (Burkina Faso) CARD (Philippines) Bandhan (India) • Health education •Health education •Health education • Health savings •Health micro- •Health loans insurance loans • Health loans •Health product •Preferred provider distribution linkages •Informal linkages •Access to to health providers affordable drugs 19
    21. 21. Cohesive Microfinance + Health Packages 20
    22. 22. Four Approaches to Health Protection Developed by MFIs in Response to Clients’ Needs 21
    23. 23. Four Approaches to Health Protection Developed by MFIs in Response to Clients’ Needs 22
    24. 24. Session 6 Health Education – A Key Approach 23
    25. 25. What Makes Freedom from Hunger’s Education Unique? • Relevant for clients • Focused on Behavior Change • Enjoyable • Easy to Use 24
    26. 26. Key Characteristics of Freedom from Hunger’s Education Delivery Channels  Field agents of MFIs or NGOs deliver sessions during regular meetings of Credit, Savings or Self-Help Groups Module Components  Facilitator’s Guide that field agents use to facilitate sessions  Trainer’s Guide that a trainer uses to train field agents Number of Sessions  Approximately 7 sessions per module Length of Sessions  30 minutes Session Structure Sessions use the following structure: Review previous session Share new knowledge/skills Analyze new knowledge/skills in depth Apply new knowledge/skills and commit to action Methods that Create  Stories, visual aids, small-group work, role-plays, games, Dialogue demonstrations, small- and large-group discussions Measures of Success  Measurable objectives for each session
    27. 27. Available Education Modules 26
    28. 28. Session 7 Costs and Benefits of Selected Health Protection Services 27
    29. 29. Savvy MFIs are adding health services in order to improve their own profitability. 28
    30. 30. Health services can create Net Benefits for MFIs Income-generating health services for MFIs: • Health education (in conjunction with village banking) • Health loans - Health savings (potentially) • Health microinsurance premium loans • Health product distribution Non-income-generating health services for MFIs: • Health education (parallel approach) • Linkages to health providers - Mobile health providers - Referrals to health providers
    31. 31. Gallery Walk: Sample Cost-Benefit Description Cost to MFI Benefit to MFI Cost to Client Benefit to Client  Additional time  Interest earned on  Additional time  Lower instance of Financial for field agents. microfinance loans spent in a credit or disease leads to covers the separate meeting. savings of money marginal cost of and time away education. from microenterprise.  Demonstration that  Improved health financial MFI cares about knowledge and Non- clients—boosts behaviors. MFI reputation and marketing. 30
    32. 32. Reflection on the Cost and Benefits of Health Protection Products/Services With others from your organization (or, if you are the only one from your organization, with another person) discuss the following two issues:  What did you find useful from the perspective of your organization?  What are your general questions/concerns you have given everything you have seen? 31
    33. 33. Session 8 Market Research – A Key First Step to Developing Health Protection Products and Services 32
    34. 34. Microfinance and Health Protection Services (Sample Development Process and Timeline) 33
    35. 35. Purpose of Market Research in the Development of Health Protection To better understand the health care environment within which you are operating and to identify the health needs of current, and potential, clients. 34
    36. 36. Characteristics of Market Research  It seeks to explain underlying reasons for behaviors and beliefs  It utilizes dialogue-based methods to develop a deep understanding;  It enables participants to discuss sensitive topics; and  It accommodates illiteracy through use of verbal and visual data-collection techniques. This and the following pages reprinted from Market Research for Microfinance and Health Protection How-to Guideゥ2009 Freedom from Hunger. 35
    37. 37. Types of Health Data Generated Through Market Research Types of Market Research Data Uses of Market Research Data  Common illnesses  Inform the design of health-related financial services, such as health loans  Frequency and cost of treating illness and savings. and disease  Household financial impact of illness  Preventive and coping strategies  Inform the design of linkages to health- service providers, such as establishing  Availability and accessibility for clients reduced prices for clients with local to various types of local health care) health-care providers. doctor, medicines, hospital) 36
    38. 38. Market Research Tools Tools Purpose of the Tools  Discuss impact of disease on the household finances  Discuss what clients know about preventing and treating local Focus Group Discussions common illnesses.  Examine challenges clients face in accessing local health services  Determine how clients currently pay for health care and the challenges they face about paying for health-related expenses.  Identify illnesses and disease that affect clients’ repayment capacity In Depth Interviews (MFI Management)  Assess the extent to which client illnesses affect the MFI’s financial performance Participatory Rapid -Appraisal  Identify where the community goes for different health services, and (Health care-seeking which health providers and institutions they trust or value and why behavior maps) 37
    39. 39. Session 9 Action Planning – Next Steps for Developing Health Protection Products and Services 38
    40. 40. What are your reactions to our discussions today and what do they mean for your institution? 39
    41. 41. Developing Next Steps for Your Organization Health protection approaches to explore:_______________________ ________________________________________________________________ Who What By When (what is needed to implement, Next Steps Needed (who is responsible in my MFI (by when do we need to i.e. information, materials, to accomplish this step) accomplish this step) technical resources) 40
    42. 42. Closing Remarks 41
    43. 43. “You know well that we are poor country people. Agriculture is not flourishing like before due to the capriciousness of the climate. Our spouses thus do not have enough financial resources and the family income is weak. With the conditions where life is expensive or where it is already painful trying to have enough to eat, we have to invest our small incomes in health and this is even more punishment. We don’t have a great way to get to the hospital, but if someone can give us ideas on how to prevent disease, we will apply these tips and save our children and ourselves.” --PADME client, when asked her opinion on the health education
    44. 44. “ When you go to the market in the morning you never know what will happen, but when you have the health savings and can get a health loan, you have the security of knowing that if you have a problem, you will be protected.” –RCPB client “ Neither health savings nor health loans have created extra work for staff. The health savings accounts do not present more challenges or difficulties than any other financial products at RCPB.” –RCPB branch directors
    45. 45. “ I joined CARD because they have many benefits; my favorite benefits are the health benefits” -Roselyn, CARD client “ Had I not received this health loan from Bandhan, I would have lost both my sons as well as my asset... Bandhan brought back light in my family and I am obliged to spread this message of my immense benefit….” --Bandhan client
    46. 46. Microfinance and Health Protection (MAHP) Myka Reinsch, Special Advisor, MAHP myka@freedomfromhunger.org Mahamadi Cisse, Regional MAHP Manager mcisse@freedomfromhunger.org www.freedomfromhunger.org www.ffhtechnical.org
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