Health and Microfinance: Leveraging the Strengths of Two Sectors to Improve Food Security
Poverty and ill health go hand-in-hand. Poverty impacts an individual’s health, including the ability to engage in health-seeking and health-promoting behavior. Concurrently, poor health can deepen poverty by taxing an inordinate amount of a poor family’s income as well as diminishing an individual’s ability to be economically productive. Given these connections, we propose to bring together the economic development and health sectors to develop practical tools that can improve health utilization and health access. Ultimately, these health improvements will translate to better health and nutrition practices of the poor, more productive economies and overall improved food security
About You
About You
First Name
Eden
Last Name
Rock
Facebook Profile
About Your Organization
Organization Name
Freedom from Hunger
Organization Website
Organization Phone
+1.530.758.6200
Organization Address
1644 Da Vinci Court, Davis, CA 95618
Organization Country
United States, CA, Yolo County
Country where this project is creating social impact
India
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
More than 5 years
Innovation
Entry Form title
Health and Microfinance: Leveraging the Strengths of Two Sectors to Improve Food Security
What change do you want to bring to the world?
Poverty and ill health go hand-in-hand. Poverty impacts an individual’s health, including the ability to engage in health-seeking and health-promoting behavior. Concurrently, poor health can deepen poverty by taxing an inordinate amount of a poor family’s income as well as diminishing an individual’s ability to be economically productive. Given these connections, we propose to bring together the economic development and health sectors to develop practical tools that can improve health utilization and health access. Ultimately, these health improvements will translate to better health and nutrition practices of the poor, more productive economies and overall improved food security
What are the primary activities of your project?
We have shown through a pilot initiative in five countries that microfinance providers (MFIs) are a viable way of delivering healthcare services the “final mile” to the world’s poor. To this end, we are committed to broad-scale uptake, and will disseminate knowledge, tools and products and build capacity to reach 1.32 million families world-wide with access to integrated microfinance and health-protection services. Each participating MFI will customize its package of health products and services to best meet the needs of its clients. Health packages include a combination of health education, health financing and micro-insurance, linkage to healthcare providers, and/or access to health products. Specifically, we will:
1) replicate the microfinance and health-protection model used in the pilot initiative in order to create a large demonstration of how to disseminate the methodologies, as well as sustain and scale the innovation over several organizations in varying contexts;
2) continue to innovate health-related products and services in the context of self-help for the hungry poor; and
3) cultivate communities of practice by publishing research papers and articles on integrating health and microfinance to generate enough excitement, relevance and value to attract and engage members.
What is innovative about your initiative? How is it a new contribution to the field?
The integration of health and microfinance is an innovative approach that uses MFIs to provide simple but life-saving health services to very poor families in very remote areas. MFIs not only have compelling business reasons to attend to their clients’ health needs, they are also often uniquely positioned in the communities they serve as trusted intermediaries between community members and the outside world. Following the scrutiny of the microfinance industry this past year, this innovation is timely and helps MFIs to achieve their social goal to reach more vulnerable clients. Freedom from Hunger’s innovation provides an opportunity to demonstrate to MFIs that health-protection services not only enhance their clients’ welfare, but is commercially viable for them.
Freedom from Hunger was one of the first organizations to develop, test and document alternative financing mechanisms for health through our Microfinance and Health Protection (MAHP) pilot initiative. We have evaluated our successes and failures and learned from “what works” and have published a series of research papers, technical guides and educational modules designed to enable other MFIs to successfully integrate health services and products. What we learn, we share, and make available at no cost via our web site.
What stage is your project in?
Operating for 1‐5 years
Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.
Freedom from Hunger’s target population of beneficiaries is the chronically hungry poor—those living on US$1.25 a day or less, who do not have consistent, reliable access to adequate, nutritious food on a continual basis. The chronically hungry are found in disproportionately higher numbers in rural areas than urban, yet resources in these hard-to-reach communities are fewest. Freedom from Hunger’s services are specifically designed for and offered to women because of their essential role in caring for children—those most vulnerable to chronic hunger.
In terms of health, our target population pays a disproportionately high amount of their meager income on health expenditures and health shocks, which further aggravates their situation. They have extremely limited access to social services, including government health services, and an inability to access health care in general.
We have engaged with this population for over 60 years and have employed three crucial metrics to monitor whether our programs are reaching them: 1) Scale—the total number of chronically hungry poor who benefit from our services; 2) Impact—the improvement in food-security status of the clients we reach; and 3) Sustainability—the profitability of the models we pursue.
Share the story of the founder and what inspired the founder to start this project
Following two decades of experience in developing and helping MFIs to successfully implement financially self-sustaining Credit with Education programs—which combine traditional village banking with nonformal education on health, business and financial topics—Freedom from Hunger sought to explore whether MFIs could feasibly go beyond health education to offer other types of high-value health services. This initiative was inspired, in part, by Freedom from Hunger’s desire to demonstrate to MFIs that they can fulfill broader social responsibilities while protecting their interests and their portfolio from illness-induced defaults. The other part was demand-driven by our clients, and their need for protection against health-related financial shocks. In 2006, with funding from the Bill & Melinda Gates Foundation, Freedom from Hunger launched its pilot Microfinance and Health Protection initiative in the spirit of exploration and experimentation.
Social Impact
This Entry is about (Issues)
Please describe how your project has been successful and how that success is measured
Our success was measured on two levels, MFI-level and client-level outcomes. The MFI-level outcomes indicated that health-related products and services could be offered on a cost-effective—if not always a full cost-recovery—basis. The average annual net marginal cost to the MFIs in 2009, one to two years after product launch, was US $.29 per client, and the average total cost when MFI overhead costs were included was $1.59 per client per year. Since these costs were calculated at the end of the pilot phase, they are expected to continue to decrease as the health programs realize increasing economies of scale.
On a client level, the research detected statistically significant changes in knowledge and behavior with regard to improved health practices, as well as client and staff satisfaction. We learned that health-protection services carry a value for clients that exceeds the MFI’s cost of providing them, creating net social value and contributing to social mission.
To measure the success and shortcomings of the initiative, outcomes research at client and MFI levels took place from 2007 into 2010. The client-level studies employed a variety of rigorous research methods to examine client-level family health and economic outcomes.
How many people have been impacted by your project?
More than 10,000
How many people could be impacted by your project in the next three years?
More than 10,000
Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact
Increase awareness of integrated health and microfinance services and reach additional microfinance clients towards annual goal.
Task 1
Provide training and technical assistance to build capacity of institutions offering integrated health and microfinance services to their clients.
Task 2
Conduct promotional workshops to introduce leaders of MFIs new to integrated health and microfinance services the value, costs, benefits and examples of tested models of adding these services.
Task 3
Increase outreach to health providers to raise awareness of the efficiency and effectiveness of microfinance as a sustainable channel to reach remote areas with health services.
Identify your 12-month impact milestone
Create ongoing capacity to support an enabling environment for the uptake of microfinance and health-protection activities to reach 1.32 million microfinance clients by December 2012.
Task 1
Continue to support health and microfinance institutions to replicate, innovate and scale up microfinance and health protection activities.
Task 2
Disseminate materials, articles and resources to raise awareness, support and recognition of health and microfinance services among the international development and health sectors.
Task 3
Conduct convening, research and feasibility activities towards the building of a global community of practice for health and microfinance.
How will your project evolve over the next three years?
It is our goal that integrated health and microfinance services evolve globally through cultivating communities of practice as well as through replication and scale-up. We will continue to disseminate materials, produce articles and present at international conferences and the like to raise awareness and support for integrated health and microfinance services. We will build support amongst practitioners, policymakers, researchers, funders and thought leaders from the international community and health sectors so that integrated health and microfinance becomes widely understood as a tool for development.
Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?
Our greatest challenge is that we are seeking to change the way a large number of MFIs do business. There is a perception by some MFIs that combining health with microfinance is costly and may negatively affect the institution’s bottom line. MFIs will need to understand what is required to add health to their services efficiently and in a way that does not compromise their viability over the long term. And, we will need to identify those MFIs that are committed to achieving a social mission and being able to gauge early and accurately their willingness to invest in adding a health component. Another challenge is sensitizing the health care sector to understand how linking with MFIs can extend their reach to the most underserved. Lessons that we learned from the pilot that we will implement are:
•Take time to do thorough market research, to refine the innovation to meet client needs and fit organizational capacity.
•Build multiple levels of commitment for common vision and cascading responsibility that can ensure continuity of momentum to counter unforeseen challenges.
•Evaluate and adjust the product design along the way to take into account continuous learning.
Tell us about your partnerships
To ensure lasting sustainability, Freedom from Hunger’s strategy is centered around partnership with in-country, local organizations to which we provide training and technical assistance to implement and deliver our innovations sustainably and effectively to their clients. We support the capacity-building of our partner organizations as well as provide them with technical expertise in product design and integration, implementation, research, monitoring and evaluation. Partnership is core to our philosophy and operating approach; Freedom from Hunger has a deep history and grounding in leveraging its impact through partnership. We are adept at selecting partner organizations and managing partner relations throughout the project life and beyond, and have well-established partnership protocol and criteria for identifying organizations that are located in our target countries or regions and share our vision for serving the poor. Many of our partner organizations have earned distinction among their peers for their strength in social performance. Partner organizations include MFIs, NGOs, SHPIs and other private and public entities serving those who are living at $1.25 a day or less.
Current annual budget of project, in US dollars
More than $1 million
Explain your selections
The initial pilot was funded by the Bill & Melinda Gates Foundation, and subsequent replication is supported by philanthropic funds from other sources. Partner organizations make an important investment towards implementation of health-protection services, the precise amount of which will vary depending on the organization and the interventions they choose to implement. In general, organizations tend to finance for themselves the majority of their participation in workshops, training, product design and studies of the project, as well as the full cost of implementation of the products they choose to offer.
How do you plan to strengthen your project in the next three years?
In order to facilitate the global expansion of microfinance and health-protection services, Freedom from Hunger will collect and analyze lessons learned and results from replications to advance a more systematized approach to the implementation of integrated health and microfinance interventions. A systematized approach includes: definition of steps for feasibility assessment, market research, product development, implementation, impact assessment and the development of estimate of levels of effort and investment required for technical assistance from the implementer. Additional strengthening will be achieved through the cultivation of communities of practice in order to promote shared learning and experience, as well as through a large and noticeable demonstration effect.
Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.
PRIMARY
Lack of access to targeted health information and education
SECONDARY
Limited access to preventative tools or resources
TERTIARY
Lack of insurance/financing options for healthcare
Please describe how your innovation specifically tackles the barriers listed above.
The overall goal of the microfinance and health-protection project is to provide MFIs new opportunities to offer the poor health-protection services that enhance both client welfare and the MFIs’ commercial viability. Each MFI partner develops a unique healthcare package to address the needs of its clients. These packages can include 1) health education; 2) health financing and micro-insurance; 3) linkage to healthcare providers; and 4) access to health products, all of which address the barriers to health and well-being selected above.
How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.
PRIMARY
Grown geographic reach: Global
SECONDARY
Enhanced existing impact through addition of complementary services
TERTIARY
Influenced other organizations and institutions through the spread of best practices
Please describe which of your growth activities are current or planned for the immediate future.
We are currently growing our activities globally through scale and continuing innovation to create a larger demonstration effect at the same time as building influence among a community of practice. What we learned from the pilot we are replicating in Latin American, Asian and African countries where we have long-standing relationships with governments and local organizations working with those in poverty. We are learning about the process of replication, documenting lessons learned to inform development of a more systematized approach to implementing health-protection programs, monitoring and evaluating to understand the minimal inputs required to achieve successful replications, and sharing what we have learned through convenings, presentations, publications and other fora.
Do you collaborate with any of the following: (Check all that apply)
NGOs/Nonprofits, For profit companies, Academia/universities.
If yes, how have these collaborations helped your innovation to succeed?
1) Public health systems create linkages to and strengthen existing infrastructure.
2) Local MFIs, NGOs and health organizations know about the unique challenges in their service areas and how, together, we might overcome them. By training partner organizations to deliver the services—and training them to train others—we ensure that the programs are locally owned and sustainable.
3) Academic and research institutions around the world conduct rigorous evaluation of our methodologies, and we document and share with others what we have learned through publications, conferences and research reports.
4) Other collaborators such as Microcredit Summit Campaign, Oikocredit and Indian Institute of Public Health help to leverage these innovations through their wide-reaching platforms.
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 | 35 weeks agoEden Rock updated this Competition Entry. |
| 35 weeks agoEden Rock updated this Competition Entry. |
| 35 weeks agoEden Rock updated this Competition Entry. |
| 35 weeks agoEden Rock updated this Competition Entry. |
| 35 weeks agoEden Rock updated this Competition Entry. |
| 36 weeks agoEden Rock updated this Competition Entry. |
| 36 weeks agoEden Rock updated this Competition Entry. |
| 36 weeks agoEden Rock updated this Competition Entry. |
| 36 weeks agoEden Rock updated this Competition Entry. |
| 36 weeks agoEden Rock updated this Competition Entry. |
