amerms course 6: why offer integrated microfinance and health services - ppt 1
DESCRIPTION
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)TRANSCRIPT
Why Add Health Services to MicrofinanceFreedom from Hunger
April 2010
Session 1
Welcome and Introductions
2
Social Performance Pathway
3
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?
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.
4
Session 2
Workshop Purpose and Objectives
5
Session 3
Discussion on Client Health Challenges and How Microfinance and Health Protection Addresses Them
6
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?
7
*Adapted from: How microfinance can work for the poor: The case for integrating microfinance with education and health services by Dunford et al.
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?
8
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.
9
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?
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Session 4
Four Health Protection Approaches
11
Four Approaches to Health Protection Developed by MFIs in Response to
Clients’ Needs
12
Bandhan Case Study
13
Session 5
Health Protection Products and Services Developed by MFIs
14
Cohesive Microfinance
+ Health
Packages
15
PADME (Benin)
• Health education
• Health product distribution
Cohesive Microfinance
+ Health
Packages
16
PADME (Benin)
• Health education
• Health product distribution
Cohesive Microfinance
+ Health
Packages
Bandhan (India)
• Health education
• Health loans
• Health product distribution
• Informal linkages to health providers
17
RCPB (Burkina Faso)
• Health education
• Health savings
• Health loans
PADME (Benin)
• Health education
• Health product distribution
Cohesive Microfinance
+ Health
Packages
Bandhan (India)
• Health education
• Health loans
• Health product distribution
• Informal linkages to health providers
18
RCPB (Burkina Faso)
• Health education
• Health savings
• Health loans
PADME (Benin)
• Health education
• Health product distribution
Cohesive Microfinance
+ Health
Packages
CARD (Philippines)
• Health education
• Health micro-insurance loans
• Preferred provider linkages
• Access to affordable drugs
Bandhan (India)
• Health education
• Health loans
• Health product distribution
• Informal linkages to health providers
19
CRECER (Bolivia)
• Health education
• Mobile doctors
• Health loans
CARD (Philippines)
• Health education
• Health micro-insurance loans
• Preferred provider linkages
• Access to affordable drugs
RCPB (Burkina Faso)
• Health education
• Health savings
• Health loans
Bandhan (India)
• Health education
• Health loans
• Health product distribution
• Informal linkages to health providers
PADME (Benin)
• Health education
• Health product distribution
Cohesive Microfinance
+ Health
Packages
20
Cohesive Microfinance
+ Health
Packages
21
Four Approaches to Health Protection Developed by MFIs in Response to
Clients’ Needs
22
Four Approaches to Health Protection Developed by MFIs in Response to
Clients’ Needs
23
Session 6
Health Education – A Key Approach
24
What Makes Freedom from Hunger’s Education Unique?
• Relevant for clients
• Focused on Behavior Change
• Enjoyable
• Easy to Use
25
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 sessionShare new knowledge/skillsAnalyze new knowledge/skills in depthApply new knowledge/skills and commit to action
Methods that Create Dialogue
Stories, visual aids, small-group work, role-plays, games, demonstrations, small- and large-group discussions
Measures of Success Measurable objectives for each session
Available Education Modules
27
Session 7
Costs and Benefits of Selected Health Protection Services
28
Savvy MFIs are adding health services in order to
improve their own profitability.
29
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
Gallery Walk: Sample Cost-Benefit Description
Cost to MFI Benefit to MFI Cost to Client Benefit to Client
Financial
Additional time for field agents.
Interest earned on microfinance loans covers the marginal cost of education.
Additional time spent in a credit or separate meeting.
Lower instance of disease leads to savings of money and time away from microenterprise.
Non-
financial
Demonstration that MFI cares about clients—boosts MFI reputation and marketing.
Improved health knowledge and behaviors.
31
Reflection on the Cost and Benefits of Health Protection Products/ServicesWith 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?
32
Session 8
Market Research – A Key First Step to Developing Health Protection Products and Services
33
Microfinance and Health Protection Services(Sample Development Process and Timeline)
34
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.
35
This and the following pages reprinted from Market Research for Microfinance and Health Protection How-to Guide ｩ 2009 Freedom from Hunger.
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.
36
Types of Health Data Generated Through Market Research
Types of Market Research Data Uses of Market Research Data
Common illnesses
Frequency and cost of treating illness and disease
Household financial impact of illness
Inform the design of health-related financial services, such as health loans and savings.
Preventive and coping strategies
Availability and accessibility for clients to various types of local health care) doctor, medicines, hospital)
Inform the design of linkages to health-service providers, such as establishing reduced prices for clients with local health-care providers.
37
Market Research Tools
Tools Purpose of the Tools
Focus Group Discussions
Discuss impact of disease on the household finances Discuss what clients know about preventing and treating local
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.
In Depth Interviews(MFI Management)
Identify illnesses and disease that affect clients’ repayment capacity
Assess the extent to which client illnesses affect the MFI’s financial performance
Participatory Rapid -Appraisal
(Health care-seeking behavior maps)
Identify where the community goes for different health services, and which health providers and institutions they trust or value and why
38
Session 9
Action Planning – Next Steps for Developing Health Protection Products and Services
39
40
What are your reactions to our discussions today and
what do they mean for your institution?
Developing Next Steps for Your OrganizationHealth protection approaches to explore:_______________________________________________________________________________________
Next Steps NeededWho
(who is responsible in my MFI to accomplish this
step)
What (what is needed to
implement, i.e. information, materials,
technical resources)
By When (by when do we need to
accomplish this step)
41
Closing Remarks
42
“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
“ 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
“ 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
Myka Reinsch, Special Advisor, MAHP
Mahamadi Cisse, Regional MAHP Manager
www.freedomfromhunger.org
www.ffhtechnical.org
Microfinance and Health Protection
(MAHP)