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EXPANDING OPPORTUNITY FOR PEOPLE LIVING IN POVERTY

IMPACT

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IN THIS ISSUE Indicates that accompanying links may be found in the e-version of IMPACT at www.globalpartnerships.org/newsletter

FEATURE ARTICLEInsights in Health Services (page 1)

PERSPECTIVES Interview with

Linked Foundation (page 2)

THE ROUND UPReports, Articles, and Highlights

on Impact Investing (page 2)

IMPACT IN ACTIONThe Crucial Link: How One Woman

Helps Connect Island-Dwellers to Medications (page 3)

FROM THE FIELDFinding Inspiration in

the Field (page 4)

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INSIGHTS IN HEALTH SERVICES

How do you know if a country’s citizens have good health care? Most of us are familiar with reports on maternal and childhood mortality rates, but what other metrics should be considered when evaluating the health of a nation’s population? Some say that the answer lies within the newly launched Social Progress Index (SPI), which ranks 50 countries according to “indicators in the areas of basic human needs, foundations of wellbeing, and opportunity.” The SPI team calculated and evaluated many indicators, including the “availability of quality healthcare.” In doing so, they found that Peru, Mexico, Colombia and the Dominican Republic (all countries in our health services portfolio) ranked in the bottom half of all countries surveyed vis-à-vis health and wellness.

Yet, we at Global Partnerships (GP) believe that the challenge is not just about availability; it’s also about access to and utilization of quality and affordable health care. In this case, access means not only affordability but also, geographic access. At GP we work with our partners to identify prevailing health conditions. We also work with them to address access and utilization challenges like: having the cash needed to visit thedoctor, raising awareness of the products and services available for treatment, and having the time needed to travel to and from the doctor.

GP works with partners, including both microfinance institutions (MFIs) and cooperatives, who are interested in integrating health care services with financial products that address these challenges sustainably. For example, in our work with Fonkoze, the largest MFI in Haiti serving women at the bottom of the economic pyramid, we have collaborated to develop a new business model to ensure the health services program will no longer depend on grant funding.

We actively gather data and insights from Fonkoze’s pilot program to inform and guide the operation to scale. Key learnings include:

• Education and basic health screening (e.g., malnutrition, diabetes) scale faster;

• Health services that address the most prevalent patient needs and that are most valued are also the most financially sustainable;

• Piggybacking on existing client contact opportunities facilitates delivery of additional services, increasing access and awareness;

(Continued on page 3)

SUMMER 2013 | VOL 10 ISSUE 3

NEW

THE ROUND UP

PERSPECTIVES

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Reports, articles and highlights on impact investing.

A Symbiotic Collaboration

A new report by Freedom from Hunger and the Microcredit Summit Campaign highlights microfinance institutions (MFIs) that are integrating health services with microfinance. Our partners Pro Mujer in Bolivia and Crecer (Bolivia) are among those featured. The report states that integrated health services show “enormous potential for reducing the vulnerability of the poor in the Andean region” and that collaboration between MFIs and the health sector can be mutually beneficial.

The World Bank Defines a New Economic Class in Latin America

Earlier this year the World Bank identified a new economic class in Latin America which earns between $4-$10 per day. The authors write that “this class has grown to now contain the highest proportion of the Latin American population when compared to other economic classes,” yet it is a class that remains at risk because illness or natural disaster can easily undo progress.

Money Alone is Not Enough An article about social sector financing for poor women in Mexico in Stanford Social Innovation Review shows that money is never enough. Financial clients need access to support networks, business training, legal assistance and other support services in order to create long-lasting change.

U.N.: Gains in Poverty Reduction

The latest U.N. Development Report says recent gains in poverty reduction have led to the projection that 80% of the world’s middle class will live in developing countries by 2030. “This year’s report [...]says higher economic growth in at least 40 developing countries has helped lift hundreds of millions of people from poverty, and pushed billions more into the new global middle class.”

INTERVIEW WITH LINKED FOUNDATION We interviewed Nancy Swanson, Executive Director of Linked Foundation, whose mission is to alleviate poverty by investing in solutions that improve the health

of women in Latin America. Linked Foundation has invested grant capital into GP’s Health Services Fund, catalyzing our Health Services initiatives. Highlights from our talk with Nancy are below; watch the full video interview online.

What innovations do you see in Global Partnerships’ work? One of the innovations that I’m seeing with [GP’s] Health Services Fund is the utilization of grant capital to help partners deliver and create sustainable ways to bring health care to their clients. And prior to that, these partners have had some level of health programming, but hadn’t been thinking about how to deliver that in a sustainable and scalable way. So a health program before might have been serving maybe 1,000 clients, but now has the potential to reach over 50,000 [such as] in the case of Fonkoze (pictured right). So the potential for real scale and reaching many many more women and their children with health care is really exciting.

What are some successes in impact investing?

Some of the successes that we are seeing in impact investing are still early stage, but we are seeing some results from some of the new pioneering business models that have been underway including the work at GP. We are seeing that the work in health [for] example [is] moving away from just a kind of straight forward health programming to really thinking about how to help NGOs and partners become sustainable.

Photos c/o Fonkoze

GET CONNECTED

CONTINUED FROM PAGE 1

IMPACT IN ACTION

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THE CRUCIAL LINK: HOW ONE WOMAN HELPS CONNECT ISLAND-DWELLERS TO MEDICATIONS

The 2,500 residents of El Tigre Island, Honduras depend on Doña Chila. Since March 2009, she has been one of just two volunteer community pharmacists providing them with affordable access to essential medications and medical injections.

Before Doña Chila became a community pharmacist, she had been a long time

member of our partner, COMIXMUL, a Honduran women’s savings and credit cooperative with integrated access to health services. Through COMIXMUL, Doña Chila received numerous business loans as well as health screenings and education.

In 2009, driven by a desire to give back to her community, Doña Chila signed up to join COMIXMUL’s newly launched volunteer pharmacies program. “My sons made fun of me when they found out I was going to sell medicines as they thought I couldn’t learn,” says Doña Chila, “[But] I’m the one laughing now as I’ve learned all the medicines and can also give injections. [Now] they call me doctor and I don’t correct them.”

Doña Chila is one of the most productive pharmacists on the island. On any given day, she is visited by 15-17 customers who rely on her for counsel on which medications to take, dosages, and side effects. Although the island has other pharmacies not affiliated with COMIXMUL’s program, Doña Chila is able to serve the poorest of customers because she offers lower prices by selling generic medications. She is also highly reliable by keeping a fully stocked medicine cabinet and offering her services to customers 24 hours a day.

Earlier this year, Global Partnerships helped COMIXMUL restructure its community pharmacies program to help it achieve the financial sustainability it is has never been able to obtain. Part of the restructuring included providing its 201 volunteer pharmacists, including Doña Chila, with a 10 percent commission, which helps incent performance in sales, quality and transparency. The commission also helps pharmacists earn additional revenue to raise their families and improve their living conditions. In spite of this, Doña Chila insists that she still considers herself as a volunteer fulfilling her civic duty. “Being a community pharmacist has been the best and most rewarding experience of my life.”

• Negotiating bulk discounts with strategic providers ensures reduced costs for clients; and

• Having sufficient management experience over health experience is more important in solving the “last mile”* delivery problem, at scale and sustainably.

With these insights, Global Partnerships is working alongside Fonkoze to create and scale up a suite of sustainable services that are affordable and relevant to the women they serve.

The SPI’s stated purpose is to “elevate the quality of discussion on national priorities and to guide social investment decisions” by ranking country performance relative to one another, which is helpful for a nonprofit impact investor like GP. But in regards to health indicators, we’ve learned that it takes more than availability to make a lasting impact.

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*Last mile: lack of access due to cost/geography.

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FROM THE FIELD

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IN THIS ISSUE

• Insights in Health Services

• Interview with Linked Foundation

• The Crucial Link: How One Woman Helps Connect Island-Dwellers to Medications

FINDING INSPIRATION IN THE FIELDBy Sixta García, Portfolio Director (Managua, Nicaragua) Close your eyes and imagine this: a woman living in a remote Nicaraguan village that is accessible only by dirt roads, whose daily income fluctuates unpredictably, and whose child has just gotten sick and needs a trip to the hospital several hours away. It is a dire but not uncommon situation for those at the bottom of the economic pyramid; one in four people in Latin America lack regular access to basic health services. Yet, within every challenge lies an opportunity, and in this case the opportunity is in working with microfinance and cooperative partners to develop business models that will allow them to sustainably deliver health services —from preventive education to affordable health providers to insurance products. As one of Global Partnerships’ (GP) portfolio directors, I travel frequently to evaluate the impact of the work done by current and potential partners.

I have met many women that face situations similar to the one described above, and I’ve observed that with the right access to health education and services, they are better prepared to handle those situations. Recently, I attended a village bank meeting at ESPOIR (pictured), a GP health services partner in Ecuador. There, women openly shared the results of their last annual checkups. They spoke confidently about how learning to detect diseases like breast cancer and prevent conditions like diabetes has improved their lives as well as their families’. What was also clear was their sense of “lealtad” or loyalty to ESPOIR because the organization was able to serve their fundamental health needs as well as their financial needs. These women and many others will benefit as GP continues to work with ESPOIR to strengthen the quality and reach of its health services work.

What I saw at ESPOIR echoes what I see while visiting other health services partners: that loyal clients are also more engaged and inclined to utilize the health services offered. By working with partners like ESPOIR to address health services availability, accessibility and utilization, GP helps create lasting impact. This is what inspires me to do what I do.