Integrating Microfinance and Health - Global Microcredit Summit 2011

In the global health community, much attention is being given to what is termed ―health systemsstrengthening,‖ with the understanding that population health, worldwide, is predicated on accessto effective and appropriate healthcare services. MFIs can contribute to this cause in multipleways, as described above. This capacity-building role can be even more direct, as highlighted byone study of a program in Uganda that shows how microfinance loans to local private medicalclinics, combined with business-skills training, can significantly improve the quality of care, asperceived by local users of clinical services. Users were more likely to choose clinics, whichinvested small enterprise loans in drug stock, clean premises and patient confidentiality (Seiberet al. 2007). Another similar innovation in health systems strengthening is the partnership in ruralTanzania between Microensure, offering health micro-insurance and managing a health plan forthe Kilimanjaro Native Cooperative Union (KNCU), and PharmAccess Foundation, which isfunding specialists to provide training to local medical staff with the goal of facilitating anincreasing number of health conditions to be treated at a primary care facility rather than referralto a hospital outside the coverage of the health plan (http://www.microensure.com/tanzania/).Health FinancingThe direct costs of health care when needed, as well as the indirect costs in lost productivity,represent risk and vulnerability for the poor worldwide. Research in Bolivia, Bénin, and BurkinaFaso found that spending on direct health costs was very high, ranging as a percentage of somelow-income households’ annual income from 22 percent in Bolivia to 67 percent in BurkinaFaso, with medications accounting for the highest proportion (Metcalfe and Reinsch 2008).Evidence also consistently points in the direction of healthcare financing making a difference intimely treatment-seeking. For example, a study in Uganda (Blanchard-Horan 2007) demonstratedthat enrollment in a health micro-insurance scheme affected how quickly microfinance clientssought professional medical treatment for malaria (particularly at a hospital); it was alsoassociated with lower hospital admission rates, presumably because of earlier treatment.The poor use a variety of mechanisms for financing direct health costs—most often borrowing,selling assets, and avoiding health care—but often with untoward consequences. Microfinanceclients want and can benefit from health-financing products such as health savings, health loans19