Costs and benefits of microfinance institutions offering health protection services to clients
Five microfinance institutions (MFIs) in Bénin, Bolivia, Burkina Faso, India and the Philippines developed and offered health protection services to microfinance clients: health education, health loans, health savings, health micro-insurance, linkages to health providers and distribution of health products. After about two years, the services were collectively reaching over 300,000 clients and are continuing to scale up. The cost to the MFI was generally low for each service (average annual net marginal cost of US$0.29 per client and average total annual cost, including allocated expenses, of $1.59 per client). Some were expected to become profitable in the near term. In addition to the financial cost of offering such services and who bears the cost, we discuss the broader benefits both to clients and to the MFIs themselves and suggest that more MFIs around the world could find similar cost-effective ways to deliver health protection services to their clients.Dunford, C. (2002) ‘Building better lives: Sustainable integration of microfinance with education in child survival, reproductive health, and HIV/AIDS prevention for the poorest entrepreneurs’, in S. Daley-Harris (ed.), Pathways Out of Poverty: Innovations in Microfinance for the Poorest Families, pp. 75-131, Kumarian Press, Bloomfield, CT.
Dunford, C. (2009) ‘Credit unions and rural banks reaching down and out to the rural poor through group-based microfinance’, Enterprise Development and Microfinance 20(2): 107-24.
Experience LINKAGES (2005) Cost and Effectiveness [online], LINKAGES: Breastfeeding, LAM, Related Complementary Feeding, and Maternal Nutrition Program, available from: http://www.linkagesproject.org/media/publications/Experience_LINKAGES_Cost&Effectiveness.pdf [last accessed 8 July 2011]. http://www.linkagesproject.org/media/publications/Experience_LINKAGES_Cost&Effectiveness.pdf
Fiedler, J.L. and Chuko, T. (2008) ‘The cost of Child Health Days: A case study of Ethiopia's Enhanced Outreach Strategy (EOS)’, Health Policy and Planning 23: 222-33 [online], available from: http://heapol.oxfordjournals.org/content/23/4/222.full [last accessed 8 July 2011]. http://heapol.oxfordjournals.org/content/23/4/222.full
Horton, S. (1992) Unit costs, cost-effectiveness, and financing of nutrition interventions, Vol. 1, report no. WPS 952, Policy, Research Working Papers, The World Bank, Washington D.C.
Junkin, R., Berry, J. and Perez, M.E. (2006) Healthy Women, Healthy Business: A Comparative Study of Pro Mujer's Integration of Microfinance and Health Services [online] https://promujer.org/dynamic/our_publications_1_Pdf_EN_English%20Version-Jan07.pdfs [last accessed 3 August 2011]. https://promujer.org/dynamic/our_publications_1_Pdf_EN_English%20Version-Jan07.pdfs
Leatherman, S. and Dunford, C. (2010) ‘Linking health to microfinance to reduce poverty’, Bulletin of the World Health Organization 88(6): 470-71.
Loevinsohn, B. (2002) Practical Issues in Contracting for Primary Health Care Delivery: Lessons from Two Large Projects in Bangladesh [online], World Bank, Washington, DC, available from: http://rru.worldbank.org/Documents/PapersLinks/746.doc [last accessed 8 July 2011]. http://rru.worldbank.org/Documents/PapersLinks/746.doc
Metcalfe, M. and Reinsch Sinclair, M. (April 2008) Enhancing the Impact of Microfinance: Client Demand for Health Protection Services on Three Continents, Freedom from Hunger discussion paper (English only), Freedom from Hunger, Davis, CA.
Metcalfe, M., Leatherman, S., Dunford, C., Gray, B., Gash, M., Reinsch, M. and Chandler, C. (2010) Health and Microfinance: Leveraging the Strengths of Two Sectors to Alleviate Poverty [online], Freedom from Hunger Research Paper No. 9, Davis, CA, available from: http://www.ffhtechnical.org/system/files/12-09-2010/MAHP.HealthandMicrofinance.Leveraging.Paper9_.pdf [last accessed 6 June 2011]. http://www.ffhtechnical.org/system/files/12-09-2010/MAHP.HealthandMicrofinance.Leveraging.Paper9_.pdf
Neidecker-Gonzales, O., Bouis, H. and Nestel, P. (2007) ‘Estimating the global costs of Vitamin A capsule distribution: A review of the literature and development of a country-level model’, Food and Nutrition Bulletin 28.
Vor der Bruegge, E., Dickey, J.E. and Dunford, C. (1999) Cost of Education in the Freedom from Hunger Version of Credit with Education Implementation [online], Freedom from Hunger Research Paper No. 6 (July 1997; updated September 1999), Davis, CA, available from: http://www.ffhtechnical.org/system/files/02-24-2010/Cost_of_Education_99-eng.pdf [last accessed 3 June 2011]. http://www.ffhtechnical.org/system/files/02-24-2010/Cost_of_Education_99-eng.pdf
World Bank (2001) ‘Tamil Nadu and Child Nutrition: A New Assessment’ [online], Independent Evaluation Group, The World Bank Group, available from: http://lnweb90.worldbank.org_TamilNadu [last accessed 8 July 2011]. http://lnweb90.worldbank.org_TamilNadu
Dunford, C. (2002) ‘Building better lives: Sustainable integration of microfinance with education in child survival, reproductive health, and HIV/AIDS prevention for the poorest entrepreneurs’, in S. Daley-Harris (ed.), Pathways Out of Poverty: Innovations in Microfinance for the Poorest Families, pp. 75-131, Kumarian Press, Bloomfield, CT.
Dunford, C. (2009) ‘Credit unions and rural banks reaching down and out to the rural poor through group-based microfinance’, Enterprise Development and Microfinance 20(2): 107-24.
Experience LINKAGES (2005) Cost and Effectiveness [online], LINKAGES: Breastfeeding, LAM, Related Complementary Feeding, and Maternal Nutrition Program, available from: http://www.linkagesproject.org/media/publications/Experience_LINKAGES_Cost&Effectiveness.pdf [last accessed 8 July 2011]. http://www.linkagesproject.org/media/publications/Experience_LINKAGES_Cost&Effectiveness.pdf
Fiedler, J.L. and Chuko, T. (2008) ‘The cost of Child Health Days: A case study of Ethiopia's Enhanced Outreach Strategy (EOS)’, Health Policy and Planning 23: 222-33 [online], available from: http://heapol.oxfordjournals.org/content/23/4/222.full [last accessed 8 July 2011]. http://heapol.oxfordjournals.org/content/23/4/222.full
Horton, S. (1992) Unit costs, cost-effectiveness, and financing of nutrition interventions, Vol. 1, report no. WPS 952, Policy, Research Working Papers, The World Bank, Washington D.C.
Junkin, R., Berry, J. and Perez, M.E. (2006) Healthy Women, Healthy Business: A Comparative Study of Pro Mujer's Integration of Microfinance and Health Services [online] https://promujer.org/dynamic/our_publications_1_Pdf_EN_English%20Version-Jan07.pdfs [last accessed 3 August 2011]. https://promujer.org/dynamic/our_publications_1_Pdf_EN_English%20Version-Jan07.pdfs
Leatherman, S. and Dunford, C. (2010) ‘Linking health to microfinance to reduce poverty’, Bulletin of the World Health Organization 88(6): 470-71.
Loevinsohn, B. (2002) Practical Issues in Contracting for Primary Health Care Delivery: Lessons from Two Large Projects in Bangladesh [online], World Bank, Washington, DC, available from: http://rru.worldbank.org/Documents/PapersLinks/746.doc [last accessed 8 July 2011]. http://rru.worldbank.org/Documents/PapersLinks/746.doc
Metcalfe, M. and Reinsch Sinclair, M. (April 2008) Enhancing the Impact of Microfinance: Client Demand for Health Protection Services on Three Continents, Freedom from Hunger discussion paper (English only), Freedom from Hunger, Davis, CA.
Metcalfe, M., Leatherman, S., Dunford, C., Gray, B., Gash, M., Reinsch, M. and Chandler, C. (2010) Health and Microfinance: Leveraging the Strengths of Two Sectors to Alleviate Poverty [online], Freedom from Hunger Research Paper No. 9, Davis, CA, available from: http://www.ffhtechnical.org/system/files/12-09-2010/MAHP.HealthandMicrofinance.Leveraging.Paper9_.pdf [last accessed 6 June 2011]. http://www.ffhtechnical.org/system/files/12-09-2010/MAHP.HealthandMicrofinance.Leveraging.Paper9_.pdf
Neidecker-Gonzales, O., Bouis, H. and Nestel, P. (2007) ‘Estimating the global costs of Vitamin A capsule distribution: A review of the literature and development of a country-level model’, Food and Nutrition Bulletin 28.
Vor der Bruegge, E., Dickey, J.E. and Dunford, C. (1999) Cost of Education in the Freedom from Hunger Version of Credit with Education Implementation [online], Freedom from Hunger Research Paper No. 6 (July 1997; updated September 1999), Davis, CA, available from: http://www.ffhtechnical.org/system/files/02-24-2010/Cost_of_Education_99-eng.pdf [last accessed 3 June 2011]. http://www.ffhtechnical.org/system/files/02-24-2010/Cost_of_Education_99-eng.pdf
World Bank (2001) ‘Tamil Nadu and Child Nutrition: A New Assessment’ [online], Independent Evaluation Group, The World Bank Group, available from: http://lnweb90.worldbank.org_TamilNadu [last accessed 8 July 2011]. http://lnweb90.worldbank.org_TamilNadu
Dunford, C. (2002) ‘Building better lives: Sustainable integration of microfinance with education in child survival, reproductive health, and HIV/AIDS prevention for the poorest entrepreneurs’, in S. Daley-Harris (ed.), Pathways Out of Poverty: Innovations in Microfinance for the Poorest Families, pp. 75-131, Kumarian Press, Bloomfield, CT.
Dunford, C. (2009) ‘Credit unions and rural banks reaching down and out to the rural poor through group-based microfinance’, Enterprise Development and Microfinance 20(2): 107-24.
Experience LINKAGES (2005) Cost and Effectiveness [online], LINKAGES: Breastfeeding, LAM, Related Complementary Feeding, and Maternal Nutrition Program, available from: http://www.linkagesproject.org/media/publications/Experience_LINKAGES_Cost&Effectiveness.pdf [last accessed 8 July 2011]. http://www.linkagesproject.org/media/publications/Experience_LINKAGES_Cost&Effectiveness.pdf
Fiedler, J.L. and Chuko, T. (2008) ‘The cost of Child Health Days: A case study of Ethiopia's Enhanced Outreach Strategy (EOS)’, Health Policy and Planning 23: 222-33 [online], available from: http://heapol.oxfordjournals.org/content/23/4/222.full [last accessed 8 July 2011]. http://heapol.oxfordjournals.org/content/23/4/222.full
Horton, S. (1992) Unit costs, cost-effectiveness, and financing of nutrition interventions, Vol. 1, report no. WPS 952, Policy, Research Working Papers, The World Bank, Washington D.C.
Junkin, R., Berry, J. and Perez, M.E. (2006) Healthy Women, Healthy Business: A Comparative Study of Pro Mujer's Integration of Microfinance and Health Services [online] https://promujer.org/dynamic/our_publications_1_Pdf_EN_English%20Version-Jan07.pdfs [last accessed 3 August 2011]. https://promujer.org/dynamic/our_publications_1_Pdf_EN_English%20Version-Jan07.pdfs
Leatherman, S. and Dunford, C. (2010) ‘Linking health to microfinance to reduce poverty’, Bulletin of the World Health Organization 88(6): 470-71.
Loevinsohn, B. (2002) Practical Issues in Contracting for Primary Health Care Delivery: Lessons from Two Large Projects in Bangladesh [online], World Bank, Washington, DC, available from: http://rru.worldbank.org/Documents/PapersLinks/746.doc [last accessed 8 July 2011]. http://rru.worldbank.org/Documents/PapersLinks/746.doc
Metcalfe, M. and Reinsch Sinclair, M. (April 2008) Enhancing the Impact of Microfinance: Client Demand for Health Protection Services on Three Continents, Freedom from Hunger discussion paper (English only), Freedom from Hunger, Davis, CA.
Metcalfe, M., Leatherman, S., Dunford, C., Gray, B., Gash, M., Reinsch, M. and Chandler, C. (2010) Health and Microfinance: Leveraging the Strengths of Two Sectors to Alleviate Poverty [online], Freedom from Hunger Research Paper No. 9, Davis, CA, available from: http://www.ffhtechnical.org/system/files/12-09-2010/MAHP.HealthandMicrofinance.Leveraging.Paper9_.pdf [last accessed 6 June 2011]. http://www.ffhtechnical.org/system/files/12-09-2010/MAHP.HealthandMicrofinance.Leveraging.Paper9_.pdf
Neidecker-Gonzales, O., Bouis, H. and Nestel, P. (2007) ‘Estimating the global costs of Vitamin A capsule distribution: A review of the literature and development of a country-level model’, Food and Nutrition Bulletin 28.
Vor der Bruegge, E., Dickey, J.E. and Dunford, C. (1999) Cost of Education in the Freedom from Hunger Version of Credit with Education Implementation [online], Freedom from Hunger Research Paper No. 6 (July 1997; updated September 1999), Davis, CA, available from: http://www.ffhtechnical.org/system/files/02-24-2010/Cost_of_Education_99-eng.pdf [last accessed 3 June 2011]. http://www.ffhtechnical.org/system/files/02-24-2010/Cost_of_Education_99-eng.pdf
World Bank (2001) ‘Tamil Nadu and Child Nutrition: A New Assessment’ [online], Independent Evaluation Group, The World Bank Group, available from: http://lnweb90.worldbank.org_TamilNadu [last accessed 8 July 2011]. http://lnweb90.worldbank.org_TamilNadu
Dunford, C. (2002) ‘Building better lives: Sustainable integration of microfinance with education in child survival, reproductive health, and HIV/AIDS prevention for the poorest entrepreneurs’, in S. Daley-Harris (ed.), Pathways Out of Poverty: Innovations in Microfinance for the Poorest Families, pp. 75-131, Kumarian Press, Bloomfield, CT.
Dunford, C. (2009) ‘Credit unions and rural banks reaching down and out to the rural poor through group-based microfinance’, Enterprise Development and Microfinance 20(2): 107-24.
Experience LINKAGES (2005) Cost and Effectiveness [online], LINKAGES: Breastfeeding, LAM, Related Complementary Feeding, and Maternal Nutrition Program, available from: http://www.linkagesproject.org/media/publications/Experience_LINKAGES_Cost&Effectiveness.pdf [last accessed 8 July 2011]. http://www.linkagesproject.org/media/publications/Experience_LINKAGES_Cost&Effectiveness.pdf
Fiedler, J.L. and Chuko, T. (2008) ‘The cost of Child Health Days: A case study of Ethiopia's Enhanced Outreach Strategy (EOS)’, Health Policy and Planning 23: 222-33 [online], available from: http://heapol.oxfordjournals.org/content/23/4/222.full [last accessed 8 July 2011]. http://heapol.oxfordjournals.org/content/23/4/222.full
Horton, S. (1992) Unit costs, cost-effectiveness, and financing of nutrition interventions, Vol. 1, report no. WPS 952, Policy, Research Working Papers, The World Bank, Washington D.C.
Junkin, R., Berry, J. and Perez, M.E. (2006) Healthy Women, Healthy Business: A Comparative Study of Pro Mujer's Integration of Microfinance and Health Services [online] https://promujer.org/dynamic/our_publications_1_Pdf_EN_English%20Version-Jan07.pdfs [last accessed 3 August 2011]. https://promujer.org/dynamic/our_publications_1_Pdf_EN_English%20Version-Jan07.pdfs
Leatherman, S. and Dunford, C. (2010) ‘Linking health to microfinance to reduce poverty’, Bulletin of the World Health Organization 88(6): 470-71.
Loevinsohn, B. (2002) Practical Issues in Contracting for Primary Health Care Delivery: Lessons from Two Large Projects in Bangladesh [online], World Bank, Washington, DC, available from: http://rru.worldbank.org/Documents/PapersLinks/746.doc [last accessed 8 July 2011]. http://rru.worldbank.org/Documents/PapersLinks/746.doc
Metcalfe, M. and Reinsch Sinclair, M. (April 2008) Enhancing the Impact of Microfinance: Client Demand for Health Protection Services on Three Continents, Freedom from Hunger discussion paper (English only), Freedom from Hunger, Davis, CA.
Metcalfe, M., Leatherman, S., Dunford, C., Gray, B., Gash, M., Reinsch, M. and Chandler, C. (2010) Health and Microfinance: Leveraging the Strengths of Two Sectors to Alleviate Poverty [online], Freedom from Hunger Research Paper No. 9, Davis, CA, available from: http://www.ffhtechnical.org/system/files/12-09-2010/MAHP.HealthandMicrofinance.Leveraging.Paper9_.pdf [last accessed 6 June 2011]. http://www.ffhtechnical.org/system/files/12-09-2010/MAHP.HealthandMicrofinance.Leveraging.Paper9_.pdf
Neidecker-Gonzales, O., Bouis, H. and Nestel, P. (2007) ‘Estimating the global costs of Vitamin A capsule distribution: A review of the literature and development of a country-level model’, Food and Nutrition Bulletin 28.
Vor der Bruegge, E., Dickey, J.E. and Dunford, C. (1999) Cost of Education in the Freedom from Hunger Version of Credit with Education Implementation [online], Freedom from Hunger Research Paper No. 6 (July 1997; updated September 1999), Davis, CA, available from: http://www.ffhtechnical.org/system/files/02-24-2010/Cost_of_Education_99-eng.pdf [last accessed 3 June 2011]. http://www.ffhtechnical.org/system/files/02-24-2010/Cost_of_Education_99-eng.pdf
World Bank (2001) ‘Tamil Nadu and Child Nutrition: A New Assessment’ [online], Independent Evaluation Group, The World Bank Group, available from: http://lnweb90.worldbank.org_TamilNadu [last accessed 8 July 2011]. http://lnweb90.worldbank.org_TamilNadu
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