Financing Healthcare Initiatives with Microcredit – The Integrated Services Approach of Pro Mujer

| April 21, 2013 | 0 Comments

Poverty and poor health do not exist in isolation. Indeed, low-income individuals around the word “report low usage of health services and delays in seeking care, stemming from barriers of cost, geographic access, cultural beliefs, and lack of trust in health providers,” indicating the need to take an integrated approach to ameliorate the health and financial situations of many people living in poverty.[1] In Mexico, Nicaragua, Bolivia, Peru, and Argentina the goals of health improvement and economic development have come together into an integrative approach developed in the 1990’s by Pro Mujer, a non-governmental organization that provides an integrated package of financial services, business and empowerment training, and primary healthcare services.

When Pro Mujer began providing services in 1990 in Bolivia, and later in the four other countries listed above, the primary health care services they provided were low-cost but provided in a fee-for-service model in which the services were only available for use by microfinance clients of the organization. The healthcare offerings are funded in part by the interest paid to the organization from their clients’ microloans, as well as the individual service fees.

The fee-for-service model still exists throughout the organization, but in 2012 in Nicaragua, a healthcare package pilot project was initiated in which Pro Mujer clients were given the option to purchase a book of coupons for approximately $28 per year containing vouchers for primary care services, cancer detection, dental exams and cleanings. Additionally, the coupon book provides discount coupons for visits to specialist clinicians in the area, including ophthalmologists, gynecologists, and internists. Though Pro Mujer clients must pay for the services provided externally, Pro Mujer negotiates with the practitioners using the compelling financial benefit of a high volume of lower-cost sales to encourage the external physicians to provide high quality care at a reduced cost. An additional benefit to clients, which encourages them to purchase, is the option to transfer individual coupons to their family members or friends for their use.

Pro Mujer’s healthcare package represents an exciting and innovative option for financing access to healthcare for low income populations. Clients may pay for the health package either using the savings they have accrued with the organization, they may pay for it in modest monthly installments with a loan from Pro Mujer, or they may pay in cash. So far, more than 90% of the clients who have purchased the package have chosen to use either their savings or a loan as the method of payment. Since the healthcare package option has existed for less than a year, it is not yet possible to determine the full health impact or the package’s long-term financial sustainability. However, the integrated approach of financial services and healthcare provides a significant advantage to the program because it provides the organization a sustainable source of funding, should the healthcare program require a period of start-up growth to reach full organizational capacity, as well as the benefit of the high volume of purchase by the organization’s clients. Pro Mujer is optimistic about the model because their clients visit the organization’s focal centers to repay their loans at least monthly, giving the organization the opportunity to encourage clients to purchase the package, as well as promoting health and thereby helping clients maintain and grow their businesses. Because the problems of health and poverty are closely related, more organizations worldwide could consider integrating health and finance as a potential funding solution for their clients.

[1] Leatherman, Sheila; Christopher Dunford; Marcia Metcalfe; Myka Reinsch; Megan Gash; Bobbi Gray. Integrating Microfinance and Health: Benefits, Challenges, and Reflections for Moving Forward. 2011 Global Microcredit Summit Commissioned Workshop Paper. July, 2011.

A family practice physician in Leon works for Pro Mujer providing integral health services to the organization’s clients.

A family practice physician in Leon works for Pro Mujer providing integral health services to the organization’s clients.

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Category: Development, NCDs, Women and Children

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