Pro Mujer in Nicaragua Health Services Fund | Jan. - June 2013 | Issue 3 THE CASE FOR IMPACT INVESTMENT BRIEF PARTNER DESCRIPTION: Pro Mujer is an international women’s development and microfinance organization with a mission to provide Latin America’s low income women with the means to build their own livelihoods and support their families through microfinance, business training, and healthcare support. In Nicaragua the program now serves over 50,000 clients via a village bank methodology in both (peri-) urban and rural markets, and has maintained high levels of both financial and social performance despite the recent turbulence in the Nicaraguan microfinance sector. Pro Mujer is a pioneer in A Pro Mujer in Nicaragua integral services models, operating in five Latin American markets, and represents dental screening facility. approximately 20% of Global Partnerships’ (GP) social investment portfolio. The early success of the Nicaragua pilot program has already influenced, and will continue to impact, the strategic direction of Pro Mujer’s health services programs in Bolivia, Peru, Mexico and Argentina. INNOVATION: Pro Mujer’s pioneering business model leverages cross-trained officers to deliver preventive education during village bank meetings, thereby achieving significant scale with low marginal cost. Additionally, client visits to branch offices are leveraged to deliver screening for cervical cancer, dental health, hypertension and diabetes; as well as primary care consultations, reducing the additional need and costs for clients to travel to the branch offices while taking advantage of existing “touch points.” Clients value the quality and convenience of services delivered by in-house women doctors, as well as the pre-paid nature of the package. If successful, Pro Mujer in Nicaragua (PMN) will effectively distinguish themselves from all other MFI competitors for their target constituency. INVESTMENT: At scale, Global Partnerships expects to see PMN reaching most of its 70,000+ clients with preventive education and basic screening components, with more than 21% of clients purchasing the optional package of dental, vision and medical consults benefiting themselves and their family members. To date, GP has disbursed $119,589 in grant capital to Pro Mujer to underwrite the redesign of the consults package and expand the pilot program to an additional branch. The development of a detailed expansion plan to reach all of their branches throughout the country has been completed. Success depends to a great extent on PMN’s achievement of client growth plans in both current and expansion markets, as well as successful marketing of the optional package of valued services.
REACH / SCALE A snapshot view of progress
SUSTAINABILITY January - June 2013
Education
Target at scale = 70,500 Current = 37,238 (53%)
Basic Screening
Target at scale= 24,780 Current = 19,708 (80%)
Optional Consults
Target at scale = 14,868 Current = 3,341 (22%)
Percent Sustainability
100 80 60
100%
99% 83%
40
60% 20 0
Education
Basic Screening
Optional Consults
Composite
SUSTAINABILITY Revenue generated covers total costs over reporting period
RESULTS •
Education delivered via cross-trained credit officers, and basic screening via PMN nurses, has scaled to all branches.
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The optional services package has been launched in the second branch, with plans to reach all 6 branches by early 2015.
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In the past semester 10,284 clients were screened for body mass index (BMI), of which 71% were categorized as overweight or obese, confirming the hypothesis that Pro Mujer’s clients are at high risk for developing chronic diseases, and justifying the focus on prevention and screening for these conditions.
INSIGHTS •
Credit officer-delivered health education sessions via village bank meetings is an effective mechanism for achieving scale with a reasonable cost structure.
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Clients are more willing to pay for tangible services (dental and vision services), or for bundled packages that include commercially valued services with the more preventive high impact services (education and screening).
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Clients value the pre-paid option, as liquidity is a barrier to utilization.
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PMN’s target clients seem willing to pay more for their financial services to receive them from an institution that cares about them as people.
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Buy-in and leadership at branch management level is key to program setting and achieving ambitions outreach targets.
HEALTH CARE SERVICES EDUCATION
BASIC SCREENING
OPTIONAL CONSULTS
Who’s covered: Clients
Who’s covered: Clients
Who’s covered: Clients and their family members
What’s covered: Glucose, BMI, blood pressure
What’s covered: Unlimited consults, PAP exam or a lab exam, dental prophylaxis, fillings and extractions, vision exam, discounts for specialist services and for medications
Delivery channel: PMN nurses
Delivery channel: PMN doctors and allied providers
Nurses and screening equipment and supplies
Doctors, office infrastructure, supplies, and payments to allied providers for services rendered
What’s covered: Cervical cancer, diabetes, hypertension, diarrheal disease, respiratory disease, family planning and reproductive health Delivery channel: Credit officers during village bank meetings
BUSINESS MODEL COSTS Curriculum development, percent of credit officers’ time, and supervision
REVENUE Portfolio yield
Optional pre-paid package ($35/client/year)