News & Insights

How do you Know if a Country’s Citizens Have Good Health Care?


Originally published in June 2013 in the Summer edition of IMPACT (GP’s tri-annual newsletter) as “Insights in Health Services”. You can subscribe to IMPACT here.

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 the doctor, 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;
  • 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.

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

 Learn More:

  1. Discover more about GP’s health services work in depth, or watch a 2 minute video that provides a quick glimpse.
  2. Read about how “empathetic capital” is used to make medical technologies affordable for all, especially those living in poverty.
  3. Have any questions about our health services work? Please let us know in the comments section below. We look forward to hearing from you.

Blog Tags: access   Fonkoze   global health   Haiti   last mile distribution   measuring impact   

Photo of Doña Chila, a member of COMIXMUL, a GP partner in Honduras.
Doña Chila is a member of COMIXMUL, a GP partner and women’s credit and savings cooperative in Honduras. Doña Chila has received health screenings, education, and business loans from COMIXMUL, and she serves as a volunteer community pharmacist for her rural island community. Read her full story at http://bit.ly/18lN1zu. © 2013 Global Partnerships

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