Poverty need not bar women from healthcare

Imagine a day in the life of a Pro Mujer client, a poor woman in Latin America. You wake up at 05.00 and make breakfast for your children. By 06.30 you are on your way to the market. You stay at your post all day; even a moment away means that you might lose a sale. At lunchtime, you run to the nearest food vendor and pick up a quick meal. You have to pay to use the public toilet, so you try not to drink too much water. By the time your children get out of school, you still have four more hours of work. When you get home at 19.30, you are tired and so is your family. You rarely take time off, because a day without work is a day without income.

In Latin America, 37% more women are living in poverty than men. Almost 50% of women over 15 have no income of their own. However, our 24 years of experience at the women’s development organization Pro Mujer show that when women have access to independent sources of income, they improve economic conditions for their children. Female micro-entrepreneurs are successful engines for economic improvement both in their communities and their countries.

According to a 2012 World Bank study, female labour in Latin America and the Caribbean reduced extreme poverty by 30% between 2000 and 2010. But when female micro-entrepreneurs become ill, their sources of income disappear and their families are dragged back into extreme poverty. Yet, this demographic does not generally have access to healthcare. Why?

Certainly there is very little access to affordable, high-quality healthcare for the 167 million people in Latin America living in poverty. This problem is compounded for the women served by Pro Mujer, many of whom work in the informal sector and support their families with daily sales. For these women, preventive healthcare is not a priority. Yet, according to the Inter-American Development Bank (IDB) in 2011, chronic diseases (including diabetes, cancer and cardiovascular disease) are now the leading causes of death in Latin America, accounting for 68% of mortality.

So how do we get these women to the healthcare they so desperately need? Our solution has four pillars: convenience, affordability, preventive care and financial sustainability.

Pro Mujer delivers healthcare services at community centres, where our clients already visit to make loan payments. Our existing infrastructure, consisting of 165 community centres in five Latin American countries, enables us to provide this care. Today we have 112 healthcare clinics, 158 doctors and nurses and 55 health administrators – all associated with our existing community centres.

We provide three levels of service: universal access to basic screenings and education; pre-paid health packages, which provide a comprehensive set of services; and pay-per-service healthcare where clients can purchase services à la carte at discounted rates.

The combination of these services gives women choice and combines services in high demand (such as dental care) with preventive services. To facilitate access, these options are either provided at no additional cost or offered at below-market rates. In addition, we leverage our microfinance platform to provide loans and access to savings for the purchase of these services. As a result, women who otherwise would not be able to pay have a convenient way to do so without interrupting their regular cash flow.

This model is designed to be financially sustainable. The programme has been launched in eight regions across three countries, and we plan to continue to expand the model and reach all our clients by the end of 2015.

We are proud and humbled by the success of this model. Yet we know that we can have a much greater global impact. There are more than 3,500 microfinance institutions working with more than 190 million households worldwide. Using the lessons learned from our healthcare model, these organizations, together with Pro Mujer, have the potential to transform the delivery of healthcare to people at the bottom of the economic pyramid.

Author: Rosario Perez is President and Chief Executive Officer, Pro Mujer, USA, and a Schwab Foundation Social Entrepreneur of the Year 2014 Awardee.

Image: The mother of a patient suffering from dengue fever sleeps by his bedside at Hospital Escuela in Tegucigalpa June 24, 2010. REUTERS/Edgard Garrido