One of the primary reasons Malian families don’t seek care at the clinic is the high cost of treatment. Though we work with the clinic and other partners on initiatives to bring down the cost of a visit, the price remains out of reach for many families. Thus, through Action for Health, we provide free care to nearly 2,000 children under age 5 and subsidized care to over 900 pregnant women. Through the program, these children and mothers receive the care they need when they need it without the worry of financial burden. However, it is also our aim to create models in which families can better support themselves. We want to foster independence so that all families can access the care that they need with or without our assistance. So, in 2013, we launched the innovative Health Savings program.
Through the program, groups of women from across the community come together weekly to learn about preventive health care and financial management. These women also deposit small amounts of money into two collective accounts. In the first, members draw loans to support revenue-generating activities, such as starting a small business. From the second, women access no-interest loans in order to cover health costs at the local clinic. At the end of a cycle, women are returned their savings, along with the dividend through interest earned, and encouraged to make good on initial commitments to allocate funding saved to preventive health products. By removing the burden of cost from a single family, these women can now ensure that they and their children seek treatment as soon as they need it and can afford to follow the treatment as long as necessary.
Assan O. is a recent beneficiary of one of these health loans. When she fell sick, she was unable to carry on her business, and stopped earning an income. At first, she was afraid to take out a loan from her Health Savings group because she feared she wouldn’t be able to pay it back in time. She sought treatment at the clinic with the little disposable money she had, but it didn’t cover the medicines the doctor prescribed. Assan couldn’t afford the medication, and so she went without it for days, her condition worsening.
When the Health Savings coordinator visited Assan, he could see that her health was not improving. When she told him why she didn’t take a loan from the group, he assured her that she need not worry – they would find a way to help her repay her loan. She borrowed enough funds to purchase her medication. Her health improved very quickly after that, and at the next Health Savings group meeting, she explained the situation to her fellow members. They understood her predicament and granted her 60 days to repay her loan, rather than the usual 30, enough time for Assan to return to her business and earn an income once again. After 47 days, she repaid her loan in full.
Asked afterward how she felt about the Health Savings program, Assan said, “This is very important to the women of this community. With initiatives like this, we will not be afraid to reach out for care for a lack of money because with the health fund, there is hope.”
Dozens of women have benefitted from the loans they withdrew from their savings groups since the program began. Some, like Assan, have paid for health costs. Others have used their loans from the general fund to start or expand their businesses. Aicha S. from Bandiagara Coura used her loan to build on her already-successful small business selling earrings. She put the funding toward expanding her collection to include beads, necklaces, bracelets, and makeup kits. With the extra money she has earned from her new products, she paid back her loan within a month and now is earning more than ever.
Health Savings drew its first cycle to a close earlier this year, and group members and non-members alike made it clear they wanted a second cycle to begin immediately. Over 130 women participated in the first round. Between them, they withdrew nearly 75 loans, 17 of which directly subsidized health care costs. Over the course of the first cycle, group members learned not only about managing their money, but also about the importance of seeking early treatment for their illnesses, how to recognize danger signs in children, and what a woman can do to ensure she has a healthy pregnancy.
With International Women’s Day this month (it was March 8th this year), we are reminded of how much power women possess to be change agents in their communities. The health and education of women has a direct and irrefutable impact on the wellbeing of their children, and thus on the future of the entire community. Through Action for Health, we are ensuring that mothers receive the care and education they need so that they can keep their families healthy. And through Health Savings, we will help those same women to build the independence they need not only to support their families, but to have the power and resources to shape and change their communities for the better.
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