A few months ago, I wrote a post discussing the advantages and drawbacks of financial institutions offering their clients healthcare services. Throughout the course of the past few months, my time spent working in ProMujer’s office has afforded me the opportunity to gain a deeper understanding of clients’ healthcare needs and the services provided to them by ProMujer. A recent conversation with Ruth Apaza, the supervisor of all nurses in the El Alto region, shed light on ProMujer’s healthcare services: why it’s an important part of their model, how they work with the women, and the challenges they face.
(Note: the following replies have been translated and paraphrased based on an interview with Ruth Apaza, Supervisor of Nurses, El Alto region)
Ruth Apaza, supervisor of nurses in the El Alto region (right), and two of the nurses from the neighborhood center Juan Pablo II
The nurses of Juan Pablo II working hard.
Why does ProMujer offer healthcare services to its clients?
ProMujer’s mission is to serve women with limited resources and one of the things these women need most is access healthcare. Many of them simply aren’t able to pay the fee for regular doctor’s visits, so ProMujer has decided to offer them certain healthcare services for a reduced price.
Why is healthcare an important part of ProMujer’s model? What other options do women have?
The healthcare services provided by ProMujer have proven to be extremely important particularly with regards to the detection of cancer. One of the main services they offer is a pap smear for all their clients, and in a number of cases, women were found to have tumors that were subsequently treated. ProMujer also, through their insurance program, assist the women in paying for any treatment they may need.
What does ProMujer focus on in the workshops they offer during Communal Banks’ monthly meetings?
They focus on prevention of diseases such as diarrhea, general information about nutrition, and education about the importance of vaccinations. In addition, ProMujer, in conjunction with the Ministry of Health, offers free vaccines for all children of ProMujer’s clients.
Posters such as this one decorate the walls of each of ProMujer's 12 neighborhood centers. They explain how the organization strives to help clients take care of their families through a variety of trainings and services.
What are the greatest challenges with offering healthcare and how is ProMujer addressing them?
The greatest challenge faced by the healthcare professionals is getting the majority of women to take advantage of the services offered. Many of the clients come to the neighborhood centers to pay off their loans, but because of busy schedules are not able to stay longer. The healthcare staff is currently working closely with ProMujer’s Loan Officers to create a strategy for increasing participation.
They have also launched a program called “Promoters of Well-Being” through which one member of each Communal Bank (typically, the president) participates in a mandatory training in basic health and is subsequently responsible for the health of the other members of the bank. If, for example, a group member is suffering from a minor health complication, the Promoter of Well-Being can assist her; if she suffers from something more major, she can advise her on where to seek help. The idea behind this participatory approach is that the individual women are more likely to come to one of their fellow bank members with their health concerns, and thus ProMujer is able to reach more of its clients.
Although I still have my doubts that healthcare and microfinance should go hand-in-hand in the long term, my time with ProMujer has convinced me of the importance of Microfinance Institutions (MFIs) addressing issues beyond the financial needs of the poor people they aim to serve. ProMujer is a not-for-profit organization with a social mission and distinguishes itself from for-profit financial institutions by prioritizing the social needs of its clients. Ideally, as clients graduate from the services offered by MFIs to more traditional banking options, they will simultaneously find themselves in a situation where they can afford doctor’s visits and medication for their families. But until that goal is reached, ProMujer provides an invaluable service to its clients, based on an observed need in the communities it operates.
Julie Shea is a Kiva Fellow in Bolivia working with three of Kiva’s field partners: ProMujer, CIDRE, and Emprender.
