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AXA shares insights on and solutions to women’s unmet insurance needs in emerging economies.

By Garance Wattez-Richard, Head of Emerging Customers, AXA Group

Women-focused insurance solutions are a central part of AXA’s Emerging Customers work. In our SHEforSHIELD report, launched with the International Finance Corporation in 2015, we found that the market is growing quickly, as women become more risk-aware and willing to invest in protection. We conducted focus groups with women in Indonesia, Nigeria, and the United Arab Emirates (UAE) and learned that women have very specific, yet unmet needs when it comes to insurance. I am happy to share the stories of three of the women we met on our customer insights journey, diving into their fears and desires and the role that inclusive, women-focused insurance solutions could play.

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> Posted by Amelia Kuklewicz, Bobbi Gray, Gabriela Salvador, Freedom from Hunger

It’s a scene many can identify with: rushing to an emergency room at 1 a.m. with a young child whose fever has spiked and cannot be controlled with over-the-counter medicine. We generally feel helpless and our mind leaps into worst-case scenarios.

While we’re considering the financial implications, they are secondary to ensuring our loved one receives immediate medical attention.

For many of us with health insurance, we already know what the visit is likely to cost us but we’re still mentally considering what financial resources we’re going to draw on to cover the emergency room co-pay.

Now imagine you are a mother that lives in Ecuador. Since neither you nor your spouse has formal employment with a consistent salary, you are ineligible for state health insurance. Private health insurance is out of the question with monthly premiums in the hundreds of dollars. To top it off, the first question you receive from the attending nurse in reception isn’t about your child’s condition but rather, “Cash or credit?” Many people are known to die during triage, simply from the requirement of having to show payment up front.

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> Posted by Jeffrey Riecke, Senior Associate, CFI

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Typhoon Haiyan, one of the strongest tropical cyclones ever recorded, struck Southeast Asia in early November 2013, creating unspeakable devastation. In the Philippines alone, where the typhoon’s wrath was concentrated, over six thousand people lost their lives. One microfinance institution, ASA Philippines, sprang into action only a day after the typhoon hit, demonstrating not just microfinance’s social mission, but also how providers in the industry are evolving to support their clients through more than just credit.

Typhoon Haiyan affected 16 provinces where ASA Philippines had operations, spanning 72 branches and 104,708 active borrowers amounting to a loan portfolio of roughly 365 million Philippine Pesos (~US$7.5 million). Fast forward to the present, about two years later, ASA Philippines has almost a 99 percent collections rate and the institution is thriving. How did the institution manage this crisis? Hint: It wasn’t because of merciless collections practices.

The day after Haiyan hit, ASA Philippines’ president traveled to Tacloban, a city that was largely destroyed by the typhoon, to visit the local ASA Philippines office. For the staff, the president’s presence underlined the ambitious and important relief work ahead of them. Under normal operating circumstances, ASA Philippines’ offices are open 24/7, reflecting the institution’s motto of BWYC: Be with Your Clients. ASA Philippines works towards a culture of immediate response, during the typical day-to-day operations, and during times of tragedy. I recently spoke with a few ASA Philippines staff members and they drew a link between support for clients and client trust. Clients will remember the first person that helps them, I was told. This connection fosters trust and connection, which in turn supports efforts to repay loans.

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> Posted by Bobbi Gray, Research Director, Freedom from Hunger

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First of all, a disclaimer. I am by no means a mental health expert. Like many, I’ve had my own experiences which have led to interests into the causes and impacts of mental health issues as well as the coping mechanisms we might use when we or someone we know suffers from a mental illness.

It’s Mental Illness Awareness Week, as you might know, and it has reminded me of a conversation that Josh Goldstein, Vice President of Economic Citizenship and Disability Inclusion at the Center for Financial Inclusion at Accion, and I started a while back — a conversation that also led to an exchange of ideas on his blog post “Four Interventions to Help Victims of Trauma Find Hope and Dignity” in which he summarized his remarks at the 8th Annual PCAF Pan-African Psychotrauma Conference held in Nairobi, Kenya. (Josh’s full conference remarks can be found here.) During this conference, Josh tried to answer the question of whether microfinance institutions (MFIs) can help victims of trauma who suffer from mental health disorders, such as post-traumatic stress disorder (PTSD), to find hope and dignity through self-employment.

In his post, Josh suggests steps to be taken by our sector to be inclusive of those suffering from mental health disorders. In this post, I’ll address two of those steps:

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> Posted by Sonja Kelly, CFI, and Thierry van Bastelaer, Abt Associates, American University, and the Microinsurance Network

Even 10 years ago, most of us would never have thought that the words “insurance” and “low-income households in the developing world” would be heard in the same sentence. It would have been as strange as, say, hearing the words “really good coffee” and “Washington, D.C.” in the same sentence.

But times have changed. Thanks to tremendous innovation in product design, pricing, and distribution systems, insurance is increasingly affordable to low-income households that are looking for ways to protect themselves from daily risky events. We should take a few moments to stop and celebrate this development. (Pause for celebration.) Thank you.

At the same time, we should learn from the history of the broader financial inclusion field. It took many years for the majority of the field to admit that credit alone can’t meet all the financial needs of poor families. Hopefully the excitement over insurance will not similarly delay the realization that it alone can’t address all the financial protection needs of these families. A great variety of financial products is needed to address an even greater diversity of needs.

So, over a cup of really good coffee one afternoon in Washington, D.C., we sketched out a possible framework that articulates where insurance fits into the product spectrum for financial risk protection vis-a-vis savings and loans.¹

We thought of risk protection expenses along two axes: frequency and size, and plotted expenses on a 2×2 table (forgive our back-of-the-napkin scribble).

Financially inclusive products are best designed to finance risk management expenses in the top left and bottom right quadrants of the graph. High-frequency inexpensive outlays can, when accumulating over time, significantly disrupt the cash flows of low-income families. Similarly, low-frequency expensive payments can ruin years of carefully planned asset accumulation. Low-frequency and inexpensive events (bottom left) can usually be covered by cash, and high-frequency expensive events (top right) are usually beyond the reach of most financial inclusion products.

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> Posted by Bobbi Gray, Research Director, Freedom from Hunger

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While recent research indicates that access to and use of microcredit alone is not transformative for the average client served (see “Where Credit Is Due”), there has been very little discussion about the types of indicators being used to measure “transformation” in the ongoing debates. In fact, it seems that we all have accepted the general findings that microcredit has only had modest impacts on, along with other indicators of poverty and well-being, education, health, and social capital because the randomized controlled trials (RCTs) have said so. There needs to be greater thought and debate about the choices of indicators used to support these conclusions.

Freedom from Hunger over the past 20-plus years has integrated health with microfinance and helped build a body of knowledge indicating that microfinance plus health services can enhance health outcomes. In an ongoing partnership with the Microcredit Summit Campaign, supported by Johnson and Johnson, we have pilot-tested a series of health indicators that financial service providers (FSPs) can use to track client health outcomes. This pilot test was built on years of experience of evaluating health outcomes with our FSP partners, as well as on similar experiences of developing common tracking indicators in the health sector. We created a list of criteria to assess the types of indicators we felt would be meaningful to track—for individuals with and without health services – which included dimensions of feasibility, usability, and reliability. Initial results have been shared in several webinars with SEEP and the Social Performance Task Force.

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> Posted by Center Staff

Happy International Women’s Day! We hope you were able to partake in the worldwide celebration yesterday. If you missed out on the action, not to fear. Plenty of activities are still underway. And of course, acknowledging the achievements of women and advancing the movement for gender equality are practices best executed every day.

To spotlight the importance of financial inclusion for women, here’s a snapshot of recent research in this area. To follow are ways that you can join groups, including the United Nations and Grameen Foundation in getting involved.

In honor of International Women’s Day, last week Gallup shared global statistics on how women view their lives – graded on a 10-point scale from suffering to struggling to thriving. About a quarter of all women questioned view themselves as thriving, while the rest chose either struggling or suffering. The two areas cited most often as important for improving their lives were jobs and personal safety. While the latter is a shocking finding, this post starts with jobs, though ultimately we will see connections to personal safety as well. Global estimates pin men as almost twice as likely as women to be in full-time formal employment. In Mexico, for example, less than 50 percent of women are part of the labor force, compared to 85 percent of men.

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> Posted by Aissatou Diallo, Special Assistant to the CEO, BRAC USA

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For the three countries most affected by Ebola – Liberia, Sierra Leone, and Guinea – the impact of the disease on society came in waves. The first wave happened around March, after the virus was first confirmed in the region. It was characterized by denial, disbelief, and a general numbness. The second wave, in May, happened as the disease spread geographically with a corresponding increase in cases and deaths. During this time, people felt overwhelmed. Even though a lot of people still doubted that the disease existed, they knew something was wrong because people were getting sick and dying at an alarming rate. The third wave, in August, blew the lid wide open on shortcomings and vulnerabilities in the region as Ebola spun out of control. Health systems collapsed, schools closed, communities were quarantined, and supply chain systems broke down. People lived in fear.

These factors contributed to severe economic losses in the region, especially for actors in the informal economy (e.g. traders and farmers) who depend on moving freely to sell their goods at markets and have little financial flexibility or cushion to absorb a shock to the system.

I just returned from a five-week trip to Liberia. In the towns and villages I visited, people told me that August was characterized by bleakness and despair. Communities looked like ghost towns, social ties were weakened, and there were sick people dying on the streets because no hospitals or care facilities were available.

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> Posted by Bobbi Gray, Research and Evaluation Specialist, and Kathleen Stack, Vice President, Programs, Freedom from Hunger

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Recently, Dean Karlan published an article in the Stanford Social Innovation Review titled “The Next Stage of Financial Inclusion.” The key points of his article are that while non-profits led the way in developing microcredit for the poor and started the movement for financial inclusion, for-profit companies have increasingly found it worth their while to offer financial services for the base of the pyramid. The entrance of new players to the market, Karlan offers, is a testament to the success of the early microfinance-focused non-profits. However, Karlan suggests that non-profits still have an important role in continuing to innovate in the financial services space. We agree. This is particularly true for extending financial services to people that banks still consider unprofitable: “the too rural, the too poor and the too young.” We would add disabled populations and the “too old.”

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> Posted by Bobbi Gray, Research and Evaluation Specialist, Freedom from Hunger

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The day after the closing of the Microcredit Summit in Merida, Mexico, conference participants were also invited to join in a day-long discussion about integrating health with microfinance. Half of the day was spent discussing a set of health indicators that are currently being tested in India, Peru, and the Philippines as part of Freedom from Hunger and the Microcredit Summit Campaign’s Health and Microfinance Alliance. Alliance data from several participating institutions was presented, with the goal of the discussion to identify the most appropriate combination of indicators to track changes in client well-being over time and identify aspects of health that can be effectively addressed by financial service providers (FSPs).

The goal of these pilots is to provide the financial services industry with a set of standardized, comparable, relevant, and reliable health indicators that they can add to the existing poverty measurements they are using to assess the impacts of their services for clients. To be most effective, these indicators must also resonate for health sector actors to promote real, active collaboration and appreciation for our respective competencies in improving health outcomes.

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The views and opinions expressed on this blog, except where otherwise noted, are those of the authors and guest bloggers and do not necessarily reflect the views of the Center for Financial Inclusion or its affiliates.