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Providing primary health care through integrated microfinance and health services in Latin America

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  • Geissler, Kimberley H.
  • Leatherman, Sheila

Abstract

The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic health needs, but challenges remain to ensure that health care provided is of reliable quality to predictably improve health outcomes over time.

Suggested Citation

  • Geissler, Kimberley H. & Leatherman, Sheila, 2015. "Providing primary health care through integrated microfinance and health services in Latin America," Social Science & Medicine, Elsevier, vol. 132(C), pages 30-37.
  • Handle: RePEc:eee:socmed:v:132:y:2015:i:c:p:30-37
    DOI: 10.1016/j.socscimed.2015.03.013
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    References listed on IDEAS

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    1. Imran Matin & David Hulme & Stuart Rutherford, 2002. "Finance for the poor: from microcredit to microfinancial services," Journal of International Development, John Wiley & Sons, Ltd., vol. 14(2), pages 273-294.
    2. Sheila Leatherman & Kimberley Geissler & Bobbi Gray & Megan Gash, 2013. "Health Financing: A New Role For Microfinance Institutions?," Journal of International Development, John Wiley & Sons, Ltd., vol. 25(7), pages 881-896, October.
    3. Kruk, Margaret Elizabeth & Porignon, Denis & Rockers, Peter C. & Van Lerberghe, Wim, 2010. "The contribution of primary care to health and health systems in low- and middle-income countries: A critical review of major primary care initiatives," Social Science & Medicine, Elsevier, vol. 70(6), pages 904-911, March.
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    Cited by:

    1. Icíar García-Pérez & María Ángeles Fernández-Izquierdo & María Jesús Muñoz-Torres, 2020. "Microfinance Institutions Fostering Sustainable Development by Region," Sustainability, MDPI, vol. 12(7), pages 1-23, March.
    2. Irene Jollystar & Francis F. Lyimo PhD, 2023. "The Contribution of Village Community Bank (VICOBA) on women empowerment in Shinyanga Municipality, Tanzania," International Journal of Research and Innovation in Social Science, International Journal of Research and Innovation in Social Science (IJRISS), vol. 7(5), pages 574-579, May.
    3. Bhuiya, Mohammad Monzur Morshed & Khanam, Rasheda & Rahman, Mohammad Mafizur & Nghiem, Hong Son, 2018. "The relationship between access to microfinance, health-seeking behaviour and health service uses: Evidence from Bangladesh," Economic Analysis and Policy, Elsevier, vol. 60(C), pages 9-17.

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