Development with a Woman’s Touch

Human Development: Microfinance, Health and Women’s Empowerment

by | Oct 2, 2011

A group of Bolivian women sitting at a conference table--members of a at a Communal Bank Association.

Women at a Communal Bank Association meeting. Photo courtesy of Pro Mujer

Today, like every day, Adela Reyes, 56, gets up at five in the morning. She serves her family breakfast, prepares lunch, organizes the household, sends the kids off to school, and takes care of her 11-month old motherless grandson, her daughter having died in childbirth in home birth in an isolated rural community. Adela leaves the house at 8:30, carrying the baby on her back as she makes her way to the small business she runs: selling school utensils in a local market. As she walks, she does mental arithmetic: today, she is due to pay back a third of the loan she owes for her business.

For many, Adela is just one more of the thousands of poor women who live in Bolivia. Although the country has made some progress in poverty reduction, it is still the poorest country in South America, and recently surpassed Brazil as the continent’s most unequal country (as measured by the widely used Gini coefficient).

For others, Adela is an indigenous woman who received a fourth-grade education with a lot of difficulty. Of all countries in Latin America, Bolivia has the largest indigenous population (about 60%), a group of people with various mixed identities who rely on a private enterprise-based western economy, combined with indigenous spiritual values, bilingualism, and traditional customs including the use of traditional clothing.

For those who understand the world of microfinance, Adela is one out of the approximately 918,000 clients served by the microfinance system in Bolivia (as of December 2010), of which women participants constitute 58.57%. For many years now, Bolivia has been a world leader in microfinance.

In the health arena, on the other hand, Bolivia has consistently underperformed, coming in second worst only to Haiti on the American continent. Adela and her family are represented in these statistics, since for every 1,000 live births, fifty Bolivian children die before their first birthday (2008, ENDSA); for every 100,000 births, 310 women die in childbirth or shortly thereafter (2008, ENDSA); and average life expectancy for Bolivians is 65.4 years (2007, UNDP). The statistics have shown a tendency to improve, but Bolivia still lags far behind other Latin American countries.

Bolivia’s health system is fragmented, split between public health, with staterun hospitals and health centers; private medicine; and the social security system. The latter only covers one out of every four Bolivians, which means the rest need to use money out of pocket to pay for health care. Unfortunately, Adela is part of the group with no coverage.

In a sense, Adela represents each of these statistics. But to Pro Mujer, a social development organization, she is a strong, respected woman and president of her Communal Bank, a group of 20 to 30 women who have organized as an association to access credit. Adela began her business six years ago with a US$100 microcredit granted by Pro Mujer; in addition to Pro Mujer’s financial services, Adela also attends medical checkups with her children and grandson at the Pro Mujer agency, and she receives training in health, personal care and basic business skills. She is very proud of being the head of her household and counting on a business that has grown considerably in the past few years because of her effort.

Pro Mujer began its health services in 1998, with full coverage in all its offices. In the last two years, it is starting to bring these services to rural communities, where health care is precarious or nonexistent, and where cultural practices often rely heavily on herbal or animal-based remedies, as well as the use of rituals.

Women like Adela—whose struggles may be the same, a little bit better, or a little bit worse—are members (or clients) of Pro Mujer. Pro Mujer aggregates approximately 93,000 women in Bolivia and close to 212,000 women in the five countries where Pro Mujer operates—Argentina, Bolivia, Nicaragua, Mexico, and Peru. These women all share a common denominator: they are entrepreneurial women who live or have previously lived in precarious conditions; who suffer from social exclusion, limited access to health services, and limited sources of financing, because while they need capital to launch a business, very few financial institutions take the risk to lend under these circumstances. They are all brave women who fight for better days, who take care of their health, and who have started their own businesses to support their families.

For the last five years, Bolivia has had a populist government under the indigenous leadership of President Evo Morales, who has made considerable strides in public health, especially by giving economic incentives to make sure women use prenatal and postnatal services and take their children for regular checkups. But it is precisely because of this policy of incentives that the public health clinics are overloaded. The consequent long waits at public health clinics represent a costly loss of productive work time for women like Adela and other Pro Mujer clients, so they prefer not to use the public system. Since they are not wage workers, they do not have access to the social security system. Thus, they often become victims of an unregulated private health system that charges too much in relationship to their unstable income. The health services provided by Pro Mujer fill a niche with easy access to free, high-quality primary care.

It is far from easy to combine financial services with human development services, such as health care and business training. But this is the formula that Pro Mujer has applied succesfully for more than 20 years, working to empower women and in the process, benefit their families and communities.

A group of Bolivian women sitting at a conference table--members of a at a Communal Bank Association.

Women at a Communal Bank Association meeting. Photo courtesy of Pro Mujer

Desarollo con aroma de mujer

Microfinanzas, salud y empoderamiento de la mujer

By Gonzalo Alaiza

Hoy la señora Adela Reyes de 56 años, como todos los días, se levanta a las 5:00 de la mañana para preparar el almuerzo, organizar la casa, servir el desayuno, enviar a sus hijos a la escuela y atender a su nieto huérfano, pues su hija murió en el parto y desde entonces Adela se hizo cargo de él. Sale a las 8:30, cargando al bebé en la espalda, rumbo a su pequeño negocio, venta de material de escritorio, en un mercado local. Mientras camina realiza cálculos mentales, pues hoy debe pagar la tercera cuota de su préstamo.

Para muchos, Adela es una más de las miles de mujeres pobres que viven en Bolivia, si bien el país ha progresado en términos de reducción de la pobreza, aún es el más pobre de América del Sur y recientemente superó a Brasil por ser el país de mayor inequidad del continente (medido por el coeficiente Gini).

Para otros, Adela es una mujer indígena que con dificultad ha cursado hasta cuarto curso de primaria. De todos los países latinos, Bolivia cuenta con el mayor porcentaje de población indígena (aprox. 60%), quienes viven en identidades mixtas y variadas de una economía de tipo occidental basada en el emprendimiento privado, combinada con valores espirituales indígenas, bilingüismo, muchas costumbres tradicionales e incluso vestimenta típica.

Para los entendidos en microfinanzas, Adela es una más de los aproximadamente 918 mil clientes atendidos por el sistema microfinanciero de Bolivia a diciembre de 2010, de donde el 58,57% corresponde a la participación de mujeres. Bolivia se ha constituido por muchos años en pionera en el ámbito microfinanciero del mundo.

Los indicadores de salud estándar de Bolivia se encuentran persistentemente en el segundo peor lugar del continente americano, después de Haití. Adelay su familia ya son parte de las estadísticas, pues la mortalidad infantil es de 50 niños por 1.000 nacidos vivos, que mueren antes de alcanzar su primer cumpleaños (2008, ENDSA); la mortalidad materna se encuentra en 310 mujeres fallecidas en 100.000 partos (2008, ENDSA) y la expectativa de vida llega a 65.4 años (2007, PNUD).

El sistema de salud en Bolivia es aún fragmentado en tres grandes rubros: la salud pública, a través de atención en hospitales y centros de salud administrados por el Estado, la medicina privada y la seguridad social. Esta última solamente cubre aproximadamente el 25% de la población Boliviana, lo que deja a 3 de cada 4 Bolivianos en necesidad de recurrir a gastos del bolsillo para la atención de salud y Adela, desafortunadamente, es parte de este grupo.

¿Y quién es Adela en realidad? Para Pro Mujer, organización de desarrollo social, Adela es una mujer fuerte y respetada, Presidenta de su Banco Comunal (grupo de aproximadamente 20 a 30mujeres organizadas que se conocen entre ellas y se garantizan en forma mancomunada para acceder a un crédito); que ha iniciado su negocio hace seis años con un microcrédito de US$150 otorgado por Pro Mujer; que asiste con sus hijos y nieto periódicamente a sus controles médicos en consultorios ubicados en las mismos Centros Focales (agencias) de Pro Mujer; que recibe capacitación en temas de salud, cuidado personal y destrezas básicas en negocios; y que se halla muy orgullosa de ser padre y madre y de contar con un negocio que en los últimos años ha crecido en forma importante, gracias a su esfuerzo.

Mujeres como Adela, en mejor, igual o peor situación, son socias (clientes) de Pro Mujer. Son aproximadamente 93.000 mujeres en Bolivia y cerca de 212.000 en cinco países donde opera la organización (Argentina, Bolivia, Nicaragua, México y Perú). Todas ellas tienen un común denominador, son mujeres emprendedoras que viven o han vivido en condiciones precarias, que sufren exclusión de diversa índole, con poco acceso a servicios salud y limitadas fuentes de financiamiento, pues muchas de ellas necesitan capital para iniciar un negocio y muy pocas entidades corren el riesgo de aprobar un crédito en estas condiciones. Todas ellas son mujeres valerosas que luchan por tener días mejores, que procuran cuidar su salud y que han apostado por gestar uno o varios emprendimientos que les permite generar ingresos para el sostén de ellas y sus familias.

En los últimos 5 años, Bolivia cuenta con un gobierno populista bajo el liderazgo indígena de Evo Morales, que impuso avances en la atención de salud por el sistema público, especialmente dando incentivos económicos a mujeres por el uso de la atención prenatal, partos, servicios postnatales y control del niño sano. Justamente a raíz de esta política de incentivos, se nota una saturación en los centros públicos de atención. Es por eso que las mujeres típicamente clientes de Pro Mujer prefieren no utilizar el sistema público por el alto costo de oportunidad que les significan muchas horas de espera para la atención. Tampoco cuentan con Seguridad Social y son víctimas de un sistema de medicina privada poco regulado con altos costos para su precaria economía. En este nicho entra el servicio de salud de Pro Mujer, proveyendo atención primaria de alta calidad, sin costo en el punto de atención y fácil de acceso.

El combinar Servicios Financieros con Servicios de Desarrollo Humano (salud y capacitación) no es fácil, pero es la fórmula que Pro Mujer ha encontrado hace más de 20 años para posibilitar el desarrollo de la mujer y a través de ella el de su familia y su comunidad, llevando su misión a la práctica.

Fall 2011Volume XI, Number 1

Gonzalo Alaiza is the director of Pro Mujer in Bolivia. He received his BA in business administration from the Universidad Católica Boliviana and a Master’s in Business Finance, a degree obtained through the joint program between the Universidad Católica Boliviana and the Harvard Institute For International Development. Alaiza has more than 14 years of experience with the Bolivian finance system. For more information on Pro Mujer, see www.promujer.org.

Gonzalo Alaiza, es Licenciado en Administración de Empresas de la Universidad Católica Boliviana y Magister en Finanzas Empresariales, título obtenido en Maestrías para el Desarrollo dela Universidad Católica Boliviana en convenio con Harvard Institute For International Development. Gonzalo tiene más de catorce años de experiencia en el Sistema Financiero Boliviano. Actual Gerente General de Pro Mujer en Bolivia. www.promujer.org.

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