Community Health Facilitators distributing food.
One of India’s first responses to the COVID crisis was a strict lockdown from late March through May. During this period, government guidelines restricted movements, especially across jurisdictions. This in turn directly limited the ability of the staff of WPF’s partner, CASHPOR, to move across their operational area (rural areas of Eastern U.P, Madhya Pradesh/Bundelkhand, Chhattisgarh, Jharkhand and Bihar). However, since 2013, CASHPOR, has been recruiting and training up a subset of their members as “Community Health Facilitators” (CHFs). While the CASHPOR staff were not immediately able to travel from branch offices out to villages, the CHFs could support their own communities. Having received a full year of training to join the CHF program, these women were very well equipped to mobilize community resources and share information.
The CHFs’ actions started with explanation about Covid-19 and the basic precautions which should be taken to limit the disease’s spread. While CASHPOR’s staff reached out to clients through phone calls, CHFs reassured their local members that CASHPOR was mobilizing to support them. They were then able to distribute support such as masks, sanitizers and dry rations to members who needed them.
CHFs making masks.
By maintaining a visible role connecting the clients to the company during this period of uncertainty and instability, the CHFs also promoted a smooth transition back to regular operations as CASHPOR was able to phase back into activity. CASHPOR helped clients to withdraw government subsidies which had been deposited into Banking Correspondent accounts and CASHPOR disbursed emergency loans to those who needed it through bank transfer. In alignment with the RBI policies, CASHPOR has offered clients repayment moratoriums for up to six months for those who need it. Those capable of regular repayments have continued with confidence based on the comprehensive support they received. Center meetings were able to resume with proper social distancing precautions. Resumption of normal activities also means that CASHPOR is now providing fresh loans for clients who need capital to restart their income generating activities.
CHFs Renu & Usha assist CASHPOR’s Deputy Head Health at a health rally in 2019.
Like the CASHPOR staff, the CHFs are now back to their routine activities. This includes leveraging the weekly center meetings to lead groups of clients through a series of health modules. These modules cover topics such as health and nutrition, water and air borne diseases, pregnancy and first aid. In past visits to CASHPOR, I have been able to meet two particular CHFs, Renu and Usha (pictured at the top of this post). When I first met them in 2016, they had recently completed their one-year training period and they were delivering some of their very first health modules, teaching clients how to make an oral rehydration solution. When I met them again in 2019, they were leading an interactive community mapping exercise on sanitation.
As the CHFs stay with CASHPOR, they get the opportunity to take on increasing responsibilities. For example, they can promote social loans such as financing for toilets and solar lamps. CHFs can support the CASHPOR field staff by checking up on these loans. CHFs also monitor the local level work of CASHPOR’s Education Program, verifying that the community level tutoring for students is taking place in the CASHPOR Education Centers. For all these jobs – from teaching the health modules to customized community support, the CHF’s earn stipends from CASHPOR. And they can earn additional margins selling health products in their communities. This is a new and additional income stream for these clients. Equally important, their training and visibility cements their status as resources and leaders for their community.
Health expenses, especially sudden or unexpected ones can have devastating effects on poor households, wiping out savings or forcing clients to close down their businesses. The effects of the CHF program are multi-faceted. Center trainings lead by CHFs help CASHPOR clients reduce the incidence of preventable diseases. CHF promotion of products like toilets and health products (and CASHPOR’s ability to finance these assets for the clients) further supports family health. Lastly, by training village bank members as CHFs, these women have an additional opportunity to earn income. The more sessions they deliver and products they promote, the more clients are impacted and the more money they earn.
So far, CASHPOR reports that the CHF training program has contributed to a 30% increase in the application of tetanus injection in pregnant women as well as 50% increase in institutional deliveries.
CHF training.
At the end of March 2019, CASHPOR has a total of 2,993 CHFs. All together, they have delivered the health module curriculum to 393,190 members (almost half of active borrowers at that time). As of March 2020, CASHPOR has over 7,000 outstanding energy loans and over 70,000 outstanding water and sanitation loans!
CHFs distributing masks.
Whole Planet Foundation has partnered with CASHPOR in India since 2012, to date providing over $5.5 million in funds for CASHPOR’s loan portfolio. In September 2014, CASHPOR was selected as part of a special fund for High Impact Projects within our network. WPF’s High Impact Projects provided additional funding for strong partners to implement impactful projects that needed funding beyond WPF’s typical loan capital support. WPF granted CASHPOR just over $200k to train 825 members, as Community Health Facilitators. This investment had the goal of bringing the CHF program to the remaining 17 regions where CASHPOR was present but had not yet implemented the CHF program. At the end of the project period, CASHPOR had successfully trained over 1000 CHFs with WPF’s funding! This CHF program was originally launched between CASHPOR and The Healing Fields Foundation. Another collaborating partner is Opportunity International, who is now supporting replication of the CHF model with other interested MFIs in Indonesia.