Tag Archives: mobile

Game on: Mobile + Money = Better Health


This morning I spoke at USAID’s MiniU on Global Health at George Washington University with Charley Johnson of the USAID Mobile Solutions Office, Dustin Gibson of Johns Hopkins, and Pamela Riley of Abt Associates.  The pearl?

1.7 billion people with access to a mobile phone have no bank account.  1 billion phone owners lack access to health care.  Game on: mobile + money = better health. 

The goal of the talk was to describe why I believe that mobile money will have a powerful impact on public health, from the perspective of my work at MEDA, where I support the organization in leveraging mobile across our 6 areas of focus – Savings, Youth, Rural Finance, Woman, Agriculture, and Health –  to make each area more efficient & effective in creating Business Solutions to Poverty.

Narrowing in on how mobile money can improve post-disaster resilience, I focused on Haiti, where a recent evaluation of non-conditional cash transfers after the earthquake found that mothers who received cash spent it on food, refrigeration, cooking, and health services, and therefore (we assume) were able to better stabilize the health and nutrition of their families.  However, this cash aid was rare and slow – after the earthquake, there simple was no way to move cash around the country due the lack of banking and transportation infrastructure, and Haitians were largely unable to receive either cash aid or remittances from family members abroad.

Understanding that the inability to transport cash around the country was one of the key hindrances to humanitarian relief efforts after the earthquake, the Gates Foundation and USAID turned to mobile money to ensure that these problems can be avoided in the future.  The resulting incentive grant, the Haiti Mobile Money Initiative (HMMI)  resulted in two mobile money products, T-Cash and TchoTcho Mobile.  The question now is, has it worked?

The good news is, yes, at least, it’s starting to.  The clearest example is the from only last month, when Hurricane Isaac made landfall near Port-au-Prince, where over 400,000 people still live in tents.  Digicel was able to send cash aid to 5000 mothers within 2 days of the hurricane, an unprecedented response time for distribution of cash aid, since the mobile money transfer via TchoTcho Mobile reduced the time and infrastructure needed to distribute cash.   We can assume that these mothers, like those after the earthquake, used this cash to maintain the nutrition and health of their families while rebuilding their homes yet again.  There are several other organizations using TchoTcho Mobile to a variety of humanitarian and development projects.

Moving from mobile transfers in post-disaster relief, I covered a different end of the mobile money spectrum:                       supply-chain management. MEDA has been working with the government of Tanzania since 2004 to prevent malaria infection through the distribution of Long Lasting Insecticidal-treated Nets (LLINs) through the Tanzania Net Voucher System, or TNVS.

The program uses vouchers to provide a sustainable and convenient way to partially subsidize the cost of the voucher to women, while still encouraging the habit of paying for bed nets, which increases the likelihood that bed nets will actually be used. Last year, TNVS switched from a paper voucher system to an e-voucher system, so that now beneficiaries receive the voucher to their mobile phone, and all transactions are monitored electronically.   In less than a year of implementation, the program has seen 3 key impacts:

  1. An estimated 30% savings in operation costs
  2. It is now possible to manage liability by having vouchers automatically expire after 60 days
  3. It is now possible to have real-time insight to the gaps in the supply chain, i.e. lack of demand for nets in certain areas or lack of supply in other areas, issues which keep vouchers from being redeemed. With the paper system, if a voucher wasn’t redeemed, there was no way to tell if the reason was on the supply or the demand side.

These are  only two of many examples of how mobile money can improve public health.  Other points that I appreciated from other panelists and audience members:

  1. The health sector is also a crucial way to promote the uptake of mobile money due to the size ot the sector in most countries.
  2. If health practitioners choose to design a program and need support from the mobile money operator, they need to sell the program based on the operator’s bottom line.
  3. In Kenya, the pilot run by John Hopkins and panelist Dustin Gibson to test using mobile money to incentivize vaccine uptake found that moms like mobile money more than airtime (in Kenya, where MPesa is ubiquitous) and that is important to involve husbands in order to increase uptake.

Where do you think the greatest potential is for mobile money to improve public health?


The Future of Mobile Money in Afghanistan


I was recently in Kabul to work with one of MEDA’s microfinance partners in Afghanistan, Mutahid.  In January 2012, Mutahid made a strategic decision to allow their clients to repay loans through M-Paisa, the mobile payments service offered by the largest telecom in the country, Roshan.   Although other banks in the country, including MEDA’s partner FNFB, allow their clients use M-Paisa for repayments, Mutahid is the only financial institution that has decided that this is the only acceptable method of payment.  The motivation is to have cashless branches, in order to avoid fraud and to give their loan officers more time to focus on credit management, rather than cash management.   In addition, Roshan received financial support specifically for this partnership by USAID’s program to Financial Access for Investing in Afghanistan (FAIDA).  Thus far, approximately 700 clients have repaid their loans at least once via M-Paisa.

While Mutahid is unique in the microfinance sector in Afghanistan for trying to use mobile money to move away from cash entirely, it is one of several partnerships that Roshan is pursuing to create demand for M-Paisa in the country.   M-Paisa is suffering  from the same challenges as many other mobile money deployments worldwide, including t lack of customer education and lack of a reliable agent network.  In addition, there are challenges more unique to the Afghan context, including extremely high levels of illiteracy, on-going instability in the country, and the legacy of the recent Kabul Bank crisis which has left most people with little to no trust in banks.  In Kenya, M-Pesa benefited from the fact that people trust the operator Safaricom more than banks; in Afghanistan, people seem to be even more skeptical of trusting a cell phone company with their money when the banks already failed to safeguard their deposits.

The Mutahid M-Paisa partnership is one small part of the larger transition towards a modern financial system, one of many major transitions occurring in Afghanistan (at the risk of stating the obvious and understating the extent of the ‘major transitions’ in the country.)

Two other major contributions are underway, which will define the electronic payments landscape in the years to come:

  1. The launch of at least 3 new mobile money services by the end of 2012, from each of the other MNOs in Afghanistan – Afghan Wireless, Etisalat, and MTN.
  1. The development of an electronic payments switch, funded by the World Bank and run by the Afghan Payment System (APS),  will allow for interoperability of cards and mobile payments.

Personally, I expect the latter development to be more significant in the long term, as it will modernize the entire financial sector and provide the basis for offering a variety of electronic payment services to Afghans, including debit cards, credit cards, and mobile financial services.

The launch of the 3 new mobile money services will help to bring competition to the mobile money sector, which should help to improve product offerings, agent professionalism, and customer service.  Unfortunately, all 3 new services look like they are also going to be modifications of the Kenya M-Pesa model, rather than innovative services grounded in the Afghan context.  It is also unclear whether these services would be launching without support from USAID, which questions their sustainability if the companies do not quickly gain a high volume of customers, or as the US government starts to withdraw support from the country.

One additional company to watch is Boloro.  Despite the challenges of being a small start-up competing with much larger companies, the product is thinking differently about how to stimulate customer uptake, and this could drive innovation in the market as a whole, as we have seen with third-party companies in other countries (for more this, see this blog post on Mobile Transactions in Zambia.)

Is Mobile Money Relevant to Refugees?


My first professional experience in the international development field was at the International Rescue Committee in Charlottesville, part-time while at the University of Virginia.  Working in a resettlement organization provided  me with a unique chance to interact closely with refugees from countries including Iraq, Uzbekistan, Burma, and the DRC, and to hear their incredible stories of fleeing terrible situations and eventually finding themselves in Charlottesville, a safe, comfortable place where they could send their kids to schools for free.   Of the many things I learned from this experience, there was one thing that struck me the most.  Despite the fact that many of these people had been professionals in their own countries before being forced to flee, they started out their new life in debt.  Unable to take any assets with them, they had no money or belongings – only a plane ticket to America which the US government asks them to repay, eventually.

Credit: IRC Charlottesville

Now, I know that resettlement is an incredibly complex issue and that there is a seemingly endless stream of challenges in dealing with refugee populations.  At the same time, this idea of loss of assets struck me as one challenge that we should be able counter, fairly simply, in our modern world where electronic money is becoming the norm.  I was so interested in this concept that I considered writing my Masters thesis on it; unfortunately, there simply wasn’t enough literature or activity in this area to do so, at the time – and this was just a few years ago.  Now, with mobile and electronic banking spreading throughout the developing world, and with organizations testing the use of new financial tools for a variety of development and humanitarian, purposes, I am excited about the possibility to revisit this topic.

There is a fair amount of work and interest being focused on how to use e-transfers – whether through mobile phones, ATM cards, or vouchers – to send people money quickly when a disaster hits (see this recent article which provides an overview on some of the projects being carried out by Concern Worldwide.) This is a great start.  However, from a resilience perspective, we have a lot more work to do to make sure that people can build assets over time and access these assets from anywhere.  In order to do this, there are are three steps that I see as critical, which cover the  financial education, regulatory environment, and quality of service.

First, people in vulnerable areas need to have a permanent account that they know how to use – voucher programs are a good initial step but do not provide this; therefore, we should be pushing to transition cash transfer programs from vouchers to accounts as quickly as possible (note: this applies to paper or mobile voucher programs.)

Second, regulations need to be in place that ensure that people can access their accounts even if they lose their official form of identification – this was a major issue after the earthquake in Haiti, and is true of many of the types of situations that create refugees in the first place.  Regulations and services also need to be in place in order to allow these accounts to be accessed in any country – in the current situation, I can access my Citibank account worldwide, but a Kenyan can only access their M-Pesa account in Kenya, which would leave them without access to those funds in a refugee situation where they were not able to return to Kenya, for any reason.

Thrid, people have to trust the organizations that provide these accounts, so they feel comfortable converting non-liquid assets, such as livestock, to electronic stored value.  While all individuals and households should make their own decision about how to diversify between liquid and non-liquid assets, it is important that they understand that only assets held in electronic form will be accessible to them in the event of a crisis where infrastructure is destroyed or where they cannot return home.

These are a few of the factors that I think are critical – I would love your thoughts on what else would be required to make mobile money relevant to refugees.