Global Digital Health Network May Deep Dive: Practical Strategies for Implementing Digital Financial Services
The Global Digital Health Network (the Network) held its first deep-dive of the year on May 4: A Workshop in Practical Strategies for Implementing Digital Financial Services. The growth in digital financial services (DFS), such as mobile money, opens up opportunities for new and innovative solutions in development. The half-day session focused on both why mobile money integration is an important opportunity for global health, as well as practical information on how to integrate mobile money. It included expert presentations (click here for the full recorded session) and in-person breakout sessions focused on training needs for DFS integration. The workshop was hosted by USAID, the Network and K4Health; for additional information, please reach out to co-developers Sherri Haas (firstname.lastname@example.org) and Pam Riley (email@example.com).
USAID - Global Health and Digital Finance
The meeting was opened by Adele Waugaman, Senior Advisor for Digital Health of USAID’s Global Health Bureau. She emphasized the tremendous room for growth in the strategic use of DFS in global health programming, including the opportunity to increase transparency, improve efficiencies, and strengthen the outcomes of global health programs.
Fernando Maldonado, Team Lead for the USAID Global Development Lab, Digital Financial team, highlighted their approach to accelerating digital finance: 1) fostering an enabling environment, 2) encouraging institutions to digitize payments, and 3) harnessing DFS to achieve development outcomes across sectors. He noted the USAID Procurement Executive Bulletin 2014-06, which promotes use of electronic payments under USAID-supported programs and comes out of the agency’s commitment to the Better than Cash Alliance. The DFS team works to “identify and advance market opportunities through partnership and alliance building, USAID mission engagement, and training and capacity-building of USAID staff and implementing partners.” Areas enabled by digital finance include payments, savings, lending and insurance. Emphasizing the opportunity to utilize DFS, Maldonado noted that 19 countries now have more mobile money accounts than bank accounts and 37 countries have more mobile money agents than bank tellers. Despite this growth, there remain challenges and barriers to entry. USAID supports programs in digital finance and to advance the digital finance space. For example, during the Ebola crisis, health workers were paid via mobile, reducing trips to the bank and saving 800 “health worker hours” in Sierra Leone. e-Payments are a foundational service and an entry point on which value-added services can be built. Maldonado said that integrating mobile payments into programs is the next frontier. Digital finance is “sector agnostic” and there are broad reaches to creating an ecosystem with business opportunities including catalyzing public/private sector investments.
Positive Externalities and Opportunities from DFS
The second presentation was given by Lauren Braniff from CGAP, a research center housed at the World Bank and funded by over 30 development organizations working toward financial inclusion. They define themselves as a “frontier group”, pushing the envelope in areas like digital finance. The Digital Finance Plus program looks at how digital finance can support innovative solutions to some of the most pressing challenges in development. Lauren cited some impressive statistics: mobile money is available in two-thirds of LMICs and there are 227 million mobile money accounts in Sub-Saharan Africa - more than there are bank accounts. The largest growth market is SouthEast Asia, which accounted for 40% of new mobile money accounts in 2016. Mobile money use is growing from simple transactions to robust digital financial services such as credit for customers who previously did not have access to formal loans. These are starting to have a huge impact, and access to mobile money has been shown to improve household’s ability to get through crises - which is the type of financial protection we also look for in global health.
CGAP is looking at how mobile money can enable access to services in new ways, such as in pay-as-you-go energy. Rather than a household needing to afford the full cost of a system up front, a base amount is paid at installation, with small payments made via mobile money over time. A remote lockout technology can turn off the lights in cases of non-payment, resulting in high rates of compliance. Now over a million homes electrified through this program. Lauren gave another example in the education sector where digitized payments for school fees and teacher salaries which are leading to increased revenue collection and improved transparency and efficiency for schools. Mobile money is expanding in many areas and creating a new ecosystem for customers who are now tapping into these services and increasing their level of comfort and ease with digital finance. Health experts can look for opportunities to digitize payments, as well as to really get creative with new partnerships and business models.
Integrating DFS in Programing
Shelly Spencer and Mandana Nakhai next presented NetHope tools and support for implementing partners transitioning from cash to digital payments. NetHope is a membership-based organization with over 50 non-profit members which joins them with technology innovators worldwide. The USAID-funded NetHope Payment Innovations Project focuses on innovative technologies such as low cost point-of-service terminals, mobile money transfer and mobile financial services, and promotes adoption of digital payments to scale the digital marketplace. The NetHope ePayment Toolkit - Making the Journey from Cash to Electronic Payments - is a practical guide for organizations looking to transition from cash payments and integrate DFS into their programs. The 10-step toolkit includes user templates, analysis tools, assessment tools, user stories from implementations and best practices guides.
NetHope also provides a thorough 2-week training on DFS integration - USAID implementing partners in Ghana, Rwanda, Malawi, Zimbabwe and Cambodia have received this training. The NetHope team gave a examples of how implementing partners are transitioning to ePayments through programs like health savings credit cards, food security programs and in purchasing health supplies. They also discussed a new method being tried in Rwanda to conduct centralized negotiations across implementing partners with mobile financial service providers, in order to access best pricing and service.
Adapting for Local Context
Katie Highet from FHI360, introduced the USAID-funded mStar project, which supports the adoption of digital technologies to increase development outcomes, and works in three areas: digital financial services, digital inclusion, and digital information. To focus the workshop on key issues of end-user implementation, Katie centered the discussion on work and resources from her experience with the GSMA Connected Women team. The work in Fiji and Papua New Guinea explored women’s use of mobile update in the region and looked at barriers to services, of which one of the key barriers was digital literacy. They build a digital literacy toolkit, the GSMA Mobile Technical Literacy Toolkit and Adaptation Framework, to help women understand the value of their mobile phone. As with any quality training, it is key to adapt materials for local context, to create materials and approaches which resonate with the specific end users targeted.
Some of the insights important to consider when planning and implementing end-user training for digital finance solutions include: 1) Don’t assume anything - go deep into your market to learn about your audience; 2) Understand where you are and where you want to go - create a digital literacy journey; 3) Be very cognizant of customization/adaptation to support what the audience needs - iterate and adapt as often as possible; and 4) Partner - the more vested stakeholders the better. An important aspect to success is understanding the value proposition for the audience and respecting the cultural norms, in this case, understanding how women access and share information.
There are a number of resources available on digital financial services, including some specific to mobile money for global health. For profiles of example activities and opportunities of DFS for health, resources include the finance profiles of the mHealth Compendium and Database created under the African Strategies for Health project and the Mobile Money for Health Case Study Compendium and Mobile Money for Health white paper under the HFG project.
Also mentioned by the speakers above:
Making the Journey from Cash to Electronic Payments - This 10-step toolkit include links to additional resources, guides, and examples for the various steps.
Mobile Technical Literacy Toolkit and Toolkit Adaption Framework - Tools and process for adapting resources based on context to enable and increase the uptake of mobile technology.