Mali Health Organizing Project Health Savings Program Supporting

In This Report
INTRODUCTION
Letter from the Executive Director
Our Vision and Values
Programs and IMPACT
Action For Health
Health Savings
Health Radio
Clinic & Maternity
Advancing the Story
OUR MISSION:
1
2
3
4
5
6
7
FINANCE and LEADERSHIP
Finances
Staff & Board
Partners & Supporters
CONTACT
Mali Health Organizing Project
PO Box 426081
Cambridge, MA 02142
www.malihealth.org
[email protected]
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11
12
Mali Health’s mission is to reduce maternal and child mortality
in resource-poor communities in West Africa. To achieve this,
Mali Health implements replicable programs that improve access
to quality primary care at low costs, while increasing the
capacity of and participation in local health systems.
Dear Friends & Colleagues
Mali Health’s sixth full year has been a successful one, thanks to ongoing support at all levels. In 2013, our programs reached more people than ever before,
as we began expanding our geographic footprint. We launched a renewed strategy, realigning with the evolving needs of the communities we serve and
informed both by our successes and by the challenges of the past several years. Most importantly, we identified those areas where we can make the greatest
impact in the lives of others.
We’re targeting programs that can have an impact at each stage of the healthcare delivery process – from health financing for women to community education
initiatives to improving the training of staff and quality of service at local clinics. We’re putting additional efforts into efficient operations and transparency. We’re
investing in local staff capacity, ensuring our small workforce on the ground is an exemplar of possibility.
One success is our new Health Savings program, where collectives of women save money into small village banking accounts, assuring access for financing
both economic activity and health expenses (p. 4). Another success is the reduction in per-visit costs for those children enrolled in our program (p. 3). By
contracting with medical management teams, standardizing treatments, and providing training for staff, the average clinical cost has been reduced 25%, from
$12.51 to $9.47. The average medical costs per month per child enrolled in the program also decreased by one third.
Our achievements last year were set against an evolving backdrop of war and peace. Rebels threated the capital city, an international military response
intervened, and democracy was eventually restored, giving hope for a brighter future in Mali. Despite the turbulence of the last two years our budget and
revenue have both grown by 40% (p. 10).
Mali Health remains in a strong position as a service provider and as an
innovator in the field of global health and development. As we expand our reach
and impact, what gives me the most confidence is the progress I see in our
organization every day. From working with our dedicated team on the ground,
communicating with our passionate supporters around the world, or watching our
model make a difference in the lives of so many, I can see our mission in action
and our role in facing the greater challenges in maternal and child health. Our
best days and deepest impact remain ahead of us.
Thank you,
Kris Ansin, Executive Director
PS - In 2014 we have begun distributing monthly program
reports - sign up here. You can also sign up for our newsletter
and visit our blog. If you have more questions about our
work, how funds are used, or have suggestions, I invite you
to contact us directly at [email protected].
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OUR VISION & VALUES
We envision a world where health systems can meet the
basic needs of the poor and eliminate preventable death,
effectively treat disease and enhance self-efficacy and
dignity for mothers and children.
For six years, Mali Health has worked with communities on the
outskirts of Bamako to improve health outcomes for women
and children through a partnership with residents, local staff,
government officials and grassroots donors. Our track record
of cost-effective results through community-driven, culturally
appropriate, and sustainable approaches serves as an effective
development model for other communities. As we prepare to
expand our reach in 2014, we remain committed to our core values:
î
We work to overcome barriers in the workplace, in the field, and
in the cultural and political landscapes, achieving success through
unremitting dedication.
î
We invest in local resource development, particularly
among our staff and field workers.
î
We hold ourselves accountable for measurable results,
including financial performance.
î
We leverage innovation, addressing existing causes of poor
health through new frameworks.
î
We empower the poor, particularly women, as a catalyst and
complement for lasting change.
î
We concentrate on supporting marginalized populations,
expanding the zones of social and financial inclusion.
Meet Mariam
Programs Director Mariam Fofana Diallo joined
Mali Health’s staff in July of 2013, bringing her
wealth of experience from international NGOs and
government organizations throughout West Africa
to lead our programs in their next stage of growth.
Though Mariam has worked for many projects,
she feels that Mali Health’s cause is particularly
near to her heart:
“To be part of this team that is working tirelessly, and
in conditions that are never ideal, to do what is vital:
saving lives, providing dignity and empowerment, and giving
hope to people forgotten by the health system.”
Read more of Mariam’s story here.
2
ACTION FOR HEALTH
Focused on the poorest residents in one of the poorest
communities in Bamako, Action for Health is working to
change health attitudes, behaviors, and outcomes at the
community level.
1,858
children covered
900
mothers receiving
prenatal care
The most vulnerable families in the community receive
lifesaving, basic healthcare for pregnant women and
children under 5 – those most at risk of dying from common
and preventable diseases like malaria, diarrhea, respiratory
infections, and malnutrition.
Community health workers make regular visits to enrolled
families, checking on the vitals of children and expecting
women and providing health education on disease
prevention and early care seeking. These community
health workers serve as a vital bridge between the most
disadvantaged citizens and the national health system,
providing a link to the most vulnerable and marginalized.
However, Action for Health provides families with more
than health services and care – it helps to preserve the
dignity of recipients. Enrollees are active participants in their
health and the health of their families. Mali Health provides
support where needed, but helps empower families to take
charge of their own health care. The result – families who
may before have felt powerless in the face of illness proudly
watch as their children develop into healthy, thriving future
leaders of their community.
“Without Mali Health, I don’t think my second child would have
celebrated her 2nd birthday. She had chronic malaria and fell sick
often. But each time she got sick, Mali Health took care of her.”
Ouleymatou Koné, mother of three
30,421
home visits
57% increase from
2012
30 hrs
between onset and
treatment
$9.47
Per clinic visit
Down 24% from
$12.51 in 2012
99.5%
survival rate
compared to 87%
nationally
3
HEALTH SAVINGS
Through Health Savings, women build the financial
independence and savvy they need not only to support their
families, and gain the power and resources to change their
communities for the better.
Health Savings seeks to improve Mali Health’s
sustainability by empowering families to provide for
their own health costs through an innovative group
savings plan. When the pilot program in closed it’s
first cycle in 2013, participants and those wishing
to participate asked that a second round begin
immediately. Mali Health is pleased to count Health
Savings as our newest full program.
“Participation in this group has truly served me well. I have
access to funds to develop my business and I have less
pressure while in charge of my family because I know that
in case of illness I can at least access first aid. The group
has also helped to foster agreement between us women,
which allows us to unite for a common cause.”
- Assan Tapily, Savings for Health participant
The women in Mali Health’s Health Savings groups
come together come together weekly to learn about
preventive health care and financial management.
These women also deposit small amounts of money
into two collective accounts. In the first, members draw
loans to support revenue-generating activities, such
as starting a small business. From the second, women
access no-interest loans in order to cover health costs
at the local clinic. At the end of a cycle, women are
returned their savings, along with the dividend through
interest earned, and encouraged to make good on initial
commitments to allocate savings to preventive health
products.
133
women saving
in 6 groups
50
loans taken out, 13
to directly finance
healthcare
100%
of loans repaid
Over the course of the first cycle, group members
learned not only about managing their money, but
also about the importance of seeking early treatment
for their illnesses, how to recognize danger signs in
children, and what a woman can do to ensure she has a
healthy pregnancy.
4
HEALTH RADIO
Mali Health’s Radio Program and it’s related listener groups serve
not only to disseminate health education to the larger community,
but to create awareness of health issues facing disenfranchised
communities and to spark dialogue and action.
Communication is at the core of Mali Health’s work in
the community and health radio is a vital tool to reach
residents and families on a large scale. This year, in
partnership with Oxfam Great Britain’s Health Policy
Action Fund, we reached community members on a
wide range of health issues including the prevention,
symptoms, and treatment of diseases like malaria,
diarrhea, respiratory infections and typhoid fever.
We also focused on the structure and functioning of the
health system in Mali and how citizens can make their
voices heard in their local community health clinics.
Finally, we were able to respond to the crisis in Mali, by
branching out and discussing the responsibilities and
rights of citizens in a democracy, especially as it pertains
to health.
“We have really begun to understand a lot of health issues
and interventions that, before, we were just unaware of or
didn’t think about. Even looking around our courtyard I can
see the difference Sigida Joli [Mali Health’s radio show]
has made for us – everything is clean and ordered now
because we know that sanitation is an important way to
prevent diseases like malaria and respiratory disease.”
- Kadia Traoré, local woman and Mali Health radio listener
After launching a discussion of the health system
among it’s listener groups, Mali Health’s reached out
to three local women’s groups and this collaboration
led to a report detailing a road map to improve the
healthcare system for the commune as a whole. On
November 14th, a public forum hosted by Mali Health
present the report to 18 health organizations, including
several government agencies. As Public Affairs Manager
and long time Mali Health employee Adama Kouyate
said, the forum served, “to give a voice to the poor and
to launch discussions about barriers to universal access
to health services, something that is not addressed as
often as it should be.”
104
shows broadcast
on Bamako’s most
popular station
415
listener group
participants
3,500+
listeners
190%
Increase in health
topic knowledge
following a show
5
CLINIC & MATERNITY
Built in 2010 by Mali Health in partnership with local
officials and community members, the Sikoro clinic has
become a focal point of health advocacy and education
in the community. We’re committed to making it a model
for equal access to health.
Mali Health emphasizes access to care as a vital component of
empowering community members to take charge of their own health.
We continue to work in an advisory role to the clinic, providing
oversight and training to improve service and lower costs, thus
addressing the substantial barriers preventing the poor from seeking
early, potentially life-saving care.
In August, the clinic reached a new milestone: a dedicated maternity
ward opened it’s doors to a community that had identified this
need in a public meeting just 10 months prior. It was a joint effort
- with One Day’s Wages and Mali Health’s network of committed
donors providing funding alongside a successful local drive and
with equipment provided by the government health system and the
Malian Red Cross.
Clinic births have increased nearly 300% in over the past three
years and the dedicated maternity ward provides a space, not just
for private, sanitary birth conditions in the presence of a skilled
attendant, but for vital pre- and post-natal care and family planning
services.
The impact couldn’t be clearer: the clinic received nearly 8,000
visits this year, our highest count ever. More women attended their
recommended visits than ever before and more children were born
healthy, properly nourished and with a greater chance of survival.
Increased access: clinic visits on the rise
“As a woman, this maternity ward warms my heart and
makes me even more proud to work here at the clinic.”
- Ms. Adam Traoré, Head Nurse
Clinic visits per year
8,000
7,899
clinic visits
up 286% from 2010
$8.22
Avg Rx Cost
Down 30% from
$10.70 in January
588
vaccinations
for common childhood
diseases
449
prenatal visits
6,500
5,000
3,500
2010
530
2011
2012
2013
babies delivered
6
ADVANCING THE STORY
Mali Health prioritizes strategic programming, targeting the
areas where we can have the greatest impact, and continually
assessing our progress toward concrete goals.
In 2014, we will set out to achieve more than ever before, we will:
o
Expand our Health Savings Initiative
o
o
Move program services into two new peri-urban communities
o
Increase our use of evidence-based programming, with full reports in
2014 on Action for Health (with Brown University and Innovations for
Poverty Action), clinical improvements, and health savings
o
Widen our range of training workshops for clinical teams, including
rational prescription, obstetrics care, and Kaizen quality improvement
o
Develop and support local advocacy and organizing campaigns to
increase participation in and access to the public health system
Here’s how we measured up against last year’s
benchmarks:
þ
Construct a maternity ward and basic laboratory to support the
growing populations of Sikoro and Sourakabougou
þ
Support 2,000 children under 5, their mothers, and their
families through Action for Health’s program expansion,
launched at the end of 2012*
þ
Collect and share year-1 results of an external randomized
control evaluation with Brown University and Innovations for
Poverty Action on the effectiveness and efficacy of our model
of health care delivery
þ
Pilot innovative financing schemes, including the launch of
a Health Savings finance initiative and rational prescription
contracts to help families save for health care costs and
control against health shocks
þ
Expand our Action Training services and Radio Listener
Groups to reach additional populations
Develop a family planning initiative
*1,886 children enrolled in Action for Health as of December
31, 2013
7
FINANCES
Expenses Detail
In 2013, Mali Health generated nearly $345,000 in revenue, a 14% increase
– or $42,000 – compared to revenue accumulated in 2012. This growth
can be attributed to an increase in number and size of grants awarded
compared to previous years, as well as a low donor attrition rate. Our
overhead remained consistent with previous years – 83% of all funds directly
supported program activities, while the remainder of funds were divided
among administrative, development, and management activities both in Mali
and in the US.
We ended our year with just over $297,000 in expenses, creating a surplus
of almost $48,000. These expenditures supported Mali Health programming
and expenses for nearly 2,000 children under 5, financed the construction
of a maternity ward, and launched new programs in health financing and
quality improvement, among several other activities. As a result of yearlong
strategic planning efforts, our Action Training program was closed and
relevant activities were incorporated in other programs, and our Radio
Program was folded into a larger Department of Communications.
In 2014, Mali Health intends to maintain a balanced financial scorecard,
soliciting revenue from our grassroots network, major gifts, and institutional
awards.
Thank you for your ongoing commitment as the organization continues to
grow, achieving greater reach and impact through our community driven
models. We aim to maintain the highest levels of both transparency and
impact. We remain grateful for every dollar received, and remain honored to
serve in the role we do with the ongoing support of so many.
Management & General
6.5%
Fundraising
10.2%
Program Services
83.3%
Revenue by Source
Foundations
& Corporations
40.5%
Gifts in-kind, interest
& other income - 0.8%
Individuals
& Family
Foundations
58.7%
8
FINANCES
Statement of Financial Position
Statement of Activities
FY2013
FY2012
FY2011
$142,471
$189,324
$87,184
$75,172
$75,000
$51,037
Accounts Receivable
$128,564
$49,462
$57,612
Undeposited Funds
$16,131
$5,225
(unaudited)
Assets Cash and Cash equivalents
Savings
Employee Cash Advances or Loans
Security Deposit
Total
$300
$364,468
$4,543
Subcontractor Holding Account
$737
$5,280
$319,011
FY2013
FY2012
FY2011
Revenue Individual and family foundations
and Foundations and corporations
Support
$202,530
$174,632
$156,689
$139,571
$120,411
$93,164
$2,826
$10,331
$572
Total Public Revenue
and Support
$344,928
$305,374
$250,425
$247,515
$151,782
$142,137
Management
$16,230
$11,477
$10,363
Fundraising
$19,284
$10,672
$7,799
Administration
$14,110
$11,468
$4,941
$297,139
$185,399
$165,240
$47,789
$119,976
$85,213
$311,400
$195,833
$112,225
$359,189
$315,809
$203,264
(audited)
$1,830
Liabilities Liabilities
and
Accounts payable and accrued
Net Assets expenses
Total Liabilities
(audited)
$195,833
$3,203
(unaudited)
Gifts in-kind, interest, and other
income
Expenses Program services
Total Expenses and Losses
Net Assets, beginning of Year
Net Assets
Temporarily restricted
Total net assets
Total Liabilities and
Net Assets
(audited)
$3,203
Increase in Net Assets
Unrestricted: Undesignated
(audited)
$24,897
$238,386
$189,336
$139,571
$80,624
$6,497
$359,188
$315,807
$195,833
$364,468
$319,011
$195,833
Net Assets,
end of year
9
FINANCES
Statement Cash Flows
FY2013
FY2012
FY2011
$342,101
$299,841
$246,386
$2,826
$3,149
$955
$344,928
$302,990
$247,341
$247,515
$152,221
$142,136
Management and General
$30,340
$23,369
$18,163
Fundraising
$19,284
$11,833
$4,941
$0
$0
$0
Total supporting services
$49,624
$35,202
$23,104
Total expenses
$297,139
$187,423
$165,240
$47,789
$115,567
$82,101
Net Assets, Beginning of year
$311,400
$195,833
$113,732
Net Assets, End of year
$359,189
$311,400
$195,833
(unaudited)
Support Received from Donors and Grantors
and
Other
Revenue
Total Support and
Revenue
Expenses Program Services
(audited)
(audited)
Supporting Services
In kind expenses
Net Assets Increase in Net Assets
10
OUR STAFF
Kris Ansin, Executive Director
Mariam Fofana Diallo, Programs Director
Devon Golaszewski, Outgoing Programs Director
Diakaridia Traoré, Medical Advisor
Adama Kouyate, Communications and Public Affairs Manager
Djibril Traoré, Health Worker Coordinator
Dramane Diarra, Action Training Coordinator
Baba Bayoko, Project Izumi Coordinator
Matthew Schinske, Outgoing Operations Coordinator
Danielle Hull, Monitoring and Evaluation Coordinator
Oumar Coulibaly, Accountant and Bookkeeper
Kadiatou Savane, Radio Announcer
Abdoul Toure, Radio Announcer
Moutaph Togolo, Radio Announcer
Aissata Touré, Radio Assistant
Mariam Sissoko, Health Savings Assistant
Lauren Veverka, Operations Manager
Stephen Muse, Communications Manager
STAFF & BOARD
INTERNS & VOLUNTEERS
Board of Directors
Joseph Camardo, MD, Chair
Maureen Caulfield, MD, Vice Chair
Nathan Duckles, Treasurer
Erin Kitchell, Secretary
Kris Ansin
Christopher Bull, PhD
Caitlin Cohen
Marie-Claude Tanny
Jason Lee
George Lehner
Marc Mitchell, MD, MBA
Mamadou Niang
Joshua Spry
Jerry Zeldis, MD, PhD
MALI ADVISORY BOARD
Ben Aboubacar, MD
Sidiki Coulibaly
Yaye Danfakha, MD
Abdoul Diallo
Alpha Zancoura Doumbia
Mamadou Niaré
Saloum Soumaré
Boubakar Traore, MD
Mary Magdalene Togo, MD
Hannah Deegan
Amelia Angevine
Leah Kazar
Christine Le
Lindsay Newton
Laurie Ohlstein
Isabel Pett
Brown University Student Group
COMMUNITY HEALTH WORKERS
Mariam Ballo ▪ Oumou Camara ▪ Mariam Cisse ▪ Sokone Coulibaly ▪
Kadia Dembele ▪ Sidi Fane ▪ Fanta Goita ▪ Aminata Keita ▪ Agaichou
Maiga ▪ Mariam Samassekou ▪ Kadiatou Savané ▪ Sanata Sissoko ▪
Moustapha Togola ▪ Oumou Togola ▪ Gauanse Traore ▪ Malick Yalcoue
▪ Francis Baya ▪ Hawa Diarra ▪ Mariam Traore
IZUMI: Christine Soucko ▪ Ramata Traore ▪ Aminata Diarra ▪
Fatoumata Founé ▪ Coulibaly ▪ Adama Iro
11
OUR SUPPORTERS
William Smith
Joshua Spry
Jim Stork
Ann Strauss
Marie-Claude Tanny
Supporters: $100-$499
Corporations and Foundations
Leaders: $2,000-$4,999
Adopt a Doctor
Child Health Foundation
Conservation, Food and Health
Healthcare Business Women Association
of Canada
International Foundation
International Institute for Communication and
Development
Izumi Foundation
Fortress Investment Group
Girls Rights Project
Merck Partnership For Giving
One Day’s Wages
Oxfam Great Britain Health Policy Action Fund
Pew Charitabe Trusts
Pfizer Matching Gifts Program
Rinet Company
Rotary International Foundation
Smith S.H.A.R.E. Foundation
Betsey Ansin
Cherie Ansin and Costas Malapanis
Ken Ansin
George Lehner and Diana Day
Helen Ryan
Karl Schmidt
Sustainers: Monthly Donors
Souleymane Konate
Julia Scarborough
Helen Lindley
Kathleen Franklin
Lindsay Clarke
Jumay Chu
David Miller
Ross Borden
Denise Pearce
Helen Smith
Vistionaries: $5,000 and up
Ron Ansin
Isma and Cherif Benattia
Joseph and Linda Camardo
Michael and Maureen Caulfield
Tournelles Foundation
Nathan Duckles
Antoine and Emily Van Agtmael
Jerry Zeldis
Partners: $1,000-$1,999
Kristopher Ansin
Kym Craven and Rick Bailey
Erica Baird
Sunita Sheth and David Bayard
Tess Borden
Christopher Bull
Lucian Cohen
Bonita Falkner and Susan Shively
Jane and John Isaac
Eric Knight
Anne-Marie and Bill Nichols
Christie Paul
Harold Marder and Jewel Slesnick
Mary Slocum
Lawrence Stein
Matt Steinberg
Joel and Jan Wierenga
Michael Zucker
Sponsors: $500-$999
Christopher Barajas
Yulii Bogatyrenko
The Borden Family
Mark Borden
Gilbert Casellas
Alan and Bari Harlam
Kathleen Hull
Wes Wolf and Katie Hunt
Louis Kayitalire
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All Saints Episcopal Church
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The Sitemaker Site
Donna Camardo
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Julan Chu
Kent Chu
Philip Chu
Catherine Clodfelter
Caitlin Cohen
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Peter Connolly
Michael Conway
Michael Cox
Jim Craven
Neal Fenwick and Christina
Dann-Fenwick
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Kenneth Foon
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Jean Freedman and Jonathan Pollock
Christoph Frevel
Maureen Friar
David Summers and Linda
Golaszewski
Devon Golaszewski
Stephen Goldfinger
Gene Miller and Jenny HackforthJones
Christopher Hamblett
Brett Hardy
Donna Higgins
John House
Donald and Lynn Janklow
Robert Jensen
Elizabeth Kast
Dede Ketover
Glenn Kitchell
Holly Kortright
The Kraft Family
Adaline Kumar
Braden Kuo
Jason Lee
Charles Lindamood
Amy Lippincott
Jacob Lipton
John And Donna Looze
Judith Lorimer
Brian and Deanna Lurvey
Peter M Abrahamsen
Bernadette Maida
Peter and Carol Mailloux
Yai-Yai And Papou Malapanis
Lorene Marini
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Mary Mcmahon
William Mees
Shelby and Henry Miller
Deborah Mills-Scofield
Marc Mitchell
Douglas Ruby and Mary Beth Moore
Jeni Morrison
Alice Nadin
Diane Nardone
Mamadou Niang
Matt Nugent
Barbara J O’Connor
Amber Oberc
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Mr. and Mrs. Leonard Orzechowski
Suzanne and Ronald Pancrazi
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Li Qi
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Walter Roberts
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Mark Singer
Rhonda Singer
Brian Smith
Scott Smith
David Snider
Laurie Sonshein
Myles and Sarah Standish
Jeffrey Stomel
Phil Strazzulla
Kimberly Thacker
Jon Vance
Rishi Varma
Christopher Vojta
Dale Whetstone
Lauren Whetstone
Jessica White
George and Judy Wohreich
Stephen Wood
OUR PARTNERS
Conservation,
Food & Health
Friends: $1-$99
Marc Abanto
Andrea Abramowitz
Rachel Agee
Naa-Sakle Akuete
Meryl Allison
Ameya Ananth
Danny and Erin Anderson
Roos Anne
Ryan Ansin
Alberto Aran
Rebecca Arian
Ariel Avila
Alyssa Bailey
Garrett Bailey
Knox Bailey
Robert Bailey
Tracy Bailey
Jessica Baird
Cornel Ban
Anne Bang
Salimata Bangoura
Diane Barbarita
Christopher Barbour
Sharon Baron
Dawn Bartizal
Ashley Belyea
Anne Best
Daniel Bilar
THE
INTERNATIONAL
FOUNDATION
Anne Blazejack
David Blazquez
Lindsay Bonanno
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Deschamps
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Pia Digirolamo and Paul Mather
Cristina Disabatino
Kevin Disabatino
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OUR PARTNERS
continued
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