World Health Day is 7 April, with a theme of ‘healthy beginnings, hopeful futures’ and a focus on maternal and newborn health. Opportunity’s Health Finance initiative, in partnership with Uplift Mutuals, is supporting better maternal and child health by filling an unmet need for healthcare financing for women like Shweta and Manisha in urban slums in Mumbai and Pune, in India.

While all women should be able to focus the joy of the birth of their child, women living in poverty instead face the stress of not being able to meet the costs of essential prenatal care, a safe childbirth and infant care.

Care for every mother and baby

Every woman and baby needs access to high quality care, in order to survive and thrive – including getting all of the necessary prenatal check-ups, a safe birth in a facility, postnatal checkups, infant care and vaccinations. But for many women living below the poverty line these services are out of reach, or difficult to navigate.

Banks won’t lend to migrant workers living in urban slums, most of whom work in the informal sector, without a paycheck. Informal lenders charge exorbitant interest rates of up to 200 per cent per annum – keeping low-income women stuck in debt traps just to afford the cost of a safe birth. Microfinance organisations won’t usually lend to a woman once they know she is pregnant, as they see it as too risky.

Health finance developed by the community, for the community

The Health Finance project provides affordable health insurance, ‘maternity wallet’ savings accounts and emergency medical loans, as well as pop-up outpatient clinics, with a strong focus on women’s health.

Low-income families including women, people with disabilities and elderly people were consulted and helped to develop the products to meet their needs.

Early results from the project are promising. We have seen an increase in access to health finance for women, with 72 per cent of emergency medical loans made to women, and 100 per cent of maternity wallets being taken up by women. A third of all emergency medical loans were used by women to fund facility-based deliveries with a skilled attendant – supporting a safe birth and improved health outcomes for mothers and babies.

Pop-up clinics and care navigation support

Pop-up clinics held in the community provide free appointments to members, and affordable appointments to women and families in the community, including antenatal checkups, as well as low-cost essential medicines and referrals, helping to keep women and their babies healthy. A 24/7 teleconsultation service is also available to all health finance clients. Staff of our local partner, Uplift, also work with local hospitals and clinics to keep costs down for low-income mothers. And they help people to navigate the health system, as well as accessing any government entitlements they’re eligible for, to keep costs down.

Building women’s health and financial literacy

Health Finance field staff also play a crucial role in building women’s financial literacy and helping them avoid huge medical costs that could plunge them back into poverty. For women who are expecting, or have recently had a child, health finance officers like Jayshree (above) conduct three household visits, helping to educate them on the importance of saving for childbirth and health costs for their children after birth. They walk women through the costs they can expect, and how much they need to save, and put together a savings plan.

Many low-income families are very familiar with loans and are used to relying on loans for their business and household needs, as well as health expenses.

By fostering financial literacy, the project aims to encourage women to save and take out insurance to reduce their vulnerability to catastrophic health costs and recurring debt traps.

Healthy savings for baby Prishan’s future

Prishan is only five months old, and her mother Shweta is already saving for her baby’s health needs and education thanks to a ‘maternity wallet’ savings account with Opportunity’s local partner Uplift.  

Despite some complications with the birth, Prishan was healthy when she was born. But Shweta knows the importance of saving for the future, and any of Prishan’s health needs in the coming years.

“If any emergency comes, any needs come, it’s important to have savings,” said Shweta. Without savings, many low-income women like Shweta need to take out loans at high interest rates to fund any unexpected health expenses.

To ensure the money she deposits in the maternity wallet savings account is reserved for her daughters, Shweta has chosen to keep the account private for now. Shweta is determined that her daughters will both have a decent education, and her husband also supports their daughters’ education.

A maternity loan supported Manisha’s choice of care 

Manisha, 24, and her husband, living in a slum in Mumbai, faced financial challenges when expecting their second child in September 2024. They chose to deliver the baby in her home village of Parbani, Maharashtra, where they had family support and more space. However, the cost of her antenatal care and delivery, including travel to a private hospital two hours away, came to INR 50,000 (around A$930). To help cover these expenses, Manisha took out a maternity loan of INR 25,000 (A$464). 

“The loan gave me peace of mind during my delivery,” said Manisha. “I could spend my pregnancy in the village and deliver at the hospital of my choice. Otherwise, I would have had to spend my pregnancy in Mumbai’s overcrowded slum in unhygienic conditions." The financial support allowed her to prioritise her health and comfort while ensuring a safe delivery without the strain of financial concerns.

Together maternity wallets, affordable health loans and health mutuals insurance are ensuring more women and babies get a healthy start and are able to thrive.

Learn more about Opportunity’s Health work here.