By: Melissa Menke, Access Afya

Take a walk around the Access Afya Kisii Village Clinic and you see women laughing together, men meeting in the street to talk about sports, and hear children playing, running through the small lane-ways together. You see so many colours: fruit hanging at local kiosks, the corrugated iron of houses and shops painted an array of bright blues, Safaricom greens and Coca-Cola reds. The other side of this is a community with no access to government services (including clean water, plumbing, rubbish removal, and street lighting), minimal health services, informal schools, and high levels of crime and unemployment. Now you also see the Access Afya micro-clinic, a friendly staff member available in the street-facing pharmacy shop and people stopping by for a chat as they purchase reproductive health pills, condoms or cough syrup. The mannequin dressed as a doctor draws onlookers, and childrenäó»s giggles, but also builds trust in the community. Access Afya is a friendly, accessible health clinic, the same size as its clientäó»s houses, mixing into the local environment. Just like the local vegetable man knows you like 3 sugars in your chai and your daughter likes soft bananas, Access Afya is a part of your routine. Outreaches include events after church and door-to-door information sharing. After youäó»ve seen a clinician they will call up to check on your progress. If your health issues arenäó»t resolved we offer complimentary follow-ups for the same issue. If you are referred to a local hospital you are still our patient. We care how your referral goes and ensure you understand your test results. Access Afya believes in improving health care for all. We run a healthy schools program, bringing health, sanitation and nutrition to local schools in the slum. Results from initial base-lining health checks of 100 students aged 3 - 8 showed 4 students were at school with pneumonia, over 25% were referred to the local clinic for more detailed health checks, including 11% with ringworm. While only anecdotal evidence so far we have seen energy levels improved, with previously withdrawn children coming out of their shell. This may be coincidence, or it may be due to the hand washing, health care, and nutrition interventions from Healthy Schools over the past month. That all sounds great, but what is a micro-clinic? Why does Access Afya think they can have an impact in informal settlements? Is there something wrong with hospitals and normal clinics? These are questions often posed to Access Afya. A recent article in Forbes has explored the area of äóÖMcDonaldäó»s style health careäó», and by this, we donäó»t mean offering fries with every visit. McDonaldäó»s have managed to franchise the burger and fries industry, ensuring across the globe if you visit a McDonaldäó»s you get the same service, clean toilets, and the trademark äóěWould you like fries with that?äóť value add offering. In a health setting this would mean accessible, technology driven locations focusing on standardized clinical protocols and pricing, customer service, centralized supply chains, continual staff training, and community education. While Forbes discusses the business case for franchised clinics in USA: äóěThe holy grail is a replicable Golden Arches-style model that puts a branded urgent care shop on every corneräóńand thatäó»s what smart money has been chasing in a long list of deals over the last few years.äóť, Access Afya is exploring a similar model in Kenya. Health care in Kenya is often a last resort. Hospitals are full, far from informal settlements, staff are often under-qualified and medicines are at risk of being fake, out of date, or out of stock. Access Afya micro-clinics are situated where the customer base lives äóń in the informal settlements. They are around 15 ft x 15 ft, offering a consultation room, laboratory for common tests, pharmacy, health and hygiene shop, and waiting room. This means we can get a branded clinic on every block, just like Safaricom or CocaCola has done in this market. By using a retail style community model for healthcare we save our clients time but also enable earlier care conversations. The retail clinic model needed to be adapted to the local market. This meant investing in outreach and community education. Outreaches in the community include deworming drives, family planning education and nutrition interventions. If we can reach the community at the onset of illness and foster positive health changes, their costs are lowered and preventative care can keep them out of the hospitals. Access Afya runs two micro-clinics in informal settlements in Nairobi, and plans to be a chain of eight clinics by the end of 2015.

References: http://www.forbes.com/sites/briansolomon/2014/07/02/drive-thru-health-care-how-mcdonalds-inspired-an-urgent-care-gold-rush/ http://www.newyorker.com/reporting/2012/08/13/120813fa_fact_gawande?currentPage=all

http://www.forbes.com/sites/stevedenning/2012/08/13/how-not-to-fix-us-health-care-copy-the-cheesecake-factory/

By: Wong Bi Ying, PlayMoolah

At PlayMoolah, we help young people build positive relationships to money, and through that, get in touch with the meaning and purpose of their lives. We do this by designing engaging experiences that empower young people with the clarity & confidence to make smart decisions. One way we do this is through our our life simulation app, WhyMoolah (www.whymoolah.com). It provides users with unique learning experiences that mimic real-life money decisions through a wide range of scenarios - from getting a first paycheck, to getting married and raising a family, all while balancing friendships and a healthy lifestyle. Phew! The app received a bunch of positive feedback, with users telling us how much it helped them recognise their bad money habits. One particularly insightful review came from Samantha, who wrote I’m studying now and currently mooching off my parents… this [app] really prompted me to understand how expensive life really is.” We were proud that we prompted our users to reflect on their money behaviours, but when we asked them what they were doing about it, it seemed that the answer was usually äóěnothingäóť. People told us that it was hard for them to hold themselves accountable for their lack of actions. After probing further, it turned out that most of them thought money was a taboo topic and could discuss it with others. We realised that since our users were facing the same problem, we could connect the dots and take our learnings to the community. Thatäó»s when we founded Honesty Circles, a monthly gathering for people to talk about their relationships with money. These are safe, open spaces for us to reflect and journey together in discovering the unspoken role that money has in their lives. Our hypothesis was that it wasnäó»t just that people didnäó»t know how to manage money, but from more deep-seated emotions, such as envy, greed and security. From there, the team brainstormed a list of topics that would get to the heart of these issues - including can money buy security spending and my principles and judgement and being judgemental. On a clear Thursday evening in Singapore in the April of 2014, 20 people gathered at The Hub to participate in the first Honesty Circle. The theme for the night was äóěDoes my self worth fluctuate with money and the ground rules were set for the first part of the conversation - no crosstalk, no judgements and keep your sharing focused on your experience. As the sharing went around the room, the refreshing honesty flowed, as we saw people nodding to what someone else said. The Circle then broke into smaller groups as the team led discussions that were grounded in the reflections. At the end of the session, our participants wrote down one gift they had taken away from their time and an action they would take to share this gift. Hereäó»s one that the team continues to be inspired by: I have learned the gift of listening and honoring different perspectives about money and self-worth. I will share this gift with the universe by listening without passing judgement on any perspective I hear, no matter who it comes from, nor will I judge myself for any perceived scarcity or abundance. In the short 3 months since its founding, Honesty Circles have rippled around the world, being held in Silicon Valley, Washington DC and San Francisco. In each of the Circles, we have seen the small steps that people have begun to take in their journey of inner transformation with a community. We’re only beginning to see the impact of seeding a community that is open to talking about money in a safe, open space. We can’t wait to see what’s in store and we invite you to start a Circle of your own to join in the conversation.

By: Jennifer Gurecki, Zawadisha

Variations of the phrase “I’d rather die poor than lose all of my belongings” is a common phrase articulated by women in Kenya. Consumed by fear of losing everything they own if they miss one loan payment, some of the most vulnerable women have been excluded from the microlending sector despite the fact that microfinance was originally envisioned as a tool to help the most vulnerable. Intimidated by borrowing from traditional microlending institutions, but eager to financially contribute to their families, the women we work with have been eagerly awaiting a lending model that place the quality of life for individuals and communities over the size of portfolios and repayment rates. Zawadisha was created to fill this gap and to offer an alternative lending opportunity for women, one with flexible repayment rates, transparent terms, and training. Women choose to borrow from Zawadisha because we prioritize the development of local leadership to leverage social capital in lieu of collateral. Zawadisha was founded in partnership with Kenyan women, and our model continues to rest on the foundation of collaboration. We are not a bank, nor do we operate like traditional financial institutions. We place women first by equalizing our bottom lineäóîthe well-being of our members is just as important as our portfolio. By expanding access to capital and training, we create a safe space for women to cultivate their businesses, test out ideas, and develop their leadership skills with their new-found independence. Rather than penalizing poor women for taking risks to create new businesses, we engage them as decision-makers and leaders in the organization, determining their own unique policies and guidelines. We are building and maintaining a flat organization where decisions are made through consensus and everyoneäó»s voice is heard. We believe this non-hierarchical organizational style allows us to remain agile and flexible, giving us the ability to iterate our program designs to fit the most pressing needs of our members, which is currently centered around water, energy, and food security. Our members determine policies that best work for their particular group and lending plans are co-created and individualized to meet the needs of diverse communities, understanding that what may work in urban cities like Nairobi might not work in rural towns like Kilgoris. Our model is building a stronger world, one in which women are self-sufficient, successful, and stand on their own two feet. We believe that this allows us to avoid a potentially harmful “one-size-fits-all”approach that characterizes similar work in the field of womenäó»s economic empowerment.