GRACE MORTON-BRUCE (am.kella@yahoo) & DANIEL E. MENSAH (demens36@hotmail)

1. From Cash To M-Money Payments For Enhanced Access To Family Planning And other Life-saving Products In Selected Rural Ghana GRACE MORTON-BRUCE (am.kella@yahoo.com) & DANIEL E. MENSAH (demens36@hotmail.com) HEALTHKEEPERS NETWORK, GHANA

2. Introduction: HealthKeepers Network(HKN) • The HKN program brings innovative and sustainable self-help solutions to the fight against diseases, chronic hunger and poverty. • It is an innovation that applies a business solution to a public health problem. • The HKN program employs a micro-franchise system in which community based agents supported by a sustainable distribution system bring quality health promoting products and consumer information to rural and underserved communities on a reliable basis. • The HKN is operated by “HealthKeepers” who go the last mile to directly sell health promoting products in their community.

3. Background • Ghana’s population has tripled from 9 million in 1970 to over 27 million today, • Ghana’s population is projected to grow to 33million in 2025 with a population growth rate of 2.3% per year. • This will challenge Ghana’s attempts to improve health, education and other services and improve the well being of its people and the environment. • Promoting family planning is therefore key to Ghana’s sustainable development.

4. Challenges However, access to family planning products and services for people in rural and underserved communities is often hindered by a number of factors. These factors include but, not limited to: • low purchasing power of the people, which often does not support a commercially viable FP business operation; • long distances and high cost of travels to supply products to such locations; • erratic product ordering practices and challenges with the collection of payments on account for products supplied; • Lack of access to financial services making most of them unbanked . These factors lead to stock out of commodities which affects uptake of family planning and the general health and wellbeing of the community members.

5. Response to challenges In response to these challenges, HKN began a mobile money (MM) payment system to take advantage of its benefits to promote family planning for sustainable development. Some of the benefits are: • rapid, timely and reliable payments; • improved security in managing, sending and receiving payments; • improved efficiency and reduced administrative cost; • improved oversight and financial management; • enhanced transparency and governance; and • improved access to financial services, particularly in remote locations. 

6. Specific Objectives Specific objectives of the project are as follows: • to introduce and build awareness for mobile money payment system • to provide HKN staff and Community-based distributors (CBDs) with a platform for interactions with mobile money applications • to integrate mobile money payment system into HKN’s day-to-day operations to create demand for its use • to increase efficiency and transparency and to save HKN cost of managing payments and account receivables • to minimize risk associated with cash collection and its transport • to incentivize and make it flexible for the CBDs to take and make payments for products • to establish and maintain partnerships with mobile money service operators to promote the use of mobile money and • to gather market intelligence and users insight

7. What the Mobile money was intended to do…

8. Partnerships HKN forged the following partnerships: • Three (3) Mobile Networks Operators (MNO) namely: MTN, TiGO and Airtel This was for HKN to obtain from the MNOs • Reliable, timely and free training and technical support; • Waivers and discounts on charges; • For easy access to Merchant SIM cards for the collection and payments of money. 2. Partnership with Banks • Ecobank Ltd • to address the challenge of non-availability of interoperability among the various MNO in Ghana • to facilitate the training of key staff in the use of their ( In-charge agent) system • CAL Bank Ltd: • to generate e-cash from HKN bank accounts into HKN mobile wallet 3.Community Influencers and Opinion Leaders in the selected districts. • For their buy-in and support

9. Advocacy & Recruitments • Advocacy sessions were held with the community based distributors (CBDs) and opinion leaders in the communities to sensitize them about HKN’s mobile money project and to solicit their inputs and commitments for the smooth implementation of the project. • The recruitment sessions were also used: • Identify mobile money agents/merchants in the communities • to register CBDs who had no mobile money accounts

10. Registered users: before and after recruitments

11. Training of CBDs • The delivery of the training combined a mix of adult learning approaches such as: • group work, • role plays, and • hands on practical sessions, to help make the various sessions very interactive and also to ensure retention of knowledge. • Participants were given an overview of the mobile money payment system, its safety, security, convenience and the benefits of it.

12. Training CBDs continue… The training also touched on the workings of the mobile money payment system: • how to transfer money from ones phones to a recipient; • how to make transfer through a merchant; and • how to cash out money from their mobile wallets. They were also taken through how to check balances in their wallets.

13. Supervision and monitoring Supervision visits were undertaken frequently to monitor the CBDs and help with any challenges they may encounter with MM service. The community based distributors/ agents were also encouraged during the supervisory visit to use the payment system and to save in their wallets.

14. Impact During the project period from June 2015 to February 2016 • HKN fully integrated mobile money payments into its day-to-day operations and created awareness on mobile money within its network in several rural and underserved communities. • 164 community-based distributors made up of 115 females and 49 males received training in MM payment system. • This has not only eliminated financial barriers for the CBDs to accessing HKN’s life-saving products, but, also made same products available to the community members. • It also enhanced flexibility in their payments for family planning products supplied to them. The number of CBDs who used the mobile money services to make payments increased. • During the project period, mobile money payment ofGHC10,495.00 was received by HKN for products it supplied to CBDs

15. Impact In addition, HKN mobile money payment system has provided financial inclusion to some of the CBDs who previously did not have access to financial services. • 50 community-based distributors were registered for the first time through HKN’s sensitization and awareness creation on mobile money during recruitment and training sessions. HKN used the system to make a total MM payment of GHC69,144.25. The payment includes staff members travel per-diems, monthly stipend, airtime, among others. Overall, HKN made significant gains in administrative cost associated with payments and cash collections

16. What Mobile Money was actually used for

17. Impact: Comments from some CBDs Comments received from some of the CBDs are as follows: • “Aside transfers and withdrawals, I am saving for a rainy day. I save a little money as and when I get it.” • Rama Sheibu, HealthKeeper, Nasia. • ‘Mobile money has helped to improve my business. Before the training, I was using the system to pay my suppliers. Some of my customers also pay me through mobile money. I currently have 30 GH cedis in my wallet’’. • Sahadatu Abdul Dramani, HealthKeeper, Nasia.

18. Challenges encountered… • Network Failure: Major challenge faced was with network/system failures. This stalled deposit of funds into mobile money account at the bank, payment of T&T allowance to trainees, inability of staff to withdraw travel per diems. This challenge was overcome by doing the aforementioned activities way ahead of time to avoid delays and also put in mitigating measures where needed. • Mobile Money charges: The high charges associated with mobile money transactions usually prevented CBDs from using this payment system and they resisted being reimbursed through it. Education on benefits of mobile money and constant reminders helped to persuade them. • Low Literacy: During training, it was realized most participants were not conversant with the features of their phone and as such navigating the mobile money menu became challenging. Most participants used their phones only to make and receive calls thus figuring out a USSD menu for the first time was challenging. Simple pictorial guidelines were given to them to constantly practice.

19. Best practices and Sustainability • Integration of mobile money into daily program operations: • For mobile money payment to be useful, it needs to be integrated into all program activities. • HKN explored the use of mobile money in its day to day running of program. This led to increase in access to life-saving health protection products. • Also, certain transactions HKN undertook as a merchant, attracted commissions from the Mobile Network operators (MNOs) which offset some of the charges incurred from other transactions. • Proper documentation: • The mobile money platform used allowed proper and prompt documentation of payments which would have taken time to be captured electronically. .

20. Best practices and Sustainability • Quality Assurance: • HKN supervision team paid visits to the CBDs regularly to monitor the system, encouraged them to share their experiences which were used to adjust program operations. • Due to the fact that the payment system was new, CBDs needed constant reminders to ensure that they made use of the system. • Partnership with MNOs and Banks: • To meet customer needs and provide timely technical support, HKN worked directly with all MNOs operating mobile money with the exception of one (which recently came on board) and Banks. • This ensured that technical assistance was obtained when required, reversal of wrong payments, and instructions could be left at the banks for e-cash to be generated when there is network failure.

21. Thank You ! Acknowledgements: Marcia Safo-Nyame, HealthKeepers Network (HKN) Patience A. Owusu, HKN Edwin AmarkaiAryee, HKN, KwasiKumiAkonor, HKN