AdvancingWomen'sHealthinLatinAmerica:ARoundtableforFundersandInvestors

Wednesday,February7,2018

OpenSocietyFoundationsNYCHeadquarters224W57thSt,NewYork,NY10019

ExecutiveSummary

Background............................................................................................................................2

Attendees...............................................................................................................................3

SessionSummaries.................................................................................................................3Session1:SettingtheScene..................................................................................................................................................3Session2:StrategiesTowardImpact:ThreeFundingExperiencesthatareMakingaDifference.........4GrandChallengesCanada.......................................................................................................................................................4MacArthurFoundation............................................................................................................................................................5LinkedFoundation.....................................................................................................................................................................5

Session3:InvestmentMappingExercise........................................................................................................................5Session4:IntrotoGenderLensInvesting......................................................................................................................6Session5:IllustrativeExamplesofInvestmentOpportunities..............................................................................6Session6:BuildingFunderCapacityforInvestmentsinWomen’sHealthInLatinAmerica...................7Session7:ReproductiveHealthInvestorsAlliance:OneModelforFunderCollaboration.......................7Session8:OpportunitiesforCollaboration:WhatCouldaFunderCollaborativeonthisIssueLookLikeGoingForward?................................................................................................................................................................7Session9:NextStepsandDebrief......................................................................................................................................8

UpcomingOpportunities……………………………………………………………………………………..………………..8

AppendixA:RoundtableAgenda............................................................................................9

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Background The Latin America region has experiencedtransformativechangeinthepast50years,withhistoricshiftsoccurringinpolitics,theeconomyandsociety, includinghealthcareandoutcomes.Healthsystemsintheregionare now generally stronger, betterintegrated and deliver better care thanthose in other parts of the developingworld. As a result, health funding to theregion has been reduced, though mostcountries continue to face challenges inmeetingwomen’shealthneeds,particularlyfor their indigenous and Afro-descendentpopulations, the economically marginalized and those living in rural areas. In addition,certainhealthcareservicesvitaltowomen’shealthandlivesaredifficulttoaccessand/orarestigmatized,suchascontraceptionforadolescents,treatmentfollowingsexualviolence,and abortion. While significant challenges remain, the overall improvements in healthsystems and othermodernizations translate to a tremendous opportunity for funders tohavecatalyticimpacttowardnarrowingthegapsinwomen’shealthaccessandoutcomes.Currently, there are various funders working to address these unmet needs in LatinAmerica,deployingfundstoorganizationsandenterprisesintheregionviagrant,debtandotherinvestmentvehicles.LinkedFoundationandFundersforReproductiveEquitysawaclear opportunity for funders to share information, conduct joint due diligence and topartner on grantmaking and investment opportunities in this area of critical need. Thisroundtable servedasanopportunity tobegin thesecollaborationsand theproductionofsharedresourcesandtoolstoincreaseourcollectivepositiveimpactonwomen’shealthintheregion.

ObjectivesOurgoalwastobringtogetherfundersandinvestorsthatshareinthemissiontoadvancewomen'shealthinLatinAmerica,withanemphasisonsexualandreproductivehealthandrights,inorderto:

• Share key learnings and organization-specific investment priorities and identifiedopportunities

• Map the investable landscape of philanthropic and investment opportunities tocatalyzecapitaltowardwomen'shealthacrossinvestmentvehicles

• Explorepotentialcollaborativefundingopportunitiesinwomen'sandreproductivehealthinitiatives

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• Explore interest and bandwidth for convening additional or ongoing women'shealthknowledge-sharingevents(includinginothergeographicareas)andfurtherco-creationoftoolsandresourcesforfunders.

AttendeesIndiaAlexis,OpenSocietyFoundationsTinaAssi,GrandChallengesCanadaEmilyBarcklow,SeattleInternationalFoundationSuzanneBiegel,CatalystatLargeSharonBissell,MacArthurFoundationAnnaDeLaCruz,LinkedFoundationJimEpstein,EFOCapitalManagementKathyHall,SummitFoundationDorothyLargay,LinkedFoundationJuliaLourie,MaverickCollectiveKristiMahoney,WestwindFoundation(videoconference)JackieNolley,FundersforReproductiveEquityEstefaniaPalomino,WyssFoundationMireillePosse,HispanicsinPhilanthropyGabrielaSalvador,AmericaresShiraSaperstein,PackardFoundationRuthShaber,TaraHealthFoundationDeniseShannon,FundersforReproductiveEquityNancySwanson,LinkedFoundationLuisVivaldi,FoundationforaJustSociety

SessionSummariesSeeAppendixAforthemeetingagenda.PowerPointpresentationsandothermaterialsfromthemeetingareavailableinaDropboxfolder.

Session1:SettingtheScene Summaryofroundtableattendees,basedonapre-eventquestionnaire

• Asagroup,thosegatheredarefundinginitiativesthatfocuson:• Contraception,abortion,andmaternalhealth• Increasedaccess,policy/advocacy,anddirectinvestments• Populationsdescribedaslow-income,oryouth• MexicoandCentralAmerica

• Asagroup,theorganizationsrepresentedbythosegathered:• Mainlyusegrantsasafundingmechanism• Haveatypicalgrantsizeof$100-$300k

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• Havelessthan20employees• Shareasignificantinterestinimpactinvesting

SummaryofWomen’sHealthLandscapeinLatinAmerica

• Advantages include overall higher incomes, betterhealthoutcomes,andamoresignificantpublicsectorrole(inprinciple),inLAthanotherregionsofneed,aswellasastrongenvironmentforentrepreneurship

• Challenges include decreased aid funding, highinequality, an increase in non-communicable diseaseburden,continuedhighmaternaldeathrates,negativehealthimpactofcriminalizedabortion.

• Opportunities includeorganizingtheinformalsectorthrough higher quality, standardized products andservices; public/private partnerships; and cross-subsidizationmodels.

Analyzingyourmarket,choosinganinterventionandfundingmechanism

• Analyzebytargetpopulation(SES)andbytheneedorproblemyouseektoaddress.Differentcombinationswillrequiredifferentsolutions.

• Thinkaboutwhatyourexitstrategymightbe,andwhoyourpartner is–thismayalsoaffectthefundingmechanismyouchoose.

• Itisimportanttounderstandyourclient.Womendon’tjusthavehealthneeds,theyalso have food, education, and housing needs. Your target client has her ownpriorities, and her time is also a major concern. To be successful, we need tounderstand our clients’ reality and not assume that they’re irrational or poordecision-makers.

• There is a BIG generational shift happeningright now. The internet and social media isreallychangingthewaysweapproachwomenandcaptureachild’sattention.Weneedtogetinputsfromyoungpeople.

Session2:StrategiesTowardImpact:ThreeFundingExperiencesthataremakingaDifferenceThree participating organizations described their organization’s mission, criteria andportfolioinordertoprovideexamplesoffundingwomen’shealthworkinLatinAmerica.

GrandChallengesCanada• GCCisbasedinTorontoandispartofthebroaderGrandChallengesinGlobalHealth

Network.• Since2010,GChassupportedabout800innovationsinabout80countries.

“If you really want to understand impact investing, Latin America

is the place to be.” ---Dr. Gabriela Salvador

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• TheGovernment of Canadanearly exclusively fundsGCC, so investmentprioritiesmimicCanada’sglobalpolicy.

• GCC has deployed about $29M of $90M in investment funds for RMNCH, the restneedstobedeployedoverthenext9-24months.

• GCfundstwostages:seedstageandtransitiontoscale

MacArthurFoundation• Large,PrivateUSFoundationwithasmallofficeinMexicosince1992.• Midwifery program in Mexico has been the ‘Capstone Strategy’ in Mexico and is

endingthisyear.• Overlast2.5years,43grants,$16M,engagedin8partnerships.Grantsrangefrom

$50kto$1M,grassrootstolargeinternationalagencies.MostbasedinMexico.• There has been an increase in training programs, progress on training and

certification,andcreationofnationalmidwiferyassociations.• Astudywithbaselineandendlineevaluatingtheprogramwillbeavailable• TheremaybeopportunitiesforinvestmentinmidwiferyinMexico.

LinkedFoundation• Primarilyfundearlystagehealthenterpriseswithinnovativegrantcapitalandfocus

onMexico.NGOsandsocialenterprises.• PartnerwithorganizationslikeGlobalPartnershipstoprovidedebtfinancing• Private sector models include health social franchising, micro finance, low cost

clinics• Portfolioexamplesinwomen’shealthincludeFriendshipBridgeandReinaMadre

Session3:InvestmentMappingExerciseThegroupcompletedanexercisebasedontheirownfundedactivities,inordertomapthefunding landscape among participating organizations. Each organization noted thepopulationtargetedbytheintervention(ultrapoor,lowincome,etc.),thetypeofwomen’shealth activity funded and the funding mechanism used, and the exit strategy. Theinterventions were then mapped in a matrix on the wall and the group discussedobservationsandwasabletoseewhereotherparticipantsareworking.

KeyTakeaways:• Mostcurrentinterventionsaregrantfunded,inlow-income,periurbanpopulations• AnadvantageinLatinAmericaisthatthereisamiddleincomepopulation,soyou

have opportunity for impact investing as well as innovative models like crosssubsidizationbetweenincomegroupsorbetweeninitiatives

• Thegroupdiscussedsomeexamplesofprogramsthatareusingcross-subsidizationandotherinnovativemechanismsinLatinAmerica

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Session4:IntrotoGenderLensInvestingThissessionwasawhirlwindintrotoimpactinvestingwithagenderlens.

KeyTakeaways• Therearedifferentvehiclesandinvestorsalongthespectrum• There are different gender lenses you can use as criteria – women as investors,

women entrepreneurs/founders, addressing human rights or social justiceconcerns,workingtodismantlestructuralgenderinequality,productsandservicespositively impactingwomen and girls, demonstrating gender equity/parity in thebusiness.

• TaraHealthFoundationexample:Whatactually improves the livesofwomenandgirls? The XX Factor publication maps this out, with the five dimensions: health,education,legalrights,economicempowerment,andpersonalsafety.

• Thebiggestbarriertoinvestingwithimpactisaccesstodata.

Session5:IllustrativeExamplesofInvestmentOpportunities

• See the Dropbox folder with meeting materials for the Illustrative Examples ofinvestmentopportunitiesspreadsheetandworddocument.

• In the month leading up to the event, the organizers asked the participants andotherinvestmentmanagers,accelerators,etc.forconcreteinvestableopportunitiesin women’s health in Latin America. From there, the organizers created aspreadsheetanddocumentdescribingthecollectedopportunities.

• Several participants shared information about a selection of the opportunities:WOOM,Agora/IPPFAccelerator,Fonkoze,DKT.

• If this collaboration becomes ongoing, the group will have the chance to look atdeals together,diligencethemtogether,sourcethemtogether,andcancollaborateandpartnertofindnewandflexiblewaystofundinterventions.

“I appreciated the level of expertise within the Women's Health space represented in terms of speakers and attendees. The case study examples

of models currently seeking financing were useful.” --Roundtable Participant

“It made no sense to me that we would create a foundation and then use just 5% of it to support our mission.”

--Ruth Shaber, Tara Health Foundation

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Session6:BuildingFunderCapacityforInvestmentsinWomen’sHealthInLatinAmericaThe participants each wrote down tools, resources, opportunities and insights that arelacking in order to work in women’s health in Latin America. The ideas were collectedtogether and grouped on the wall. The tools and resource ideas are collected in aspreadsheet(seethelistofresourcesintheDropboxfolder)

Session7:ReproductiveHealthInvestorsAlliance:OneModelforFunderCollaboration

• Tara Health Foundation wanted to get a clear view of the reproductive healthlandscapeintheUStobetterunderstandwhereandhowtheycoulddeployfundingtohavethebiggestimpact.Theyrealizedotherswereinterestedindoingthis,too,so they brought on 8-9 other organizations to create The Reproductive HealthInvestorsAlliance.

• FirststepwastohiretheCamberCollective(consultants)todeveloptheInvestmentCase,whichmapsoutthesystemsthatimpactaccesstoabortionandcontraceptionintheUSandhowtheyinteract.Nowyoucanpickaproblemandunderstandhowtousedifferentfundingmechanismstosolveit.

• Futurevisionisabigpoolofcapitalthatcangreenlightdealsdirectly.• Thismodelcouldbeusedelsewheresuchasforwomen’shealthinLatAM.

Session8:OpportunitiesforCollaboration:WhatCouldaFunderCollaborativeonthisIssueLookLikeGoingForward?

Whatkindsofthingsareimportanttoeveryoneinthiscollaboration?

• Structureandresources• Clearcommunication• Highdo:talkratio• Wheretohousethegroup?• FRE experience: diverse membership

isagoodthing,strongrelationshipsarekey, collecting data to analyze andshareisimportant.

Thiswas in initialbrainstorm; theorganizerswill assess ideas/feedback and propose nextsteps.

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Session9:NextStepsandDebrief

• Thegroupdiscussedthingstheylearned,orareinterestedinlearningmoreabout,which included: more about impact investment readiness and other funders’pipelines

• People offered up commitments they would make which included: sharing theresources from the day, discussing barriers to investment with their foundationleadership,apossiblesubgroupinDC.

• Whatwentwell:severalofthepresenters,theamountaccomplished,thestructure,sharingresourcesinadvance,respectfortime,theabilitytojoinremotely

• The event opened the doors for thinking about the investment side within afoundation,withagood introduction tosomeof theseconcepts.Participantswereinspiredbytheexpertiseandpassionintheroom

• Severalorganizationssaidtheycouldseethemselvesfundingtheinfrastructureforagrouplikethisgoingforward.

UpcomingOpportunities

• Second annual Gender Lens Investing Breakfast (during Skoll World Forum):Thursday12April2018,8:30–10:00am,GeorgeStreetSocial,Oxford,UK

• Global Gender Lens Investing Summit; November 1-2, 2018, London, UK (seecatalystatlarge.com)

• InterestandpotentialforreplicatingthismeetinginMexicointhefall• Discussions taking place about sidemeeting opportunities at SOCAP, FRE annual

meeting,CentralAmericaDonorsForum,amongothers.

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AppendixA:RoundtableAgenda

Advancing Women's Health in Latin America: A Roundtable for Funders and Investors

Wednesday,February7,2018OpenSocietyFoundationsNYCHeadquarters

224W57thSt,NewYork,NY10019

8:30-9am Breakfast9-9:45am Welcome&GettingGrounded Reviewmeetingobjectivesandgroundrules;Participantintroductions DorothyLargay&NancySwanson,LinkedFoundation DeniseShannon,FundersforReproductiveEquity ElisaSlattery,OpenSocietyFoundations SuzanneBiegel,CatalystatLarge9:45-10:15am SettingtheScene

Women'shealthinLatinAmerica:challenges,opportunities&thefundinglandscapeAnnaDeLaCruz,LinkedFoundationDr.GabrielaSalvador,Americares

10:15-11:15am StrategiesTowardImpact

Threefundingexperiencesthataremakingadifference TinaAssi,GrandChallengesCanada

SharonBissell,JohnD.andCatherineT.MacArthurFoundationDorothyLargay&NancySwanson,LinkedFoundation

11:15am-12:15pm InvestmentMapping

ParticipatoryexercisemappingcurrentinvestmentsontothefundinglandscapeDr.GabrielaSalvador,AmericaresAnnaDeLaCruz,LinkedFoundation

12:15-12:45pm Lunch

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12:45-1:15pm IntroductiontotheInvestmentSpectrumandGenderLensInvesting Whatistherangeofinvestmentvehiclesandhowdoweintegratea

genderanalysisintoourinvesting?SuzanneBiegel,CatalystatLargeDr.RuthShaber,TaraHealthFoundation

1:15-1:45pm IllustrativeExamplesofInvestmentOpportunities

Sourcedfromcurrentfunders,investorsandintermediariesSuzanneBiegel,CatalystatLargeAnnaDeLaCruz,LinkedFoundation

1:45-2:30pm BuildingFunderCapacityforInvestmentinWomen’sHealthinLatin

AmericaTools,resources,opportunitiesandinsightsintostrengtheningfundercapacitySuzanneBiegel,CatalystatLargeDeniseShannon,FundersforReproductiveEquity

2:30-3:00pm ReproductiveHealthInvestorsAlliance Onemodelforfundercollaboration Dr.RuthShaber,TaraHealthFoundation3:00-3:30pm OpportunitiesforCollaboration Whatcouldafundercollaborativeonthisissuelooklikegoingforward?

SuzanneBiegel,CatalystatLarge NancySwanson,LinkedFoundation

3:30-4:00pm NextStepsandDebrief Plansforfollow-upandreflectionsontheday SuzanneBiegel,CatalystatLarge

DorothyLargay,LinkedFoundation 4:00-5:30pm WineReception