The first time I knew I wanted to be a Women's Health Nurse Practitioner, I was a teenager at the women's health clinic on Cape Cod where I grew up. I was there to start the birth control pill, and at that time a pelvic exam was required before you could get a prescription. The Doctor who saw me that day was cold and abrupt during my exam and made a rude comment midway through. Instead of feeling ashamed, I remember thinking to myself at that moment, "I would be so much better at this. Women deserve to feel cared for and supported, not humiliated."
To this day, that thought continues to guide my practice as a Women's Health NP. It is always my goal, first and foremost, for each patient to feel validated, comfortable, and supported. All too often, women's health concerns are routinely brushed aside by a large number of GYN providers, leaving women without accurate medical answers and treatment options to their questions about things such as urinary incontinence, chronic pain, fertility, and contraception options, and sexual related pain/dysfunction. These issues are complex and involve time and attention to listening and helping to guide patients through a care plan that is appropriate for each individual. Proper treatment can be life-changing for women, and I want to be able to provide that kind of support to my patients.
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Funded
A loan helped buy IUD inventory and a colposcope which improve access to essential reproductive health care.
Stephanie's story
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Business Description
I have worked predominantly for community-based family planning clinics in and around Metro Boston throughout most of my 15-year career until Covid hit in 2020 and schools nationwide closed down indefinitely. I was a newly single parent at the time, and suddenly faced the task of homeschooling my three children, ages 6-11, while also finding a way to continue full-time work at the busy outpatient clinic where I was working.
Additionally, my frustration with the healthcare system was at an all-time high. Patients were not receiving adequate time and attention from their providers, leaving women without accurate medical answers or treatment options that could drastically improve their quality of life. I wanted to find a way to provide insurance-covered care that improves the lives of both patients and providers by providing high-quality, personalized health care, and expanding this practice model into opportunities for other providers to do the same.
In October of 2021, I brought that idea into reality by opening Direct Health for Women, LLC - a "micro practice" Gynecology & Women's Health office accepting most major insurances (including Medicaid and Medicare). By keeping overhead costs low through administrative automation, I can provide the level of care patients deserve without burdening them with "membership fees" or out-of-pocket cash pay fees. My focus is always on listening to each individual I encounter and providing my patients with personalized, convenient, holistic, evidence-based services. It is my goal for each individual to leave an encounter feeling understood, reassured, and empowered with the information and resources they need to feel their best.
What is the purpose of this loan?
As a medical practice, it is my mission to reduce, as much as possible, unnecessary barriers to care - especially access to contraception. The demand for long-acting, reversible contraception, such as IUDs and Implants, is at an all-time high and I want to meet the needs of my patients who are looking for quick, easy access to this kind of contraception. In order to make sure I have adequate inventory to meet the demand, I must front the cost (each IUD and Implant costs roughly $1000 to purchase upfront) and pre-order the devices from suppliers, then wait to get reimbursed by the patient's insurance company after insertion, which can take several weeks to months. By starting with dedicated money for inventory, I will then be able to use the reimbursements from insurance to keep replenishing the supply moving forward.
Additionally, I would like to be able to provide my patients with continuity of care by providing more in-office procedures which I'm qualified to provide, including colposcopy. By purchasing a colposcope for the office, I will be able to provide the necessary follow-up care for patients who have abnormal pap smear tests, which will allow them to receive more timely care and critical follow-up in-house.
This requires an upfront cost to have IUD/Implant inventory and colposcope equipment on hand for patients that need contraception and pap smear follow-up testing. I have self-funded my entire business up until this point and recently had to change electronic health record systems and billing platforms, which caused a temporary slow down in cash flow as I completed the onboarding for this new system. I have been unable to secure any outside small business loans that could fund these service add-ons, and am therefore looking to Kiva to help fund my business.
Loan details
Loan length:
Repayment schedule
Monthly: One repayment made per month
End of term: One repayment made at the end of the loan term
Irregular: Any other repayment schedule
To see a detailed repayment schedule for a specific loan, click the "Repayment schedule" link on the loan profile under "Loan details."
What is the disbursed date?
In the case of partner loans, many of our Lending Partners choose to disburse loan funds before the loan request is posted on Kiva. We allow pre-disbursal because it ensures that the funds reach the borrower as soon as they are needed. Loan funds from Kiva lenders then go to backfill that amount and as a lender you assume the risk of the loan. By doing this, our Lending Partners assume the risk that, if the loan isn't funded by lenders, they will have to fund the loan without any funds from Kiva.
If a partner loan is not pre-disbursed, it will be listed on Kiva with an expected "post-disbursed" date. If a post-disbursed loan is not funded on Kiva, there is a chance that the borrower may not receive their loan. Some Lending Partners choose to disburse loans with other sources of funding, while other partners don't have the resources available to fund loans without Kiva lenders' support. No direct loans will be disbursed unless they fully fundraise on Kiva.
Funding model
What does "Partner covers currency loss" mean & how could it affect my Kiva loans?
Potential for currency exchange loss is noted on every loan profile under the loan details:
"Yes" means the Lending Partner will cover any currency loss. Lenders will not bear losses due to currency fluctuation
"Partial" means that the Lending Partner has opted to cover losses only up to 10%. If the U.S. dollar appreciates more than 10% against the local currency, those losses will be passed onto lenders.
"No" means that the Lending Partner is not covering any currency losses and all losses will be passed onto lenders.
"N/A" means the Lending Partner disburses loans to borrowers in USD so their loans are not subject to any currency fluctuation.
Do Kiva borrowers pay any interest on their loans?
Our partners collect interest from borrowers because there are many operational expenses associated with microfinance in developing markets, especially in rural areas. Many of Kiva's Lending Partners also provide additional services alongside their loan products such as business training, financial literacy lessons, or health services.
Kiva will not partner with an organization that charges unreasonable interest rates, and we require Lending Partners to fully disclose their rates. In addition, we only partner with microfinance institutions and organizations that have a social mission to serve the poor, unbanked, and underserved.
There are some 0% interest loans on Kiva, including all direct loans in the United States. To learn more about the interest rates Kiva borrowers pay, you can review the "Average cost to borrower" field on a loan profile.
We also encourage you to read the following articles if you are interested in further educating yourself on the topic: Microfinance 101 (https://www.kiva.org/microfinance), Top 10 things to know about microfinance (https://www.kiva.org/blog/top-10-things-to-know-about-microfinance), Microfinance interest rates explained (https://www.kiva.org/blog/whats-up-with-microfinance-interest-rates)
What is a risk rating?
The Lending Partner risk rating reflects the risk of institutional default associated with each of Kiva’s Lending Partners. A 0.5-star rating means the organization has a relatively higher risk of institutional default, while a 5-star rating indicates the organization is at a relatively lower risk of default, based on Kiva's analysis and the available information displayed in the Lending Partner section of every loan. Lending Partners with the lowest credit tier undergo a lighter level of due diligence and do not receive a risk rating; instead, in places where a risk rating would normally appear, these partners are labeled as “Experimental.” For more information, see "What is an Experimental Lending Partner?"
Direct loans also do not receive a formal risk rating. Instead, these loans are approved through “social underwriting”, where trustworthiness is determined by friends & family lending a portion of the loan request, or by a Kiva approved Trustee vouching for the borrower. Direct loans will appear as "Unrated" and lenders should always assume these loans represent the highest level of repayment risk on Kiva.
How are loans facilitated?
Kiva loans are facilitated through 2 models, partner and direct, that enable us to reach the greatest number of people around the world.
For partner loans, borrowers apply to a local Lending Partner, which manages the loan on the ground. Lending Partners are responsible for screening borrowers, disbursing loans, posting borrowers to the Kiva website for funding, collecting repayments and otherwise administering Kiva loans on the ground to borrowers.
For direct loans, borrowers apply through the Kiva website and may or may not be endorsed by a Trustee. Unlike Lending Partners, Trustees don't handle any financial transactions or have any duty to repay loans on behalf of their borrowers. Instead, Trustees take the role of providing support and business advice to their borrowers throughout the term of the loan.
More information about successive and concurrent loans
Most borrowers take out loans consecutively, meaning that they receive a second loan after having repaid the first. However, sometimes our Lending Partners give out concurrent loans, allowing borrowers to take out one primary loan and a secondary "add-on" loan along with it. These additional loans are typically smaller than the borrower's primary loan and serve a different purpose. We trust our partners to determine whether a borrower has the means to be able to repay a successive or concurrent loan.
About Direct Health for Women
Lenders and lending teams
Country: United States
Trustee
What are Trustee tiers?
For for more information about Trustee tiers, visit: kivaushub.org/trustee-tiers
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Loan tags help lenders find loans that match certain areas of interest.
Loan details
Loan length:
Repayment schedule
Monthly: One repayment made per month
End of term: One repayment made at the end of the loan term
Irregular: Any other repayment schedule
To see a detailed repayment schedule for a specific loan, click the "Repayment schedule" link on the loan profile under "Loan details."
What is the disbursed date?
In the case of partner loans, many of our Lending Partners choose to disburse loan funds before the loan request is posted on Kiva. We allow pre-disbursal because it ensures that the funds reach the borrower as soon as they are needed. Loan funds from Kiva lenders then go to backfill that amount and as a lender you assume the risk of the loan. By doing this, our Lending Partners assume the risk that, if the loan isn't funded by lenders, they will have to fund the loan without any funds from Kiva.
If a partner loan is not pre-disbursed, it will be listed on Kiva with an expected "post-disbursed" date. If a post-disbursed loan is not funded on Kiva, there is a chance that the borrower may not receive their loan. Some Lending Partners choose to disburse loans with other sources of funding, while other partners don't have the resources available to fund loans without Kiva lenders' support. No direct loans will be disbursed unless they fully fundraise on Kiva.
Funding model
What does "Partner covers currency loss" mean & how could it affect my Kiva loans?
Potential for currency exchange loss is noted on every loan profile under the loan details:
"Yes" means the Lending Partner will cover any currency loss. Lenders will not bear losses due to currency fluctuation
"Partial" means that the Lending Partner has opted to cover losses only up to 10%. If the U.S. dollar appreciates more than 10% against the local currency, those losses will be passed onto lenders.
"No" means that the Lending Partner is not covering any currency losses and all losses will be passed onto lenders.
"N/A" means the Lending Partner disburses loans to borrowers in USD so their loans are not subject to any currency fluctuation.
Do Kiva borrowers pay any interest on their loans?
Our partners collect interest from borrowers because there are many operational expenses associated with microfinance in developing markets, especially in rural areas. Many of Kiva's Lending Partners also provide additional services alongside their loan products such as business training, financial literacy lessons, or health services.
Kiva will not partner with an organization that charges unreasonable interest rates, and we require Lending Partners to fully disclose their rates. In addition, we only partner with microfinance institutions and organizations that have a social mission to serve the poor, unbanked, and underserved.
There are some 0% interest loans on Kiva, including all direct loans in the United States. To learn more about the interest rates Kiva borrowers pay, you can review the "Average cost to borrower" field on a loan profile.
We also encourage you to read the following articles if you are interested in further educating yourself on the topic: Microfinance 101 (https://www.kiva.org/microfinance), Top 10 things to know about microfinance (https://www.kiva.org/blog/top-10-things-to-know-about-microfinance), Microfinance interest rates explained (https://www.kiva.org/blog/whats-up-with-microfinance-interest-rates)
What is a risk rating?
The Lending Partner risk rating reflects the risk of institutional default associated with each of Kiva’s Lending Partners. A 0.5-star rating means the organization has a relatively higher risk of institutional default, while a 5-star rating indicates the organization is at a relatively lower risk of default, based on Kiva's analysis and the available information displayed in the Lending Partner section of every loan. Lending Partners with the lowest credit tier undergo a lighter level of due diligence and do not receive a risk rating; instead, in places where a risk rating would normally appear, these partners are labeled as “Experimental.” For more information, see "What is an Experimental Lending Partner?"
Direct loans also do not receive a formal risk rating. Instead, these loans are approved through “social underwriting”, where trustworthiness is determined by friends & family lending a portion of the loan request, or by a Kiva approved Trustee vouching for the borrower. Direct loans will appear as "Unrated" and lenders should always assume these loans represent the highest level of repayment risk on Kiva.
How are loans facilitated?
Kiva loans are facilitated through 2 models, partner and direct, that enable us to reach the greatest number of people around the world.
For partner loans, borrowers apply to a local Lending Partner, which manages the loan on the ground. Lending Partners are responsible for screening borrowers, disbursing loans, posting borrowers to the Kiva website for funding, collecting repayments and otherwise administering Kiva loans on the ground to borrowers.
For direct loans, borrowers apply through the Kiva website and may or may not be endorsed by a Trustee. Unlike Lending Partners, Trustees don't handle any financial transactions or have any duty to repay loans on behalf of their borrowers. Instead, Trustees take the role of providing support and business advice to their borrowers throughout the term of the loan.
More information about successive and concurrent loans
Most borrowers take out loans consecutively, meaning that they receive a second loan after having repaid the first. However, sometimes our Lending Partners give out concurrent loans, allowing borrowers to take out one primary loan and a secondary "add-on" loan along with it. These additional loans are typically smaller than the borrower's primary loan and serve a different purpose. We trust our partners to determine whether a borrower has the means to be able to repay a successive or concurrent loan.
Trustee
What are Trustee tiers?
For for more information about Trustee tiers, visit: kivaushub.org/trustee-tiers
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