PHA-Exchange> Health Micro-Insurance Schemes

[Aviva]

From: "Céline Peyron" <C.Peyron at itcilo.it>

> Background
>
> Today, in most African countries, only limited public health expendi-
> tures reach the poor. Decreasing social and health budgets, often in-
> adequate and poor quality health services, as well as cultural prob-
> lems, are major constraints for many poor to gain access to health
> care services.
>
> Social protection is, first and foremost, the legitimate right of
> every individual. It is also a condition for social and economic pro-
> gress. In many developing countries formal social security systems
> are often not giving adequate coverage to people working in the in-
> formal economy, even if the legislation promotes social protection
> for all. The issue of identifying ways to extend social protection to
> workers in the informal economy is a new challenge and little practi-
> cal experience in this field exists. There is a need to determine ap-
> propriate mechanisms for providing social protection, especially in
> health, and to test them. Micro-insurance has been identified as one
> of many ways to provide better access to health care services for the
> excluded.
>
> Community-based health micro-insurance schemes combine the fundamen-
> tal principles of insurance, participation and solidarity. They use
> the basic principles of insurance because, by paying contributions,
> the members receive service - from the group as a whole - when they
> fall ill. The micro-insurance concept is also based on the solidarity
> principle as all the members contribute, but only those affected by
> an event covered by the scheme benefit from financial support. These
> schemes promote participation because membership is voluntary and all
> members have the right to participate directly or indirectly, in
> various decision-making bodies and to control the operation of their
> micro-insurance scheme.
>
> Several micro-insurance schemes have been created in Africa to en-
> hance access to health services for the most vulnerable. Micro-
> insurance refers to the different insurance systems, which can reach
> poor people on the basis of an ethic of mutual aid and the collective
> pooling of health risks, and in which the members participate in its
> management. A number of recent studies confirm their potential to en-
> hance access to health care, which has attracted growing interest
> from the general public, governments and their partners.
>
> There is a need for capacity building on the design and the manage-
> ment of micro-insurance schemes. To strengthen transparency and deci-
> sion making, member's skills, especially those of managers, should be
> reinforced with respect to the management of administrative and fi-
> nancial data.