PHA-Exchange> Micro-Insurance Schemes in Africa

[Aviva]

From: Céline Peyron <c.peyron at itcilo.it>
 
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.