Calcutta Kids, India

Grantee

Calcutta Kids is an NGO founded in 2003 with a mandate to conduct public health work in slum areas of Howrah, India (the twin city of Calcutta). It increases access to health and nutrition services, providing health information, and encouraging positive health-changing behaviours. Calcutta Kids' community-based programs advance the promotion and delivery of good health care, medical advocacy, and health education. On March 1st, 2009, it will begin operating a health microinsurance scheme in its catchment area. This scheme has been developed and will be operated in partnership with MicroEnsure, Medicare TPA, and United India Insurance company.

Project Summary

• Project name: Enhancing and sustaining health microinsurance through outpatient counselling
• Project start date: March 2009
• Duration: 2 years
• Country: India

Beneficiaries

The NGO targets the poorest children and pregnant women in an underserved slum area hosting about 18 000 residents. Calcutta Kids targets specifically expectant mothers and their children up to age 3. The outpatient counselling service that is proposed would reach all clients within the NGO's network that access outpatient care at a local clinic.

Project Description

Voluntary health microinsurance schemes worldwide face difficulty in retaining their clients. One reason for this is because the bulk of clients do not make a claim in a given year, and thus see no tangible benefit in the product. Calcutta Kids seeks to address this problem by creating value for non-claimants through an "outpatient counselling service" - an additional service that Calcutta Kids' health insurance product will provide.

When clients access outpatient care with a doctor within Calcutta Kids' network, a health worker will be sent to their house two days later. There the health worker will: (i) check that the client is following the doctor's prescribed treatment (and encourage them to do so if they are not), (ii) in the case of common sicknesses, provide simple behavioural advice to clients, and (iii) record the progression of old symptoms and the onset of new ones in a case file. At the Calcutta Kids office, a manager will review all cases, and, with the assistance of a staff doctor, decide which ones require outpatient follow-up. If follow-up is necessary, a health worker will inform the client the next day.

The service may also reduce the overall claims expense by preventing some minor illnesses from becoming major, and also by encouraging timely admission into hospitals in the case of major illnesses.

Finally, the service will be a means of monitoring the quality of outpatient care within the network, and also the illness patterns of the target population.

Key Challenges

One challenge will be to make best use of existing systems of outpatient health care providers, as opposed to creating alternative systems. While the temptation exists to do the latter, the former is more likely to be a scalable solution.

Another challenge will be to, as far as possible, have the operation of the service not rely upon a few high-skilled employees. Accomplishing this will facilitate the replicability and scalability of the intervention.

Learning Agenda

• Do health counselling services add value for clients and if so, how much and why? Do they help the clients feel more satisfied with their insurance? Do health counselling services result in higher renewals of inpatient cover?
• Are hospitalizations avoided? Are inpatient claims costs reduced due to lower severity of illness?
• Is the cost of counselling services offset by potential claim cost reductions, and policy renewals? Is it financially sustainable?

Quote

More information on the project

• Calcutta Kids