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Grantee
Swayam Shikshan Prayog (SSP), meaning self education for empowerment, is a development organization that provides access to social and economic opportunities through technical support. It promotes community-driven entities and forges partnerships with institutional actors. Since 1993, SSP has mobilized grassroots women's groups around reconstruction and local governance issues. It transforms mass-scale disaster recovery processes into development opportunities by restoring livelihoods, setting up sustainable federations and enterprises, and addressing gaps in village development and local governance. SSP operates in ten disaster prone districts in three states of India and reaches over 300,000 families.
Consortium member:
Swasth India Services (SIS) focuses on providing good health care to low-income households - both urban and rural - across India. SIS works with communities to implement health care projects encompassing both a delivery network and appropriate financing options.
Project Summary
- Project name: Enhancing community resilience in low-income households in India
- Project start date: 1st July 2009
- Country: India
Beneficiaries
The project targets low-income women in households earning less than US$5 per day, in 100 villages in two districts in the state of Maharashtra. The majority of these women and their families depend on agriculture for their livelihood, and thus experience irregular and unpredictable income patterns. About 50% of the targeted households report no or minimal savings, with 20% taking high interest loans in the last year to respond to a health problem. Nearly 30% of illnesses go untreated due to a lack of financial resources to pay for care.
Project Description
With over 70% of healthcare spending being out-of-pocket, about 20 million people in India annually fall into poverty due to health related events. To access health care, many poor households have to take emergency loans at high interest rates (3-5% per month) or to sell their productive assets, therefore reducing future earning potential.
In partnership with Oriental Insurance Company, the project seeks to build resilience in low-income households by improving healthcare access and creating an economic safety net through grassroots women's groups. Members pool savings to create a self-sustaining Community Health Fund (CHF). Building on more than a year of field demonstration, a hybrid model is proposed to provide: 1) insulation from high cost health events through a group insurance policy and "cashless" (i.e. no out-of-pocket cost to members) access to hospital services, and 2) reduction of 30% in healthcare costs through quality primary care and preventive services designed to lower incidence of disease.
The project also aims to offer the following insurance benefits: 1) affordable annual premium (USD 13 - 22 for a family of 5) and 2) a simple product that is easily understood and adopted by clients; and 3) offer additional coverage for catastrophic cases.
The CHF will forge partnerships across the health value chain - insurers, hospitals, doctors and pharmacies - focusing on acceptability, affordability and quality to build a robust, low cost and low overhead comprehensive health system.
Key Challenges
- Providing comprehensive coverage while minimizing financial risk borne by the community health plan.
- Combining a commercial insurer's catastrophic benefit plan with a preventive and outpatient based community health
plan to create a hybrid model that provides comprehensive benefits and is financially viable.
- Reducing complexity to sell and manage health insurance products which traditionally have exclusions, varying
benefit limits, etc.
- Creating sustainable cost reductions in the health delivery system.
Learning Agenda
- What are the essential factors that contribute to an effective community regulated, microinsurance health model
that works for the poor?
- What are the requirements for making community health and insurance partnerships work to serve low-income clients?
- What is the economic and social impact on clients and their families (e.g. reduced health expenditure, lower child
and maternal mortality, improved health status of women)?
More information on the project
Website of the grantee:
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