ICCO Health Insurance Trajectory Asia
30 October 2008
The Health Programme of the ICCO-Alliance is carried out by three organisations: ICCO, Kerkinactie and the Prisma Association (consisting of app. 15 member-organisations). Within the health Programme, access to health care, especially for the poor and vulnerable is a major goal. Many factors contribute to access to health care. One of the strategies that is increasingly being practised is the development of health insurance schemes, both on the national levels (a.o. social health insurance) and on the community level (a.o. community based health insurance).
Health insurance has clear potentials as a mechanism to promote access to health care and minimising risks on household levels of falling into poverty when confronted with large health expenditures. For health providers, health insurance can provide a relatively stable source of finance.
Some questions related to health insurance are:
- the extent to which the poorest can benefit
- the administrative and managerial capacities required to operate a well-functioning health
insurance scheme.
Bearing this in mind, the ICCO-Alliance has decided to seriously consider to what extent it can support the development of health insurance systems in low and middle income countries by promoting training, ‘linking and learning’, and implementing health insurance. The ICCO-Alliance has also learnt that health insurance is but one way of health financing: it has to be seen in the wider context of national health policies, health systems and its financing. To enable the poorest to access health care, other forms of ‘social assistance’ are often necessary. These forms of ‘social assistance’ have to be complementary to make (primary) care and treatment accessible for the poor.
In 2007, several steps have been taken in order to prepare the ICCO-Alliance for working on health insurance.
· Several ICCO-Alliance staff members have been trained in the field of health insurance
· We have established relationships with knowledge institutes, health insurance companies, NGOs and other stakeholders individually and within the framework of the Netherlands Platform for Health Insurance for the Poor (HIP) of which we are a core group member.
· We have made an inventory of partner-organisations in several countries in Asia and Africa, East Europe and the Middle East which are working on health insurance or might have an interest in the subject. These partners have received and returned a questionnaire from us, the results of which we have analysed and described in a short report.
· From 22-26 February 2008 a seminar on Community Based Health Insurance and Social
Assistance Funds was organised. 10 Organisations from India, The Philippines, Cambodia, Cameroon and Bangladesh and ICCO/Prisma gathered in New Delhi to learn, exchange experiences and brainstorm about their work in Health Insurance. The seminar was facilitated by
experts from ITM Antwerp, IPH Bangalore, Cambodia, and I/C Consult Netherlands.
· After the seminar, most of the participants indicated the way in which they would like to work on
the theme by completing a pre-set format.
In supporting health insurance the ICCO-Alliance aims to follow a programmatic approach: bringing different kinds of organisations together (NGOs, health care providers, knowledge institutes, insurance companies, etc), sharing knowledge and experiences and finding out how organisations can cooperate to promote the development and implementation of health insurance. Because of the importance and potential of the matter, the ICCO-Alliance is in principle ready to commit itself for a multiple-year period to such a process, depending of course on the way in which a successful trajectory comes into being. Our commitment can be worked out in different roles, such as:
- financing capacity building and linking and learning,
- facilitating in bringing together relevant partners in the South and in the North,
- finance or having a role in advocacy and lobby if needed
- initiating or financing research
- financing implementation of pilots
- other
It is not the intention of the ICCO-Alliance to finance/subsidize premiums in health insurance schemes. Currently (October 2008) the consultant Dr. Deva Devadasan, Founder and Director of the Institute of Public Health Bangalore India, is conducting a mission to discuss with stakeholders the needs and strategies to be followed. Further steps will be developed based on the outputs of this mission.
