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Page 1 Page 2 Page 3 Strengths of the Scheme The ACCORD-AMS-ASHWINI Community Health Insurance Scheme has been quite successful in sensitizing the tribal populations on health issues. As the Scheme emphasizes on universal health care, the tribal groups have realised the importance of taking care of their health and has subsequently improved their . . . → Read More: ACCORD-AMS-ASHWINI Community Health Insurance in India 3 (contd) Page 1 Page 2 Page 3 Objectives of the Scheme The objectives of the “Composite Tribal Health Insurance Package” are: To access health care with dignity by not depending on charity or handouts; To encourage health seeking behaviour by offering comprehensive health care with minimal payment at the time of use of the services . . . → Read More: ACCORD-AMS-ASHWINI Community Health Insurance in India 2 (contd) Page 1Page 2 Page 3 Background ACCORD is an NGO based in the Niligiris and was founded in 1986 with a mission to “fight against the unjust alienation of the adivasi lands and other human rights violations by organising them as a strong group.” The area of operation is largely inhabited by tribal groups . . . → Read More: ACCORD-AMS-ASHWINI Community Health Insurance in India Page 3Page 1 Page 2 In T. Narasipura, the three main health facilities have been provided with a wireless sets and computes for faster communication and maintenance of database. The health facilities are also connected to Karuna trust office. Also the Karuna Trust ambulance at the general hospital is connected through wireless to facilitate . . . → Read More: Community Health Insurance: Karuna Trust-India…3 Page 2Page 1 Page 3 Characteristics of the Scheme 1. In T. Narasipura Taluk, the seven public health facilities that were to be involved in the insurance scheme: a general hospital of T. Narasipura, 2 CHCs (one in Bannur and the other at Talakkadu) and 4 PHCs (at Kaveripura, Mugur, Malangi and Gargeswari), were . . . → Read More: Community Health Insurance: Karuna Trust-India…2 Page 1Page 2 Page 3 Background Karuna Trust is a local NGO based in T. Narsipur, located in Mysore District. It is led by a well-known social activist, Dr. Sudarshan. He has been working for the improvement of the health conditions of the tribals living in the area. . According to Dr. Sudarshan, tribals . . . → Read More: Community Health Insurance: Karuna Trust-India…1 Page 2Page 1 Characteristics and Functions 1. The annual premium charged by SEWA is Rs. 72.5 for members, and an additional optional Rs. 22.5 and Rs. 20 for their husbands. 2. In order to get into the program, members must pay Rs. 72.5. If they want their husbands covered, they can add on life . . . → Read More: SEWA (India) Health Insurance Scheme 2 Page 1 Page 2 Background SEWA started as a trade union movement in 1972 to organize the poor women working in the informal sector. Its objective was to provide full employment to its members by creating income-generation opportunities. It also works to support health, education, housing and insurance needs of the people. It . . . → Read More: SEWA (India) Health Insurance Scheme 1 Page 2 Page 1 Page 3 Characteristics and Functioning of the Scheme 1. The scheme has only one type of membership wherein a family person pays a premium of Rs. 20 per annum. This premium insures the person as well as all his/her family members 2. The premiums collected from members are consolidated . . . → Read More: PREM-PLAN Health Micro-Insurance Programme – India 2 Page 3 Page 1 Page 2 Strengths of the Scheme1. The social embedding of PRHPS through the CBOs among adivasis, dalits, fishermen and women mentioned in the introduction helps in ensuring a large membership base, instilling a sense of ownership of the scheme among its members, prompt premium collection and prevention of moral hazards and . . . → Read More: PREM-PLAN Health Micro-Insurance Programme – India 3 Page 1Page 2 Page 3 Background The Peope’s Rural Education Movement (PREM) was started by Mr. Jacob Thundiyil and Chacko Paruvanany in 1980 in Berhampur in Orissa to empower the tribals, scheduled castes, small and marginal farmers and marine and inland fishermen through provision of literacy, raising their awareness on their rights and enhance . . . → Read More: PREM-PLAN Health Micro-Insurance Programme – India 1 Background Voluntary Health Services (VHS), a registered non-profit organisation came into existence in Chennai in 1958 by Dr. K.S. Sanjivi, who is popularly known as the father of primary health care movement in India. Its prime areas of focus include provision of preventive care, promoting family as the unit of care and enhancing community participation. . . . → Read More: Health Insurance Scheme for Low Income Groups-VHS (India) Page 2Page 1 Page 3 Characteristics and Functions… 1. The Yeshasvini plan covers 1,600 surgeries available only at approved hospitals on cashless basis to beneficiaries. The plan pays the participating hospital a fixed tariff for each of these defined benefits. It is stated that the tariff is 40-50% off the “regular” price of the . . . → Read More: Yeshasvini (India) Rural Micro-Health Insurance Scheme 2 Page 3Page 1 Page 2 Each accredited hospital signs an agreement to: • Provide a help desk staffed 24 hours to receive and assist Yeshasvini members• Admit all patients free of charge for OPD, the covered services of surgeries, at general ward admission• Bill the Trust only at the tariff for special admission• Submit . . . → Read More: Yeshasvini (India) Rural Micro-Health Insurance Scheme 3 Page 1Page 2 Page 3 Background The Yeshasvini rural health micro-insurance scheme was conceived by Dr. Devi Shetty and a group of doctors to demonstrate the fact that health insurance could be extended to the poor. The idea emerged when Dr. Shetty, a well-known cardiac specialist himself, noted that the low utilisation of . . . → Read More: Yeshasvini (India) Rural Micro-Health Insurance Scheme 1 Health micro-insurance is a form of micro-insurance in which resources are pooled to mitigate health risks and cover health care services in full or in part. Health micro-insurance schemes are more complex in nature compared to life insurance schemes, as they provide services towards specific risks or illnesses and involve the role a health care . . . → Read More: 20. Micro-Insurance: Health Micro-Insurance In the Full-Service Model, the institution delivers micro-insurance services along with various other insurance products such as health, life, maternity protection, childcare, assets and livestock. There are two different approaches of offering this kind of service. First, the insurance service provider may design various kinds of insurance products with different pricing for different products and . . . → Read More: 19. Micro-Insurance: Types – The Full-Service Model In the Integrated Model of micro-insurance, an institution offers more than one service to its members. One of the various services catered to the members is micro-insurance. Integration of various services has the benefit of satisfying the various demands of the members so as to improve the quality of life of the community at a . . . → Read More: 18. Micro-Insurance: Types – The Integrated Model In the Provider Model, the health care provider is providing the insurance services. Health institutions under social obligation or pursuing a social objective develop the health micro-insurance scheme for people who have limited access to health care. In many cases, the scheme promoted by these institutions are subsidized. The model only provides health services. In . . . → Read More: 17. Micro-Insurance: Types – The Provider Model In the Partnership type of micro-insurance model, a formal public or private insurance company is the service provider, which offers an insurance product in health, life, maternity benefits, childcare, assets, livestock etc. An intermediary organisation (CBO/NGO etc) makes a partnership with the insurer and cater to micro-insurance services for the poor segments of the community . . . → Read More: 16. Micro-Insurance: Types – The Partnership Model In the Independent Model type of micro-insurance, the micro-insurance scheme and the service provider have no direct relationship. Here, the insured members are free to chose any health care provider and the scheme will directly reimburse to the members the costs of the services used, as defined in the benefit package. The model is applicable . . . → Read More: 15. Micro-Insurance: Types – The Independent Model The principles of micro-insurance are: Risk-sharing and Pooling of Resources: The main principle of any micro-insurance scheme is that a group’s (community) resources are pooled to share risks (such as health, death, pension, accidents etc) in order to organise protection directly for themselves. Specified Risks Only: A micro-insurance scheme can be designed to protect only . . . → Read More: 14. Micro-Insurance: Principles of Micro-Insurance Insurance is a kind of a financial service whereby clients pay a premium on regular basis in return for reimbursement at higher rate when a risk occurs. In principle, it is one of the risk management tools to counter the losses suffered from a crisis. It is a pool of resources developed by the contributions . . . → Read More: 13. Micro-Insurance: Definition Women and men working in the informal economy are exposed to numerous kinds of risks as they work under difficult work conditions. These conditions are characterised by risks associated with lack of hygiene, poor access to health care services and no fixed wages at fixed times. Besides, during times of social, political and natural crisis, . . . → Read More: 12. Micro-Insurance: Risks in the Informal Economy According Robert Holzmann and Steen Jorgensen, “the notion of risk refers to uncertainty or unpredictability that result in welfare losses.” There can be different types of risks ranging from natural, health, social, economic, political and environmental. Bonilla Garcia and J.V. Gruat have broadly classified risks in the following manner: Idiosyncratic (Individual) Risks: Those risks which . . . → Read More: 11. Micro-Insurance: Risks Social protection is definitely a need in the growing world. It has been acknowledged as a fact that both social protection and economic development are mutually reinforcing each other. Besides, it is playing an important role in promoting social justice and equity and reducing poverty. Following are some of points favouring social protection: Poverty reduction . . . → Read More: 10. Micro-Insurance: The Need for Social Protection The introduction of social protection has often been considered as one of the most significant social achievements of the 20th Century. It is perceived to be one of the systematic tools to eradicate poverty and enable the vulnerable sections of the society to live a decent life. It is also said that it can play . . . → Read More: 9. Micro-Insurance: Social Protection is a Human Right Social protection refers to certain measures adopted by the society to protect its members from socio-economic challenges. Following are some definitions of ‘Social Protection’: According to The United Nations Economic and Social Council, social protection should be “broadly understood as a set of public and private policies and programmes undertaken by societies in response to . . . → Read More: 8. Micro-Insurance: Social Protection Since informal economy is characterized by low-incomes, unhygienic conditions, lack of social protection systems and poor organization, women are likely to suffer more from such critical problems, as they have additional role of carrying out household work like looking after children. Informal economy has series implication on women. These are outlined below: Although most women . . . → Read More: 7. Micro-Insurance: Implications of Informal Economy on Women Women constitute a substantial portion of labour force in the informal economy. In countries like India, Indonesia and the Philippines, the share of women in home-based work is more than 80%. The following table gives an overview of the share of women and men in non-wage employment: The factors responsible for the higher proportion . . . → Read More: 6. Micro-Insurance: Women and the Informal Economy More than 80% of the population in India works in the informal sector and just about 20% in the formal sector. Nearly 50% of the people in Indonesia and Thailand for the non-agricultural labour force working in the informal sector. In the Philippines, about 63% of the people belong to this economy. In Pakistan, . . . → Read More: 5. Micro-Insurance: Some Facts about Informal Economy Informal sector is the pre-existence of the formal sector. However, its contribution to the world economy has been very recently recognised and debated upon. The word, “informal economy” was first brought into reference in 1970s. But its advocacy process began way back in the 1950s and 1960s when it was insisted that post-world war economy-building . . . → Read More: 4. Micro-Insurance: Scope of Informal Economy The term, “Informal Economy” was first used by Keith Hart (Informal Income Opportunities and Urban Employment in Ghana” in Journal of Modern African Studies) during the 1970s to describe the temporary economic strategies adopted by migrant workers in Ghana. Over time, various definitions have come into place: ILO’s Kenya Report (Employment incomes and equality: A . . . → Read More: 3. Micro-Insurance: Definitions of Informal Economy The Formal Economy… has an organized system of employment with clear written rules of recruitment, agreement and job responsibilities. has standardized relationship between the employer and the employee is maintained through a formal contract. the employee is expected to work for fixed hours and receives fixed salaries in addition to incentives and perks. He works . . . → Read More: 2. Micro-Insurance: Characteristics of Formal and Informal Economy In a Formal Economy,…a person gets a job at a software company. He has a letter of appointment with a contract explaining his job responsibilities. He gets a fixed salary in addition to incentives based upon his qualifications and experience. He works in an organized environment where his colleagues enjoy similar benefits. He is entitled . . . → Read More: 1. Micro-Insurance: The Difference between Formal and Informal Economy |
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