- 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 health seeking behaviour. It has been noticed that there is significant improvement in knowledge and skills of the community in adopting preventive health care and also seeking appropriate curative services
- The Scheme has created a sense of self-responsibility within the community. As the Scheme is managed by the local community with contribution from its members itself, there is greater emphasis on keeping transparency and accountability. The ownership factor is one of the important features of the Scheme. The adivasis own, manage and implement it. ACCORD’s earlier activities to promote solidarity within the tribal groups helped in managing this scheme with a strong feeling of communal solidarity.
- The Scheme has mobilised community resources considerably. In addition to financial contributions made by the community, it has also seen that community members have a high sense of dedication in voluntarily working for the entire community.
- The Scheme has greatly considered the cultural sensitivities of the tribals like for example collecting premiums during coffee-plucking seasons when the demand for labour is high and tribals are able to earn well.
- One of the biggest strengths of this health micro-insurance programme is the presence of the adivasi hospital and provision of health care through a multi-tier system such as hospital, regional-level Health Sub-Centres (HSCs) and health workers at village-level. This kind of arrangement has strengthened the referral services of the area and complicated cases have been handled with care.
Weaknesses of the Scheme
- The major drawback of the Scheme is its dependency on donors and external sources of funding. It did not visualised the sustainability factor right from the beginning and has remained dependent upon donor funding. It will be a long way before tribals would be able to cover the costs of implementing the Scheme all by themselves.
- The Scheme has a strong dependency on doctors, as well. It is assumed that if doctors move out of the programme, finding a suitable replacement will not be an easy task
- Finally, the Scheme has not been profitable to the insurance company. NIAC could make profit out of it, although it had entered the scene merely out of social commitment. However, the programme was a loss-maker to NIAC.
