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Micro Health Insurance in Nepal

Structured Technical Assistance
Project Title:Micro Health Insurance in Nepal: DEPROSC-Dhading and NIRDHAN-Banke
PROJECT CATEGORY:Structured Technical Assistance
OBJECTIVE:

The project aims to lower health risks and increase utilisation of health care by poor families through the implementation of two community-based micro insurance schemes in the districts of Dhading and Banke, Nepal. 

BACKGROUND:

A baseline survey completed in 2009 in Banke and Dhading provides evidence that 12% of households reported illnesses, of which 72% were acute and 20% were chronic conditions. Children under age 5 (found in 43% of households) and the elderly (in 26% of households) experience higher incidences of illness. Yet, like most of the poor, they do not have access to health insurance because of the limitations of existing insurance products in terms of coverage, cost, and exclusion criteria based on age and types of illnesses. As a consequence, many households are forced to deplete their assets to finance health care in the event of illness — and do so by borrowing money (19% of illness episodes and 53% of hospitalisations).

PROJECT CONCEPT:

MIA, in collaboration with our local partners, will develop affordable and inclusive micro health insurance for households belonging to the women that are clients of two active MFIs in Banke and Dhading. The programme is tailored to respond to the needs and willingness to pay of the target population, and relevant data has been collected during the baseline survey. Importantly, the benefit package will complement services that are accessible at no cost to the community under existing schemes. It could cover any combination of hospitalisation, maternity care, transportation costs, income-loss compensation, testing and imaging services. Being a community-based project which leverages the existing women's groups in the target districts, the women are in charge of building and finalising the benefit package along with administrating and running the microinsurance schemes.

PARTNERS:

 

Collaborating partners for first phase of project – (Baseline Survey and first Micro Insurance Education Campaign):

  • Save the Children USA, Washington D.C., USA;
  • Save the Children Nepal, Kathmandu, Nepal;
  • Nirdhan Utthan Bank Limited, Central Office, Bhairawa, Nepal;
  • Nepal Development Project Service Center (DEPROSC), Kathmandu, Nepal

 

Collaborating partners for second phase of project (Implementation of the Micro Insurance Schemes):

  • Save the Children Nepal, Kathmandu, Nepal;
  • Nirdhan Utthan Bank Limited, Central Office, Bhairawa;
  • Nepal Development Project Service Center (DEPROSC), Kathmandu, Nepal.
FUNDING:

Funding for this project has been obtained from a number of donors, some of which wish to be kept anonymous. The Rockefeller Foundation (New York) has contributed to the baseline study in the two districts. USAID’s Field Project funded the first Insurance Education campaign of the project. Save the Children—Finland provided interim funding for three months between the Insurance Education and the Implementation phase. Finally, MISEREOR-Germany is the core funder for the three-year implementation of the microinsurance schemes in the two districts in Nepal. This final phase also consists of insurance education activities.

DURATION:2009-2013
COUNTRY:Nepal
LOCATION:
  • Data analysis and desk research were completed at MIA office in New Delhi, India.
  • Audio/Visual work for Insurance Education was done in Kathmandu and Delhi.
  • Field work was carried out in nine Village Development Committees(VDCs) in Dhading: Jogimara, Dhusa, Benighat, Gajuri, Trisuli, Pida, Baireni, Kalleri, Kumpur and Bhumisthan; and five VDCs in Banke: Kohalpur, Khajura Paraspur, Udaipur and Ranjha.
  • Monitoring of the scheme is done through field visits to Nepal and by communication from the Delhi office.
CONTACT:Dhriti Bhatta, Project Manager, dhriti@mia.org.in
PROGRESS:

The Baseline Survey (data collection and analysis from Focus Group Discussions, Key Informant and Household Interviews) was completed in 2009. A full report of the survey is available on MIA's publications page. Workshops were conducted from April-October 2010 to educate target communities on micro health insurance and engage them on various processes required to begin the schemes.  In this period community members finalised the structure and the benefit packages for the two microinsurance schemes. They also prepared various awareness tools like posters, songs, and street plays for the insurance education campaigns. 20 women facilitators in each of the two locations used these tools to raise awareness about micro health insurance at the grassroots level for two months. The outcome of the awareness campaigns was evaluated by MIA (Quantitative Survey, Focus Group Discussions and Key Informant Interviews) and a preliminary report on the findings was drafted.

 

Executive and administrative members for the microinsurance schemes were selected by community members in November 2010. Four trainings were provided to these ground structure members in each location, including one on the Management Information System (MIS) that they will use to organise data on beneficiaries when the schemes start.

 

Enrollment in Dhading started in December 2010, and the Saubhagya Micro Health Protection Fund was launched in Dhading in January 2011. Five claims have been settled by the scheme in the first month.

 

The scheme at Banke (in Nepal) went live on 15 June 2011 and has already received about 5000 enrollments - which is an extraordinary start when compared with similar schemes.