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Emerging Lessons in Health Microinsurance

Health Microinsurance Working Group

In order to learn more about the impact of health microinsurance on health outcomes and household well-being, the Microinsurance Network Health Working Group extracted lessons from academic journals, publications by industry leaders and submissions from practitioners and other stakeholders actively working in health microinsurance and health systems innovation. You can learn more about specific lessons by clicking on the Emerging Lessons column. You can also sort the Emerging Lessons by Region or Theme by clicking on the column heading. For further information on the health insurance scheme or publication featured in the lesson, click on the respective links in the Source column.

Lessons Aggregator Page Picture
Region Theme Source Emerging Lesson
Asia and the Pacific Consumer Education SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) Client education needs investment and targeted messaging.
Asia and the Pacific Marketing SSP Learning Journey “Word of mouth” (testimonials) is an effective strategy to spread the word on insurance.
Asia and the Pacific "Cashless" Products SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) "Cashless" claims may encourage moral hazard by both clients and healthcare providers.
Asia and the Pacific Health Claims SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) Preventable illnesses are significant drivers of claims costs, and must be controlled, for the scheme to achieve financial viability.
Asia and the Pacific Partnering with Health Care Providers SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) A low premium health insurance product must control the utilization of high cost facilities.
Asia and the Pacific Health Seeking Behaviour SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) Access to outpatient services may reduce inpatient hospitalization.
Asia and the Pacific Community Health Workers SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) It can be difficult to impossible find local staff in a low income, rural community with the skills to do both sales and health promotion.
Asia and the Pacific Community Health Workers SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) Training of field health and insurance promoters is more successful when done in iterative, ongoing sessions.
Asia and the Pacific Community Health Workers SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) Recognition and certification are valuable elements for Community Health Worker retention.
Asia and the Pacific Community Health Workers SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) It can be difficult to train community women to sell and service insurance.
Asia and the Pacific Community Health Workers SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) A social mission can be more motivating than financial rewards to recruit and retain Community Health Workers.
Asia and the Pacific Pharmacy SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) It can be challenging to set up an independent community pharmacy.
Asia and the Pacific Pharmacy SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) A successful drug supply chain may require more than one pharmacy delivery model.
Asia and the Pacific Partnering with Health Care Providers, Pharmacy SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) Doctors resist the increased use of lower cost drugs, if approached with a commercial proposal.
Asia and the Pacific Pharmacy SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) Patients can resist a change in a prescription to a lower cost alternative, so it’s important to overcome their perception that cheaper drugs may be inferior.
Asia and the Pacific Training Staff SSP Learning Journey Arogya Sandhi (Swayam Shikshan Prayog (SSP)) Capacity building for a community-run health insurance scheme is important.
Client Value Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). The poor perceive more value in comprehensive coverage for healthcare, including preventive and routine healthcare services.
Health Seeking Behaviour Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). Enhancing out-patient benefits encourages regular health check-ups, earlier diagnoses, and timely care for minor illnesses.
"Cashless" Products Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). Cashless benefits can help clients overcome financial constraints when a claim is incurred.
Health Claims Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). Outsourcing administration of health microinsurance to third-party administrators (TPAs) can increase operational efficiency of health microinsurance.
Partnerships Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). Private-public partnerships are a potential solution to the challenge of offering comprehensive health microinsurance coverage
Partnerships Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). One of the most frequently mentioned benefits of PPPs is the potential for significant outreach (possibly leading to universal coverage for the very poor) with the support of government resources.
Asia and the Pacific Partnerships Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). Quality assurance the need for uniform standards of quality, cost of treatment and accreditation are areas where the government can play an important role in public-private partnerships.
Latin America and the Caribbean Enrolment Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). Nicaraguan Social Security Institute Incentives can be an effective way to encourage clients to enrol.
Asia and the Pacific Technology Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). CARE Arogya Kendra Mobile technology can help to connect doctors with rural patients.
Asia and the Pacific Technology Leatherman, S., Jones Christensen, L. & Holtz, J. 2010. Innovations and Barriers in Health Microinsurance (Geneva: ILO). First Microinsurance Agency (FMiA) Technology can be used to improve health outcomes for people who suffer from a lack of available clinics.
Latin America and the Caribbean Maternal Benefits Banthia., A. Johnson, S., McCord, M. & Matthews, B. 2010. Microinsurance that Works for Women (Geneva: ILO). SolSalud (Zurich - BancoSol) A seven month waiting period can be used to create a viable product that provides full maternity coverage and offers value to clients.
Africa Maternal Benefits Microinsurance Innovation Facility. 2010. Protecting the Special Health Needs of Women (Geneva: ILO). l'Union des Mutuelles de Sante de guinee Forestiere (UMSGF) In some communities, women and girls may not be enroled in insurance schemes because their health is valued less by household decision makers. Family products with compulsory registration of all dependents may help to avoid this.
Asia and the Pacific Enrolment Microinsurance Innovation Facility. 2010. Protecting the Special Health Needs of Women (Geneva: ILO). VimoSEWA Financial incentives can be used to encourage members to enrol their whole families and avoid the exclusion of women and girls.
Maternal Benefits Microinsurance Innovation Facility. 2010. Protecting the Special Health Needs of Women (Geneva: ILO). First Microinsurance Agency (FMiA) Pregnancy is not a risk that can be risk-pooled in a pure insurance sense. Some voluntary schemes have found the need to institute waiting periods to avoid adverse selection.

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