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Enhancing community resilience in low-income households in India --SSP

About the Project

Project Name: Enhancing community resilience in low-income households in India --SSP
Type of Facility Project: Microinsurance innovation grantee
Country of Operation: India
Region: Asia and the Pacific
Sub Topics: Business viability, Product development, Impact, Value-added services, Health

Organizational Overview

Swayam Shikshan Prayog (SSP), meaning Self Education for Empowerment, is a development organization that provides access to social and economic opportunities through technical support. It promotes community-driven entities and forges partnerships with institutional actors. Since 1993, SSP has mobilized grassroots women's groups around reconstruction and local governance issues. It transforms mass-scale disaster recovery processes into development opportunities by restoring livelihoods, setting up sustainable federations and enterprises, and addressing gaps in village development and local governance. SSP operates in ten disaster prone districts in three states of India and reaches over 300,000 families.

The mission of Swayam Shikshan Prayog ('SSP') is to build resilience in low income households in rural India by improving access to healthcare services and insurance and creating an economic safety net through grassroots women’s collectives. 


Project Description

SSP has partnered with Swasth India Services ('SIS') to pilot a Community Health Fund (CHF) in which a comprehensive health product has been offered.  The project envisaged implementation of a health insurance product (inpatient care insured and cashless delivery) with an out-patient component delivered through a network of Community Health Workers (CHWs), physicians, diagnostic centers and drug dispensing units, coordinated by a Community Health Trust.  The overall objective of the pr...READ MORE


The project targets low-income women in households earning less than US$5 per day, in 100 villages in two districts in the state of Maharashtra. The majority of these women and their families depend on agriculture for their livelihood, and thus experience irregular and unpredictable income patterns. About 50% of the targeted households report no or minimal savings, with 20% taking high interest loans in the last year to respond to a health problem. Nearly 30% of illnesses go untreated due to a lack of financial resources to pay for care.


Learning Agenda

  • What are the essential factors that contribute to an effective community regulated, microinsurance health model that works for the poor?
  • What are the requirements for making community health and insurance partnerships work to serve low-income clients?
  • What is the economic and social impact on clients and their families (e.g. reduced health expenditure, lower child and maternal mortality, improved health status of women)?


Project Status

Key Performance Indicators

Project Updates
As of August 2009 (Project kick-off) In 2007 Self Help Groups (SHGs) in India were demanding health insurance to deal with shocks. SSP undertook a pilot project to promote health awareness, to test a community-based hospitalization scheme, and to train Community Health Workers (CHWs).  The main role of CHWs was to promote health policies which promised clients up to US$200 of reimbursement for hospitalization. The money was pooled to form a totally self-insured Mutual Health Fund with a ...READ MORE

Project Lessons

On client value from a comprehensive health insurance product (satisfaction and impact) Attractive rates can be negotiated with hospitals, if approached with the broader social objectives. The larger hospitals are more compliant to agreed processes than smaller ones.  Hospitals have offered rates which are about 20-25 per cent lower than those offered to other clients – both individual patients and insurance companies. They not only respect these rate...READ MORE
On effectiveness of Community Health Workers as entrepreneurs 1. Efficiency of CHW to service clients It can be difficult to impossible to find local staff in a low income, rural community with the skills to do both sales and health promotion.  It was in fact very difficult to develop a cadre of CHWs, and the role as initially envisioned was dropped in a short time.  SSP learned the importance of testing and adapting based on experience the sel...READ MORE
On the feasibility of a low-cost drug supply chain 1. Revenue potential for retail drug sales It can be challenging to set up an independent community pharmacy.  SSP experienced significant challenges to get permits for a community pharmacy. In the Indian environment, each pharmacy needs to have full-time B.Pharm (Bachelor of Pharmaceuticals) license-holder; these professionals are very scarce. Real estate near a high traffic point (typically the ma...READ MORE
On Project Management It’s easy to underestimate the complexity of a project and resources required, or to anticipate where the bottlenecks will occur, or fully anticipate impact of challenges in one facet of the project on others.  Ample time and budget also needs to be provisioned for recruitment and training of operations staff. All processes, even with the introduction of IT systems, need to have a backup manual process also defined – in order t...READ MORE
Date of last update:  November 2011