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Health microinsurance consumer education -- FFH

About the Project

Project Name: Health microinsurance consumer education -- FFH
Type of Facility Project: Microinsurance innovation grantee
Country of Operation: Ghana
Region: Africa
Sub Topics: Renewals, Enrollment, Consumer education, Impact, Health
Type of Risk Carrier: Government
Type of Distribution Channel: Government networks

Organizational Overview

Freedom from Hunger is a not-for-profit organization, founded in 1946 and working in 17 countries in West Africa, Latin America, and Asia. Its mission is to bring innovative and sustainable ‘self-help’ solutions to the fight against chronic hunger and poverty. Its core activities focus on designing and disseminating integrated financial services and lifeskills training that equip the rural poor to escape poverty and achieve household food security. The organization’s experience and expertise extend across multiple sectors that address the causes of chronic hunger and poverty, including microfinance, livelihood development, health and nutrition, household food security and empowerment of women. Freedom from Hunger’s work currently reaches 5.1 million microfinance clients.


Project Description

Although a diverse set of actors is currently involved in providing health microinsurance (HMI) to low-income people, outreach has been limited, particularly in rural areas. For most low-income people in the developing world, the concept of insurance—to protect against the cost of illness, accident and extended ill health—is new, untested and not well understood. To fill the gap, Freedom from Hunger set out to develop a consumer education module targeted to poor families on how HMI works, th...READ MORE


The project will target one or more vulnerable groups amongst the ‘chronically hungry poor’ who lack access to health insurance and who have correspondingly poor health status. The groups have below-poverty-level incomes, high levels of illiteracy, and include predominantly women and families.


Learning Agenda

  • How can a consumer health education module be developed for use with low-income consumers that incorporates generic information on the value of health insurance, and that is designed with built-in modularity to enable replication by health microinsurance providers across a range of different settings, sponsors, and schemes?
  • Does the delivery of a series of technical learning conversations based on adult learning principles measurably increase the knowledge, skills, and attitudes of poor consumers about the advantages of health micro-insurance, and how the insurance program works to provide financial protection to the enrollee and/or the family?
  • What is the added value of consumer education for insurance uptake, retention, access to and use of covered health benefits, and the capacity of consumers to use health insurance to help manage the financial risks of illness and poor health?

Project Status

Key Performance Indicators

These data show Freedom from Hunger’s best estimate of the enrolment status for all of the individuals in the sample from baseline to endline. Since clients who reported that they were registered could not always show ID cards, this data is extrapolated using the percentages of clients who reported they were registered, could show cards, or whose enrolment could be verified.  This percentage was then applied to the number of people who reported that they were registered but could not show their insurance cards. Although differences across groups are not statistically significant, even controlling for initial enrolment rate, the number of individuals enrolled in the SAT groups increased by 55 per cent over the course of the study. When looked at from the perspective of total penetration or uptake, the percentage of SAT clients in the sample who were enrolled went from 33 per cent at baseline to 50 per cent at endline. 

Project Updates
April 2009–March 2010: Product development; partner identification; field test Freedom from Hunger started with research to identify consumer education materials currently being used with HMI, and discovered that few tested and applicable materials existed. Using well-tested principles of adult learning, Freedom from Hunger designed the TLCs to be easily delivered by MFIs or NGOs providing financial services using the following six sessions: Costs and risks of illness How insurance ...READ MORE

Project Lessons

On setting up a consumer education module Certain key messages about HMI resonate better with low-income clients; pilot-testing is a good way to test and improve these messages. For example, during the field test, Freedom from Hunger observed that low-income households may place more value on the range of insurance benefits to enable them to access needed care and reduce the total costs related to illness, and place less value on insurance as a mechanism tha...READ MORE
On the impact of a consumer education module—uptake, retention, access and use Gaps in knowledge existed, but may not have been the biggest barriers to enrolment. During the field test, it was found that overall knowledge of the insurance was quite high. Although the education seemed to improve some knowledge gaps immediately after the sessions, lack of knowledge may not have been the biggest barrier to enrolment. Clients reported that the main reasons the...READ MORE
On project set-up The selection of an implementing partner and an HMI scheme to pilot-test an intervention such as consumer education should be well-structured and carefully considered. Freedom from Hunger established and followed several criteria for selecting a test site and partner:  Scheme had to be operational, stable, and with a membership of at least several thousand; ideally it will be a private-sector product Product had to be appro...READ MORE
Sharing results and examining implications Key findings and implications for continuing to find ways to increase health insurance coverage of poor families have been presented and discussed in two separate forums, as detailed below. The first was a knowledge sharing forum organized by the ILO’s Microinsurance Innovation Facility in India in September 2012. A complete report of that workshop can be accessed here, including a summary of lessons learned an...READ MORE
Date of last update:  March 2013