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Health insurance

Developing organized demand for healthcare

Reducing out-of-pocket expenditure through insurance or other forms of pre-payment offers financial protection and peace of mind for people in case they fall ill.

At the same time, predictable income, for example from health insurance, helps healthcare providers to run their business effectively.

Our mobile health payment activities build on existing social solidarity mechanisms to offer easy access to new forms of pre-payment and risk sharing for healthcare. High mobile phone penetration in many African countries opens up possibilities for targeting specific population groups through segmentation based on mobile phone and money usage, location and demographic information. Lower transaction costs, increased transparency and shortened cash cycles in turn make the businesses of healthcare providers more resilient and enable them to improve the quality of care. In fact, these low costs and high penetration of mobile phones throughout the continent are key for a health insurance system for all.

With African partners such as governments, mobile network and mobile money operators, insurers and insurance distributors, we design and develop private and public-private health insurance schemes for lower-income groups. By providing risk sharing mechanisms, we reduce financial risks for local partners in order to kick-start sustainable market development and growth. We build on existing institutions and stimulate not only the demand side of the market through insurance, but also the supply side of the market. Quality improvement of healthcare providers, for example, is a central aspect within all our health insurance schemes.

Universal Health Coverage

Including the private sector is indispensable for realizing UHC. While many African governments have committed to roll-out financing and service delivery reforms towards the goal of Universal Health Coverage, providing quality care and coverage for all their citizens remains a challenge.

Implemented well, insurance reforms can fundamentally change how revenue for health is raised and pooled or re-distributed across the population, as well as how revenue is managed and translated into improved service delivery. Such reforms, however, require sufficient supply of quality healthcare, as well as significant financial resources, organizational and administrative capacity to implement efficiently and effectively at scale.

 

 

As public-sector infrastructure is still building up in these areas, African governments increasingly include the private sector to complement their own efforts. The mobile revolution now provides opportunities to ease administration, increase scale, efficiency and effectiveness and reduce costs. Through the building of trust the platform helps to stabilize national health systems thus contributing to the Health Systems Strengthening objective of Dutch development policy and bringing universal health coverage within reach.

Kwara State Community Health Insurance scheme

In Nigeria, the Kwara Community Health Insurance scheme has helped build a stronger, cost-efficient healthcare system. The program is built on a public-private partnership between the private insurer Hygeia Community Health Care, the Kwara State Government and PharmAccess Foundation. Aim of the program, set up with the support of the Dutch Ministry of Foreign Affairs in 2007, is to provide affordable access to quality healthcare through the introduction of subsidized health insurance and the improvement of healthcare quality.

The program has delivered substantial results in Kwara State in terms of improved maternal and child healthcare. Among other results, Kwara has shown an impressive rise in women giving birth in hospital, including women who aren’t in the health insurance program: hospital deliveries rose from 50% in 2009 to 70% in 2013, an increase which can be attributed to the program.

 

 

 

 
World Bank data show that, since the start of the program, Kwara has become the second-best performing Nigerian state in maternal and child care. It is internationally lauded as an example of how the private health sector can complement public health service delivery.

In 2017, Kwara adopted a health insurance law to institutionalize the provision of healthcare for all citizens. The law makes health insurance mandatory and commits the state to allocate 1% of its budget to health insurance. An important development, and a fitting one considering that the program has been geared towards a building an effective, efficient and sustainable health system from the start.

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Interested in working with us or learning more about our health insurance programs?

AHTC, Tower C4 • Paasheuvelweg 25
1105 BP Amsterdam • The Netherlands

T: +31 (0) 20 – 210 3920
E: info@pharmaccess.org