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Insuring Primary Care- A Sustainable Financing Solution for Rural Primary Health

Organization: 
About the Project
Project start date: 
Mar 2009
Duration: 
3 years
Country of Operation: 
India
Product: 
Health - out-patient
Project Thematic Focus: 
Product design

Project Basics

Implementing Partner:

CARE Foundation is a non-profit organization with the mandate to make quality health care affordable and accessible to all through the appropriate use of technology. The Foundation implements its mission in three main ways: a) conducting research and providing specialized training, b) developing cost-effective medical products, and c) providing healthcare to low-income populations.

Consortium member:

The Centre for Insurance and Risk Management (CIRM) is a non-profit organization affiliated with the Institute of Financial Management and Research (IFMR) in Chennai, India.  CIRM engages in action research initiatives with insurers, NGOs and regulators to test innovative insurance products and to improve knowledge on risk-mitigating mechanisms.

Project Description

The project aims to study the impact of microinsurance coupled with healthcare services delivered through hand held devices (HHDs). In rural areas, the population generally can only access poorly qualified medical professionals for primary care. Additionally, high illiteracy, and a general lack of awareness about good health practices and the importance of managing risks makes microinsurance very difficult to implement in rural India.

Through voluntary health insurance, the project will enable consumers to make informed choices. It is expected that the overall treatment cost will be reduced through prevention, early diagnosis and timely care emphasizing best practices at the hospital. Tele-monitoring will be used for after-care service to prevent re-hospitalization and conduct quality control.

Key aspects of the project include:

  • Hiring and training Village Health Champions (VHCs), who are women based in the community, to facilitate access to medical advice from specialists through HHDs and mobile communications. The role of the VHC includes health education, illness prevention, promotion of hygiene, assistance with referrals and transportation to medical facilities.
  • Supporting the VHC network with a primary health centre staffed by a medical officer, remote doctors consulting team, nurse, pharmacist and laboratory technician, and which can provide minor procedures, drugs and, diagnostic services.
  • Developing and field testing HHDs which include both clinical and non-clinical functionalities to enable delivery of basic health care, data collection, biometric identification, and insurance and financial transactions.  Delivery of basic care at the doorstep by VHCs utilizes a Clinical Decision Support System (CDSS), which provides clinically tested protocols to initiate diagnoses and treatment plans.  The CDSS is an interface between the VHC and the remote doctor at the CARE clinic.
  • Partnering with CIRM to develop and launch a health microinsurance product sold by the VHCs or suitable channels through pre-paid health cards. The enrolment campaign will be supported by an insurance literacy program and distribution of highly discounted preventive products or services to provide clients with some immediate value for their money. Members will receive services at fee for services at nominal prices from the VHC network plus assistance to obtain hospitalization wherever required.  Renewals will be encouraged by discounted premiums, and/or increased benefits.
  • An Action Research Program with discounted vouchers will be conducted to test the viability of the product and its impact on health and economic indicators on clients.
  • In the last 2 years of the project, the product will be rolled out in 50 rural villages around Yavatmal, in the state of Maharashtra (total population:  100,000).  

Date of last Learning Journey update: April 2012