Emerging Lessons in Health Microinsurance | ILO Microinsurance Knowledge Management Portal

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.

Region	Theme	Source	Emerging Lesson
Asia and the Pacific	Pharmacy	Care Foundation Learning Journey CARE Arogya Kendra	Pharmacy management is a leading determinant of the sustainability of an outpatient insurance product.
Asia and the Pacific	Consumer Education	Care Foundation Learning Journey CARE Arogya Kendra	Prospective clients in rural Maharashtra, India do not appear to understand the concept of insurance, so it can be useful to avoid use of insurance terms, and emphasize good health, avoidance of disease, etc.
Asia and the Pacific	Partnering with Health Care Providers	Care Foundation Learning Journey CARE Arogya Kendra	It is difficult to get specialist doctors to visit the hub clinic when patient volume is low, and difficult to attract patients to the clinic without an array of specialists.
Asia and the Pacific	Health Claims	SEWA Learning Journey VimoSEWA	It is essential to analyze health claims on a frequency and cost basis per member (or per 1000 members) to uncover what is really driving results.
Asia and the Pacific	Health Claims	SEWA Learning Journey VimoSEWA	Hysterectomies may be a leading source of expenditure and claims.
Asia and the Pacific	Health Claims	SEWA Learning Journey VimoSEWA	Hospital claims data require significant time and effort to sort and code to obtain more useful analysis.
Asia and the Pacific	Health Claims	SEWA Learning Journey VimoSEWA	Urban clients have more claims and the cost per claim is higher than their rural counterparts.
Asia and the Pacific	Health Claims, Pharmacy	SEWA Learning Journey VimoSEWA	Drugs are a key driver of claims costs.
Asia and the Pacific	Health Education	SEWA Learning Journey VimoSEWA	Implementing guidelines on how to conduct health education sessions can ensure consistent quality.
Asia and the Pacific	Health Claims	PWDS Learning Journey Palmyrah Workers' Development Society (PWDS)	Endorsement from someone within the community who has received a claim has been a big hit.
Asia and the Pacific	Health Claims	PWDS Learning Journey Palmyrah Workers' Development Society (PWDS)	Constant engagement of the insurance personnel from the insurance company and their presence gives confidence during the enrollment and claims phases.
Asia and the Pacific	Product Design	PWDS Learning Journey Palmyrah Workers' Development Society (PWDS)	Involving local communities in the product development process and using a bottoms-up approach gives confidence to the people.
Asia and the Pacific	Health Claims	PWDS Learning Journey Palmyrah Workers' Development Society (PWDS)	Educating clients and staff about document requirements can lead to improved claims performance.
Asia and the Pacific	Health Claims	PWDS Learning Journey Palmyrah Workers' Development Society (PWDS)	Providing efficient and transparent service enhances the claims experience and builds loyalty for the insurance service provider.
Asia and the Pacific	Cost Sharing	PWDS Learning Journey Palmyrah Workers' Development Society (PWDS)	Choosing the co-payment option shows that members are willing to self-regulate.
Asia and the Pacific	Technology	PWDS Learning Journey Palmyrah Workers' Development Society (PWDS)	Use of mobile phones for enrolment has reduced policy issuance time.
Asia and the Pacific	Partnering with Health Care Providers	PWDS Learning Journey Palmyrah Workers' Development Society (PWDS)	Health care providers who are new members of the network tend to overcharge patients availing cashless facility.
Africa	Consumer Education	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	When developing health insurance education tools, seek input from health insurance experts early in the development process.
Africa	Consumer Education	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	Pilot testing is a good way to test and improve certain key messages about HMI so that they resonate better with low income clients.
Africa	Consumer Education	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	Lessons on how insurance works must be simple and minimize the use of insurance terminology.
Africa	Consumer Education	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	It is potentially beneficial to reinforce messages about the benefits of health microinsurance when re-enrollment occurs.
Africa	Consumer Education	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	Consumer education tools must be flexible; the development process should allow for adaptation and include field testing.
Africa	Consumer Education	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	Insurance product enrolment, and by extension interventions such as consumer education, should be timed to coincide with the availability of discretionary income.
Africa	Client Value	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	Even with national schemes for health microinsurance, the benefits of a product and knowing how to use it are poorly understood.
Africa	Enrolment	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	Operating practices of a scheme can have unintended effects on enrolment and use.
Africa	Health Seeking Behaviour	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	Registration and enrolment in the Ghana National Health Insurance Scheme encourages use of doctors in place of chemists.
Africa	Partnerships	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	The selection of an implementing partner and a health microinsurance scheme to pilot test an intervention like consumer education should be well structured and carefully considered.
Africa	Partnerships	Freedom from Hunger Learning Journey National Health Insurance Scheme (Ghana)	Working with public health insurance programs can mean unforeseen challenges due to shifting government policy, changes in financing, management or infrastructure issues.
Asia and the Pacific	Health Seeking Behaviour	MicroFund for Women Learning Journey Caregiver (MicroFund for Women)	Having insurance may increase health seeking behaviour.
Asia and the Pacific	Client Value	MicroFund for Women Learning Journey Caregiver (MicroFund for Women)	Clients appear to be able to use a hospital cash product with ease. Although claims rates may increase over time, the actual frequency of hospitalization may be less than expected, thus keeping claims costs low.