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Enhancing and Sustaining Health Microinsurance through Outpatient Counselling

About the Project
Project start date: 
Sep 2010
2 years
Country of Operation: 
Region of operations: 
Asia and the Pacific
Project Thematic Focus: 
Insitutional models and business processes

Project Basics

Calcutta Kids is an organization committed to the empowerment of the poorest children and expecting mothers in underserved slums in and around Kolkata, India. Calcutta Kids aims to increase access to health and nutrition services, provide health information and encourage positive health-changing behaviors. Calcutta Kids’ primary objective is to initiate community-based programs that advance the promotion and delivery of good health care, medical advocacy and health education.

Voluntary health microinsurance schemes worldwide face difficulty in retaining clients. One reason is because the wide majority of clients do not make claims in any given year, and thus see no tangible benefit in the product. Calcutta Kids seeks to address this problem by creating value for non-claimants through an outpatient counseling service (OPCS) - an additional service offered by the Calcutta Kids' health insurance product.

When clients access outpatient care with a doctor within Calcutta Kids' network, a health worker is sent to their house two days later. There the health worker: (i) checks that the client is following the doctor's prescribed treatment and encourages them to do so if they are not, (ii) in the case of common sicknesses, provides simple behavioral advice to clients, and (iii) records the progression of old symptoms and the onset of new ones in a case file. At the Calcutta Kids office, a manager reviews all cases, and with the assistance of a staff doctor selects cases that require outpatient follow-up. If follow-up is necessary, a health worker informs the client the next day.

Along with the goal of improving renewal rates, it is also hoped that this service may result in a reduction of overall claims expenses by preventing some minor illnesses from becoming major, and by encouraging timely admission into hospitals in the case of major illnesses.

Finally, the service offers a means of monitoring the quality of outpatient care within the network, and also the illness patterns of the target population.