Monday, 18 June 2007

Feasibility of health insurance schemes in West Africa

This short paper was written by Gerrit de Vries, ICCO programme specialist on Healthcare, as part of a course with the Royal Tropical Institute (May 2007). The paper is quite relevant as ICCO is further developing its work on health insurance via the HIP, Health Insurance Platform, set up in 2006. Other HIP members are: other NGOs, Ministry of Foreign Affairs, insurance companies and knowledge institutes.

The paper – "Feasibility of Health Insurance Schemes in very low income countries: focus on four West-African countries" explores the feasibility of (community) health Insurance in very low income countries.

It is based on a literature review. Studies of four West African countries - Ghana, Burkina Faso, Guinea-Conakry, and Senegal - were gathered to provide evidence related to the topic. Evidence from these four countries was analysed focusing on financial feasibility, enrolment, and administrative capacity.

The conclusion of the paper is that community health insurance is an important way to finance health care and improve access in low-income countries, as well as to provide financial protection. However health insurance, and more specifically community health insurance, will only be feasible provided a few aspects are taken into account:
  • Administrative capacity of the schemes should be improved, e.g. by providing technical assistance or other forms of capacity building.
  • Ownership of the schemes has to be taken seriously.
  • Schemes are developed bottom-up. Small, localised schemes should first be established and working, before trying to scale up to regional or national levels.
  • Measures are implemented to avoid moral hazard and adverse selection. It was shown that such measures, such as co-payments and probation periods, are easy to implement.
  • Measures are taken to enrol even the poorest of the poor. Such measures can include more flexible payment systems, e.g. not paying at once but in several instalments, or (partial) exemptions for the poorest.
Read the report.

The synopsis was prepared by Justine Anschütz to help make ICCO sponsored 'research' more accessible

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