Community Based Micro Health Insurance Project.
Community Based Micro Insurance Project (CBMHI), Sanjeevani, is being implemented by Nirdhan NGO since October 2010 in Banke district with the financial assistance from Save the Children Nepal with technical partnership with Micro Insurance Academy (MIA), India. Sanjeevani is an inclusive, community owned and managed micro health insurance program, working in impoverished areas of Banke, through which the scheme members pool their resources to reduce their collective financial risks when receiving health services. The bottom-up model aims to close the health gap and reduce vulnerability through the active participation of community members in all stages of management and decision-making processes. By providing discounted health services and offering linkages with service providers, the CBMHI has been building community trust in formal health systems and changing health-care seeking behavior to improve health states. Thus, Sanjeevani hopes to increase economic security by reducing the financial burden of accessing local health care and validate itself as a model to extend universal health coverage in rural Nepal.
The voluntary and contributory CBMHI has completed four years of successful implementation and is in the second phase of its implementation. Within this period, it has obtained significant triumphs that have been universally commended. Currently, the micro health insurance program has extended its coverage to 15 VDCs, a municipality (Kohalpur) and the Sub-Metropolitan city of Nepalgunj in Banke, creating a strong network of about 13,701 members clustered within the 300 self-reliant groups (SRGs) of Nirdhan Utthan Bank Limited (NUBL). The project’s technical partner Micro Insurance Academy (MIA) has been providing training, technical assistance, information dissemination, and management and evaluation services for the successful and collaborative implementation of the CBMHI. Similarly, financial support is provided by Save the Children Nepal through donations from MISEREOR.
Objectives: The project has been targeted to achieve the following project objectives through the 5 results:
Objective 1: Increased access to inclusive and affordable micro health insurance scheme :
Result 1: Micro heath insurance units are financially sustainable and cover 45,000 consumers of all ages and risk profiles.
Objective 2: Increased knowledge of financial risk management among poor households:
Result 2: Potential consumers have access to information on the potential benefits of micro health insurance.
Objective 3: Increased capacity of communities to self-administer a micro health :
Result 3: Community self-administer Micro Health Insurance Units, through standard detailed business processes and MIS systems.
Objective 4: Increased risk transfer from communities to commercial entities (re-insurers) :
Result 4: Commercial entities cover outlier and catastrophic exposure when Insured persons are likely to be exposed to catastrophic costs above the insurance cap.
Objective 5: Policy makers acknowledge micro insurance as an effective poverty alleviation and risk management :
Result 5: Local, District and National level policy makers are exposed to micro insurance and its benefits.
Nowadays Target groups have started to feel and hope CBMHI will let them have enormous possessions for their health treatment expenses. Not only the health insurance program has become very informative for community health education, it also has increased the level of knowledge on health risk management as well as changing behavior of communities for health consciousness. Members have got highly confident and feel safer health services accessible to them as the number of service providers has been increased according to their need and interest.
Organizational structure of the micro-insurance model:
There is one Main committee/Coordination committee which includes seven members representing five Self Help Groups (SHGs). At least a member from a Sub-committee comes to participate in the main committee.
There are five SHGs/Claim committees each of which includes seven member governing committee in each SHG comprising representatives from sub-committees.
The SRGs are formed by NUBL Branch offices: Kohalpur, Ranjha, Udaypur, Paraspur, and Khajura. All the SRGs are from different clusters and VDCs within Banke district. These structures are facilitated by Nirdhan NGO. The members of sub-committee, SHGs and Main Committee comprise 300 SRGs, and are working into the community based program.
All the SRGs are from different clusters and VDCs within the district. These structures are facilitated by Nirdhan NGO through its program staffs, coordinators and activists (even though, they are paid by project, they are controlled and supervised by SHGs and Main committee). The members of sub-committee, SHG and Main committee are the member of SRGs, making the working model as completely community based.