Center for Health Market Innovations (CHMI)

The Microinsurance Network has partnered with the Center for Health Market Innovations (CHMI) and the Microinsurance Innovation Facility to centralize information gathering and knowledge sharing for micro-insurance health programs in low- and middle- income countries. The partnership has helped to enrich CHMI's database, which now includes more than 120 distinct health insurance products designed for low-income populations in developing countries.

But what exactly is microinsurance? Moreover, what makes a successful insurance product? While many agree that health microinsurance offers a promising way to mitigate the risks of ill health and provides hope that the poor will receive, at a minimum, reliable access to affordable health care, in compiling an inventory of health microinsurance products and emerging lessons, the Microinsurance Network’s Health Working Group kept coming back to these two questions.

In the end, there was no right answer. After much internal debate, the Working Group decided to use a broad definition to include five institutional models delivering health insurance to low-income households in developing countries: 1) commercial insurer, 2) community based health insurance/mutuelle, 3) healthcare provider-driven, 4) partner-agent, and 5) public/social sector schemes. Rather than enforcing a definition or developing criteria for a successful product, the Working Group included emerging lessons that could be applied across institutional models and regions to allow stakeholders to have a platform to share initiatives and tools that have been successful and ideas that have not.

In addition to creating program profiles detailing information on the design, administration, and delivery of health insurance products and services for any health insurance schemes not currently listed in CHMI, the Working Group added emerging lessons, when possible, that can serve as a guide to overcome many challenges that limit the growth and impact of the sector. A full, searchable inventory of health insurance products and lessons mirroring the information found on CHMI can also be found on the International Labour Organization’s Microinsurance Innovation Facility website. Examples of the emerging lessons found on both platforms include:

• Swayam Shikshan Prayog (SSP) in India found that seasonality influences willingness to pay for health insurance and enrolment, particularly in rural, agricultural and undiversified economies. Similarly, in implementing a consumer education campaign in partnership with the National Health Insurance Scheme in Ghana, Freedom from Hunger observed that insurance product enrolment, and, by extension, interventions such as consumer education, should be timed to coincide with the availability of discretionary income.
• In Latin America, health microinsurance schemes are developing viable products that offer value to female clients by covering maternal benefits and preventative care. One product offered by Zurich Bolivia and BancoSol—Sol Salud—provides full maternity coverage with a rare 7-month waiting period, giving pregnant women a valuable 2-month window to purchase insurance to cover the birth of their child. Sixty-two percent of BancoSol’s clients are women, compared to just 45 percent of loan borrowers, underscoring the high value of gender-sensitive microinsurance programs for women. Aseguradora Rural in Guatemala has responded to market research by developing a product that covers preventative and curative gynecological services for low-income women as well as cancer indemnity coverage that offers high value to female clients.
• A study of mutual health organizations in Ghana, Mali and Senegal found that members’ out-of-pocket expenditures for hospitalization are much lower than non-members’ while membership does not appear to have a significant effect on out-of-pocket expenditures for outpatient care, perhaps due to a co-payment for outpatient services.

The Microinsurance Network Health Working Group hopes that by posting the health insurance products and lessons inventory to CHMI and the ILO’s Microinsurance Innovation Facility platforms, more stakeholders will join the discussion, submit and update health insurance program profiles, and contribute lessons learned from their own programs or research.

The Microinsurance Network Health Microinsurance Inventory is made available by the Health Working Group of the Microinsurance Network and Abt Associates in close collaboration with the International Labour Organization’s Microinsurance Innovation Facility, Results for Development or CHMI, and Denis Garand and Associates.