Center for Health Market Innovations (CHMI)

Programs

Mutolere Community Health Insurance Scheme

last updated Jul 6, 2012

Overview

Implementing organization: 
St. Francis Hospital, Mutolere
Legal Status: 
Private (not-for-profit)
Year Launched: 
1998
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Donor
Additional Source(s) of Funding: 
Membership/subscription fees
Funders: 
Cordaid, DFID, Uganda Community Based Health Financing Association (UCBHFA)

Scale

Number of Clients Served: 
1,119 insured (in 2006)
Summary: 

Mutolere Scheme is a non-compulsory community health insurance project that aims to provide sustainable health insurance while offering whole family registration.

Key program components: 

Mutolere Scheme, a community health insurance project, carefully calculates premium charges to control cost escalations, uses identification cards, and insists on compulsory registration of the whole family to control fraud, while ensuring whole family registration as well as pre-existing groups to control for adverse selection. It has also put in place co-payments, limits on coverage, and gives no discount on renewals in an effort to control moral hazard.

The scheme's membership is mainly comprised of the "engozi" (burial) groups, employee groups, and village groups. A monthly premium fee of Ug.shs 500 (US$ 0.21) is payable per person every two months to an elected committee. The benefits package includes primary care, maternal and child care, and in-patient care. HIV drugs are supplied at no cost to every patient who qualifies. The insured must seek care from the Mutolere Hospital. Additionally, co-payments are made for every episode/visit to the hospital to the pre-payment office to discourage misuse of services.

The scheme was subsidized by DFID until 2002. Subsidies resumed under CORDAID in 2002.

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