Summary

Key program components

The Community Health Insurance Program is made up of health centers located in five communities in mountainous and coastal Ecuador. Families pay $0.50 cents monthly for affiliation and $0.50 cents for medicals visits. With this input each community is able to create a mutual fund which allows their clinics to be self-sustained. Affiliated families receive the following medical attention: - General and pediatric medicine - Dentistry - Gynecology - Psychology - Physical therapy - Laboratory services - Pharmaceutical services. The clinics utilize client history management software which allows them to share information through the Internet. One of the community health centers has installed a Maternity Clinic as part of a project supported by the Unión de Organizaciones Campesinas del Norte de Cotopaxi (North Cotopaxi Union of Farmer’s Organizations). The clinic’s construction was supported by the Ministry of Public Health, and the community itself participated in fund-raising in order to purchase an ambulance. They have also implemented a Traditional Medicine Program, which provides services including cleanses, reiki, energy balancing, and others in combination with conventional medicine. The Foundation provides economic support to the on-the-ground implementers in each of the health centers to cover the salaries of the professionals and promoters, and the cost of medicine, administration and medical equipment during the first five years of operation. Following this period, the health centers are expected to be self sustainable. The community itself provides the physical infrastructure needed for the center. Income received from health center services goes to a mutual savings fund administered by an elected community member. The system’s pharmacies offer a 15% discount for affiliates of the program. Health promoters originating from and elected by the community have also been trained. One of their responsibilities is to assist in emergencies; so that once the emergency patient has been stabilized they are able to be transported to the nearest hospital. The promoters also provide health education training to different community groups. The promoters organize and participate in special activities, workshops, home visits and community visits. The Foundation has also implemented two savings cooperatives (with initial set-up funding from the Foundation) in order to support agricultural production by providing short-term microcredit to associates with collective guarantees. This service is tied to the health service in that the principal requirement to access credit is to have been affiliated with the health system for at least one year. In 2010, the Foundation served 14,664 clients in the community health centers and 7,132 families were affiliated to the community health insurance.