ROLE OF COMMUNITY MOBILIZERS ON REACHING RURAL POPULATION FOR MICROHEALTH INSURANCE
Dr. Heri Marwa (MD, MA-HPM) Date: March 2014
CONTENT GENERAL 1. INTRODUCTION – PHARMACCESS 2. HEALTH INSURANCE SCHEME FOR COFFEE FARMERS
3. TARGET POPULATION
4. MARKETING AND DISTRIBUTION CHANNEL
5. ACHIEVEMENT
6. CHALLENGES
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INTRODUCTION
2
PharmAccess is a Dutch NGO, found in 2000 with focus on
making HIV/AIDS treatment accessible in Africa PharmAccess is dedicated to making quality health care
accessible in Africa, contributing to healthier populations and social and economic development
By combining quality improvement (by ensuring standards), access to finance for healthcare providers, health plans and in-depth impact research we simultaneously stimulate the demand for and supply of healthcare services
Three key programs are Medical Credit Fund (MCF), SafeCare and health Insurance Fund (HIF)
Offices in 5 African countries; Tanzania, Nigeria, Kenya, Ghana
and Namibia. In Tanzania, PharmAccess started to operates in 2007 with
HIV/AIDS support to Armed forces
In 2010 we won a G20 award that President Obama presented to us for our innovative healthcare financing model.
HEALTH CARE IN AFRICA STUCK IN VICIOUS CIRCLE
• African healthcare systems stuck in a vicious circle of low demand and supply
• Access to quality basic health care among the poor is low
Delivery
Financing Demand ↓ Solidarity
↑ Out-of-pocket expenses
↓ Access to health care
↓ Ownership
Supply ↓ Quality and
capacity
↓ Efficiency
↓ Availability data
↑ Risk for owners and investors
Patient ↑ Catastrophic spending
↓ Utilization
Low
Low
Delivery
Financing Demand
↑ Solidarity
↓ Out-of-pocket expenses
↑ Access to health care
↑ Ownership
Supply
↑ Quality ↑ Efficiency ↑ Availability of data ↓ Risk ↑ Investment
opportunities
Patient ↑ Increased willingness to pre-pay
↓ Decreased financial risk
Higher
Higher
Prepayment (contribution)
by users
Medical Credit Fund
Access to Loan
Donors / governments (tax)
Government (public)
BREAKING THE VICIOUS CIRCLE AND BUILDING TRUST
-Premium subsidies
-Education and marketing
- Upgrading and capacity building
- Quality assurance - Quality Certification
Health Insurance
Fund
- Introducing health insurance
SafeCare Set Quality Standards
HEALTH INSURANCE SCHEME FOR COFFEE FARMERS
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KNCU Health Plan: KNCU is largest cooperative in Tanzania with over 68 primary
societies across 4 districts in Kilimanjaro region and close to 150,000 members, Mainly dealing with petty coffee farming
The scheme which is for KNCU members and their dependents is
funded by Dutch government .
The scheme Started in mid 2012, after 8 months pilot. It cover basic primary care, chronic diseases and maternal care.
PharmAccess Provides technical support on product development,
admin & marketing and service quality assurance Premium 14,500 per person (subsidy 60%, co payment average
5,000 pp) Over 12,000 enrollees are covered (of the 31 reached cooperatives)
by Dec 2013 Use private and public health care facilities
Use third part administrator (TPA) for marketing & sensitization,
provider management & feedback system
Coffee farmers in one primary society.
Healthcare workers training sponsored by health plan.
FACTS ABOUT TARGET POPULATION Target group research showed that:
• Socio-economic status and education levels are low • Knowledge about health and insurance is limited • Low confidence in health insurance • Exposure to health risks (and related expenses) is high
MARKETING AND DISTRIBUTION CHANNELS
KNCU has 68 primary societies which are used as main delivery channel
Farmers are enrolled into the Health Plan after an intense period of marketing, sensitization and sales activities
Strategies used to reach the community, among others are; radio, Primary Society Board meetings, church meetings and interactive group sessions.
Sales force has community mobilizers and sales clerks
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DISTRIBUTION
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SALES CLERKS: Young and energetic, employee of TPA coming from
different parts of the country
Have knowledge and experience on marketing / sales or insurance
Low trust in the community
COMMUNITY MOBILIZERS Elderly and not very energetic. Work as volunteers with
commission received per sales
Selected among community members by villagers themselves, can speak local language (chaga).
Trusted and can act as guarantors for paid premium
Community Mobilizers training.
Treasure pot game at CM training.
ACHIEVEMENTS
Target group
Aware of health plan
Sufficient knowledge of health plan
Health Plan is salient
Intention to enroll
Conversion
• The mobilisers have been successfully used for re-enrolment activities in 2013 without being accompanied by the sales clerks
• Reduction of sales costs during renewal
PharmAccess marketing funnel
% of the target group is approached for the Health Plan
% has sufficient knowledge of the Health Plan
% intents to enroll into the Health Plan
% has enrolled into the Health Plan
% is aware of the Health Plan
59.7%
N/A
71.4%
35.6%
100%
35.8%
THANKS FOR LISTENING
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I WELCOME ANY CLARIFICATION / QUESTION Special thanks to: Edgar Masatu Marketing officer - PharmAccess
After persuasion by CM, sales clerk completing the sale