shameran abed, why integrating microfinance, health education, and other forms of health protection
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Taking health to the people: comprehensive poverty reduction
www.brac.net
Shameran AbedBRAC
November 14, 2011
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BRAC in 30 seconds
• Founded in: Bangladesh, 1972• Program coverage: 136 million worldwide
(110m in Bangladesh)• Working in: 10 countries
www.brac.net
• Working in: 10 countries• Bangladesh budget (2010): US$ 495
million• Self generated: 71%• Health budget as %: <10
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Holistic Approach
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1970s: Health and poverty
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Health delivery for the poor
www.brac.net
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Oral Re-hydration Therapy
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Tuberculosis
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Health Workers
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Health Forum
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Reducing maternal, child, and neonatal mortality
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2011: Health and poverty
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Why Health Insurance?
• Expenditure on health as % of GDP - 3.4• Government expenditure as % of total exp. on
health - 31• Out-of-pocket spending as % of total exp. on
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• Out-of-pocket spending as % of total exp. on health - 58.9
• Out-of-pocket spending as % of private expenditure on health - 86
Source: WHO 2007 and ILO 2007
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In the Absence of Health Insurance
There are significant health costs:- Not seeking healthcare when needed- Seeking care very late (often when it is too late)- Poor quality of care
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And financial costs:- The financial shock of health expenditure could push people below the poverty line- Nearly one-third of defaulters for microfinance cite health shocks as primary reasons for defaulting on their loans
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Challenges
• Is it possible to provide value for money and still make it viable?
• Supply side weaknesses
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• Supply side weaknesses
• Poor renewal rate
• Adverse selection/moral hazard
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Opportunities
• Leverage extensive distribution network of MFIs to offer health insurance at low-cost
• Provide an additional suite of products to
www.brac.net
• Provide an additional suite of products to borrowers which will likely lead to lower default rates and better retention
• Potential for integrating technology to reduce costs of delivery
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Thank You
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Thank You