Implementing a Participatory Model of Micro Health Insurance Among Rural Poor with Evidence from Nepal

The Geneva Papers 2014, 39, (280–303)

24 Pages Posted: 7 Jan 2014 Last revised: 19 May 2014

See all articles by David M. Dror

David M. Dror

Micro Insurance Academy (MIA)

Atanu Majumdar

Micro Insurance Academy

Pradeep Panda

International Institute of Health Management Research

Denny John

Micro Insurance Academy

Ruth Koren

Tel Aviv University - Professor Sackler Faculty of Medicine

Date Written: January 15, 2014

Abstract

This paper reports on two voluntary, contributory, contextualized, community-based health insurance (CBHI) schemes, launched in Dhading and Banke (Nepal) in 2011. The implementation followed a four stage process: initiating (baseline survey), involving (awareness generation and engaging community in benefit-package-design), launch (enrollment and training of selected community members) and post launch (viable claims ratio; settled within satisfactory time, sustainable affiliation). Both schemes were successful on four key parameters: effective planning; affiliation (grew from 0 to about 10,000) and renewals (>65%); claims ratio (~50%); and promptness of claim settlement (~23 days). This model succeeded in implementing CBHI with zero premium subsidies or subsidized healthcare costs. The successful operation relied in large part on the fact that members trust that they can enforce this contract. Considerable insurance education and capacity development is necessary prior to launch of the CBHI, and for sustainable operations as well as for scaling.

Keywords: Nepal; micro health insurance; community-based health scheme; benefit-package design; health insurance performance indicators; microinsurance implementation process

Suggested Citation

Dror, David M. and Majumdar, Atanu and Panda, Pradeep Kumar and John, Denny and Koren, Ruth, Implementing a Participatory Model of Micro Health Insurance Among Rural Poor with Evidence from Nepal (January 15, 2014). The Geneva Papers 2014, 39, (280–303), Available at SSRN: https://ssrn.com/abstract=2375137

David M. Dror (Contact Author)

Micro Insurance Academy (MIA) ( email )

New Delhi, NCR
India
+41 78 790 6789 (Phone)

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Atanu Majumdar

Micro Insurance Academy ( email )

52-B, 1st floor
Okhla Industrial Estate, Phase III
New Delhi, 110020
India

Pradeep Kumar Panda

International Institute of Health Management Research ( email )

Plot No. 3, Sector – 18A
Dwarka, New Delhi 110075
India

Denny John

Micro Insurance Academy ( email )

52-B, 1st floor
Okhla Industrial Estate, Phase III
New Delhi, 110020
India

Ruth Koren

Tel Aviv University - Professor Sackler Faculty of Medicine ( email )

Ramat Aviv
Tel-Aviv, 6997801
Israel

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