SHEPHERD – TAMILNADU, INDIA

August 2014

AOA CONFERENCE

SRI LANKA

26TH AUGUST 2014

Shepherd is a Social Development Organization Working with 70,000 low

income families in 7 districts of central Tamilnadu, India,

working with women (only)

Promoted 4865 Surabhis (SHG)Providing services like

Savings

Credit

Health initiatives

Micro insurance (Life & Health package)

Community Health Mutual

Livelihood Promotion

Surabhi (SHG) Meeting

Micro insurance started in the year 1999 because:

-Six women from surabhi died naturally with in one year.

-700 huts were burnt in communal riots.

- 40% of internal loans from surabhi had been spent for “curative” purposes.

Health Security: Three Attributes.

1. Prevention – Medical Camps

2. Protection - Micro / Mutual health insurance

3. Promotion – Health Education

WHY ?

Issues in Health Insurance Poor women are asking refund of premium, when there

is no claim

Poor people don’t know where to take treatment (hospital) during emergency.

Poor don’t have adequate money to pay as advance for treatment in hospitals

Insurance companies are asking all original reports and bills from hospitals

Bureaucratic approach (Top down)

Unable to get full pledged medical reports with bills from

some hospitals.

Poor women also don’t know how to collect all reports

The choice of hospital left with poor people??

Delay in claim settlement by insurance companies more

than 50 days

No fund for operational cost

Unsettled amount goes to ins. Company corpus

Un willingness of ins. Company to do rural micro

insurance (life & health)

HOW ?

Health Education -TOT

Health Education

Health Conferences

Community Mutual Community mutual is an initiative by women leaders

of Surabhi (SHG)

Objectives:

To share their knowledge, experiences and best

practices in order to provide quality health care

services to the poorest sections of the society in a

professional manner there by improving the overall

efficiency of health care delivery system.

Shepherd is promoting community based Health mutual

fund

The contribution (Premium) divided in to 3 parts

60% towards benefit (claim)

20% for operating cost

20% for Benefit (claim) reserve

Community Mutual Committee

Social Protection Committee consists of women leaders

Initially we work with surabhi (SHG)women on Health

Doctors are working as advisory group to the claim

(benefit) committee.

Operational Coverage

YEAR ENROLMENTCONTRIBUTION

RS.

NO OF

CLAIMS

BENEFIT

AMOUNT RS.

2011-12 3250 4,06,250 32 1,16,954

2012-13 5704 7,13,000 17 68,776

2013-14 2881 3,60,125 28 57,858

TOTAL 11,835 14,79,375 77 2,43,588

RATIO’S Average claim ratio – 27.4%

Average enrollment No.– 3,945

Claim rejection ratio – 12%

Renewal rate – 51%

OSS – 82.1%

Impact Claim settlement duration reduced

Timely assistance for post treatment services

Women are willing to take early treatment of disease

Moving towards self management approach (cost

coverage)

Health Camp

Health education created good awareness on primary

and secondary care

Transparent operation system fund managed by

women leaders (Self –reliance)

Mutual health insurance provide timely support to

women borrowers

Limitations Still willingness level is low

TN state Govt.’s free health insurance up to Rs.1,00,000

(US$ 1666) / family / year ???

Regulator is not considering people’s initiatives

(Mutual)

NGO’s/ MFIs are reluctant to do health mutual

(complications & paper work)

Yet to reach operational self sufficiency

Way forward Keen to upscale at least 20000 families / year

Establishing mutual as core programe

Sensitization of government officials towards

people’s initiatives (Regulations)

Capacity building of women staff

Networking among NGO/MFIs for larger coverage

Health Education Posters

THANK YOU…….

E-mail: shepherddevorg@gmail.com