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

1

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

5

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

7

DISTRIBUTION

8

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

12

I WELCOME ANY CLARIFICATION / QUESTION Special thanks to: Edgar Masatu Marketing officer - PharmAccess

After persuasion by CM, sales clerk completing the sale