ADED DR Congo Presentation Gilbert MUTUTSI ADED CEO

Transcription

1 ADED DR Congo Presentation Gilbert MUTUTSI ADED CEO

2 Session objective Sharing the ADED experience with a Self Help Group approach as a pro poor strategy to access health insurance in the fragile context of DR Congo. Share challenges gain insights from members on strategies going forward

3 -70% of population in rural area with 0,44 $ income/day - 64% of population no access to health care - Insurance penetration 2,03% nationally - Insurance penetration rate in ADED intervention zone 0,6% - Malaria as first disease in term of morbidity and mortality

4 ADED experience in mutual health insurance - Community Mutual insurance * TUSHIRIKI AFYA YETU* as a way of sustaining ADED medical outreach strategy to vulnerable people - It covers 50% of costs in case of ambulatory bills and 80% in case of consultation, hospitalization and observation, laboratory and imagery medical exams, surgery, birth... - DEPROMUS (Department in charge of mutual health insurance) has been created within ADED to drive Community Mutual insurance expansion

5 -Self Help Group approach as a strategy of building community resilience and responses to medical care to vulnerable household. - SHG approach principles: Every human being has tremendous strength which can be unleashed if a conducive environment is provided; - Through SHG tremendous hidden strength of poor people are strengthened in tree pillars [ economic, social and politic]

6 Survey results compared to reality - If 2734 person - mutual health insurance - 7 USD each only 32% could fall ill => USD, i.e. 27 per case - Survey: If every member contribute USD 9,5 then premiums will cover claims (excluding admin costs) but there are two issues: 1. The poorest people will not be able to join the mutual health insurance; 2. Few number of people joining will mean few contribution - In reality, 2734 joined the mutual, they contributed USD. On overage 40% people fell ill per months and they consumed an average of 2188USD i.e. 24USD per case. Total of USD over 12 months; - To cover the total expenses of health, there was a need to mobilize 7118USD i.e. 27 % Just For The Health Care (without admin costs)

7 Forecast short term The expected renewal rate is 95% whereas the expected growth rate is 100% Main reasons: - The mutual health insurance appreciated by people within the area, is very - People have trust in ADED due to its honor bills capacity to - the management style adopted by ADED [ Focal points] in partners health facilities; - community cells, solicitations by communities, etc.]. -This could help to reduce adverse selection.

8 Strategy for growth - Community education: Through churches, schools, media, etc. - Mutual cells within neighbourhood - Strengthen monitoring and evaluation system, and control of quality of services provided to our beneficiaries in partners organizations. - Economical Strengthening of poor households through SHG - Implement flexible mechanism for managing solutions for the low-income households (Contribution in slices, etc.) - Lobby and advocacy to decision makers

9 Challenges - Limited insurance education on community level; - Weak structure of the mutual at the base level(cells, sections, etc.) ; - Define contectualized economical and socials indicators - Digitalise the management system - Build and implement ADED strategy on accompaniment of mutual health insurance in Southern South Kivu. - Build and implement a common lobby and advocacy strategy for mutual insurance to state decision makers

10 Conclusion - Despite many challenges, we are very proud to work and provide opportunity to vulnerable people to access health care, get trust from the government and communities - We would be very glad to be partners with capacity building organisations and funding partners for microinsurance - We would be happy to see the Network focusing on building a conducive environment to let the poorest of the poor [Less than 0,44 USD] to have access to health insurance - It would be good if the Network could develop particular strategies to support community microinsurance schemes.

11 Question the audience What additional strategy could be put in place to contribute to success of mutual insurance in fragile areas like DR Congo?