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Promoting Community Health Financing

Health care expenditure in low income countries tends to decrease with the implementation of structural adjustment policies. Shrinking health budgets tend to affect the most vulnerable part of impoverished populations in Africa, particularly women and children. In this respect the belt-tightening adjustments prescribed by the World Bank and IMF constitute a threat to underprivileged groups and communities. Increasing prices of maintenance, living, food, antenatal care, hospital care etc, tend to make people refrain from utilizing live-saving skills that are available in health units due to unbearable costs. In several African countries, the minimum wage level has fallen 30-50% in recent years and health expenditure in families and households has diminished sharply. The deterioration of health services implies the risk of physical weakness and illness, powerlessness, lack of productive assets and limited chances of pulling families and communities out of poverty and underdevelopment. There can be no meaningful development without health. Given the extremely high cost of medical care, direct payment by the patient can pose a tremendous financial burden on the bread winner of a household. Therefore, as an alternative, Community Health Financing through Health Insurance is an absolute necessity today. Insurance is not necessarily an investment from which one expects to get one’s money back but by offering protection against risks that already exist, insurance is a way to share risk with others. Since ancient times, communities have pooled some of their resources to help individuals who suffer loss. The cost of insurance and the type of coverage varies from country to country, but the fundamental principle of insurance - sharing risk- remains the same. Similarly the more family responsibility a person has, the greater the impact if he or she falls sick and cannot have access to proper health care because the person and even the extended family cannot meet the cost of treatment. In other words the implications of failure to provide medical treatment for the bread-winner are huge. Many African countries have some form of state-sponsored insurance that provide such benefits as pensions for seniors and medical care. In many places workers may receive health insurance as a condition for their employment. However, in Cameroon for example, just 10% of the population-workers in state institutions and corporations are covered by some form of insurance. The majority of Africans are languishing under the weight of hospital bills, doctors’ operating fees, and the payment for non-surgical doctors’ fee in and out of the hospital. They face this harsh reality in spite of the fact that the normal African spirit of solidarity still exists in the communities. Africans need to be sensitized and educated on the need and importance of “ risk sharing”, particularly health risk, through insurance. Sharing of health risk in their different groups, associations and organizations will go a long way to reduce the burden on bread winners and other individuals. It is equally going to work towards a healthy workforce in Africa. With a healthy workforce, poverty will no longer manifest itself so vividly as is the case today in Africa. Global Health Dialogue has as one of its objectives to promote solidarity for health and socio-economic development through the sharing of resources, especially by setting up community revolving funds. This is the concept that GHD is advancing in the publication: Towards Health Insurance in African Communities. The holistic approach of involving all actors and beneficiaries in the different communities and walks of life paves the way for a sound and efficient drive towards the attainment of national health insurance.
Towards Health Insurance in African Communities
The question of who pays for healthcare is a missing link in the process for transforming the quality of healthcare provision in Africa. Unlike developed world countries who can provide universal healthcare free at the point of care through a combination of public funding or through sophisticated private insurance schemes, the people of Africa frequently face a nightmare of sudden requirements to pay health bills. Such bills can be even more difficult to meet if the family bread-winner is the one who is ill and income to the family is consequently reduced. Global Health Dialogue argues that health insurance should be recognised as a national objective. We wish to provoke thinking, discussion, decision and concrete action so that public opinion demands such insurance and leadership can adopt a road-map for achieving national health insurance. GHD has produced a booklet entitled Towards Health Insurance in African Communities which sets out our thinking and which members of the web-site can find within the site’s Health Development Knowledge Bank. A link to an introduction to this work can be found by clicking on the link below: [add link] We are most interested to hear your reactions to our thoughts and to learn more about what insurance arrangements exist in your locality so we can share learning and best practice. We can be contacted at info@globalhealthdialogue.org

(Posted on :Monday, 20/12/2010 (12h:56 PM))