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Community-Based Health Financing

After the success of the Social Health Insurance Project in Batanes, HDI, together with AWO International, decided to transfer the learnings and experience from the former to develop another health financing scheme that would benefit organized groups in Mindanao.

This Project, a community-based health financing model, was conceptualized to provide access to health care to people belonging to the Informal Sector. Since informal workers are not compulsory members of PhilHealth, they do not receive hospitalization benefits that regular or sponsored PhilHealth members experience. Given the high cost of medicines and hospitalization, the Project aims to come up with an effective, sustainable, affordable, accessible, and equitable community-based health insurance model that will provide sufficient health care benefits to organized group members, particularly cooperative members.

Objective of the Project

Enhancement of informal sector access to health care through institutionalized service delivery network and sustainable financing mechanism implemented in partnership among stakeholders. The overall objective of the Project is: Mitigation of the burden of poverty among households in the informal sector through strengthening of health security mechanisms of community organizations

Key Result Areas

  • The umbrella organization manages a customized health insurance program in at least two cooperatives
  • Established partnership between umbrella organization and national program to mainstream health protection to households in the informal sector
  • A network of service providers delivering quality health care to coop members
  • Dissemination of SHI experience and expertise among national and international partners of project sta

Beneficiaries

This innovative health care financing scheme shall benefit:

  • The umbrella organization, which has a strong membership base of more than 700
  • Has the potential to reach almost 20,000 cooperative members from Mindanao in one primary cooperative only, half of which belong to the informal sector
  • Has a high probability of reaching all coop members who belong to the informal sector through the umbrella organization's members nationwide
  • Capability building for:
    • 6 key officers of the umbrella organization
    • 10 management and board members of the primary cooperative
    • hospital personnel and medical professional
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Partners

The strong partnerships among the following stakeholders made the development of a community-based health financing program in Mindanao a success:

  • The umbrella organization or federation of cooperatives, Coop Life Insurance and Mutual Benefit Services (CLIMBS)
  • The pilot-site and the primary cooperative, Mindanao State University Iligan Institute of Technology Multi-Purpose Cooperative (MSU-IIT MPC
  • Two tertiary hospitals in Iligan City, Mercy Hospital and Gregorio Lluch Hospital
  • One diagnostic clinic, Coop Lab
  • PhilHealth

Project Accomplishments

  • The community-based health financing scheme developed for cooperative members is viable, affordable, accessible, and equitable. It is also coop member-sensitive.
  • HDI initiated capability-building trainings and workshops on basic actuarial science, social marketing, systems development, database management and customer service for CLIMBS and MSU-IIT MPC.
  • A viable business plan was developed to ensure the sustainability of the Project.
  • A strong social marketing campaign was conceptualized to gain the support of the cooperative members, and to effect behavior change on their end in terms of changing their health-seeking behaviors.
  • Systems and policies were intelligently crafted to make the Project run even without close assistance from HDI.
  • An efficient database software and systems were created to be able to manage all the information systems of CLIMBS and MSU-IIT MPC.
  • An efficient and effective health service delivery system was developed together with some health service providers in Iligan City.
  • A strong partnership was established between and among CLIMBS, MSU-IIT MPC and health service providers.

 

Materials and Reources

Click here for complete list of materials and resources.