Community Health Insurance: Some Issues in Group Formation

Publication Date: Nov 2006
Published by: New Delhi, India: Jawaharlal Nehru University
Document Type: Presentation

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Presentation on micro health insurance at “Developing Pro-Poor Health Insurance in India” conference, November 1- 2, 2006, New Delhi, India.

This presentation explores the use of self-help-groups in the provision of community health insurance, identifying factors that would provide an enabling environment for the same.

The presentation examines:

• Health sector reforms currently undertaken in structurally adjusting countries like India;
• Group formation from the point of view of health provisioning, and finds that the important determinants of group formation are morbidity, expenditure and sources of funds;
• A study in Kerala, India, that looked at different economic groups and their preferences regarding public and private institutions;
• Community-based insurance and the findings of the “Bhore Commmittee” regarding health as the right of every individual.

The presentation looks the origins of self-help-groups (SHGs) in India and states that:

• The enabling conditions for group formation include economic benefits and income generation;
• SHGs have been successful in the state of Kerala, because Kerala has a history of effective decentralization and a favorable socio-political climate;
• Women members can play an effective role in mobilization and maintaining solidarity;
• However, SHGs that focus on women are constrained by the patriarchal social structure and often do not result in social empowerment.

The presentation concludes that:

• Existing institutions such as SHGs can be utilized as alternative models for community-based insurance as well as for primary health care given an enabling environment.
• Enabling environment would include:
  • Effective health services at the primary and secondary levels;
  • Savings-linked insurance;
  • Mobilization of women as the leading players.