CARE RURAL HEALTH MISSION HMI, DELHI
SEP 26, 201211/20/2012 1
INSURING PRIMARY CARE- A
SUSTAINABLE FINANCING SOLUTION
FOR RURAL PRIMARY HEALTH
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LOCATION MAP
Yavatmal
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LEARNING AGENDA
• Is the information technology or intervention with hand held device cost-beneficial for the sustainability of the scheme?
• Does purchasing the insurance package increase the access to health care, health outcomes, and financial risk protection of the insured participants?
• What are the likely impacts of public health interventions (in this case, the preventive and promotive interventions) on health outcomes and expenditures in the population of interest?
• Has the CARE intervention improved quality of health services to its users?
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PROJECT SCHEDULE
• June 2009 – Program Initiated
• Action Research Field study – Aug - Sep 2010
• Microinsurance Program launch – Nov 2010
• Midline Study – May 2011
• HHD technology – Pilot Launch July 2011
• Microinsurance Program 2nd year – Nov 2011
• Endline Study – Oct -Nov 2011
• HHD Scale up – Oct - Nov 2012
• Research Study – Jan 2013
• Project Closure – May 2013
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THE DELIVERY MODEL…
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Project Framework
• District – Yavatmal, Maharashtra
• Area background– Tribal , agriculture area
– Low income population
– Low literacy levels
• Health workers – 50
• Remote Doctor – 2
• Project Staff – 12
• Population coverage – 35,000
• Treatments - 20,000/ annum
• Services – Primary Care 24 X 7
• Microinsurance– Families : 1032 ( 4316 lives)
– Premium : Rs 300 ( family of 4)
– Product benefits : Consultation, drugs, Injection, IV fluids and Basic blood tests
– Claims Ratio : 172% ( till June 2012)
– Renewals Rate : 37%
– Coverage Ratio : 14.39%
– Frequency per capita : 1.41
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VILLAGE HEALTHCENTER
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PRODUCT• Out-Patient (OP) primary health care services through a hub and spoke
model with the clinic at the backend, and Village Health Champions (VHC) with hand-held devices at the front-end in the villages.
• Consulting services through healthworker and remote doctor
• Generic drugs at the village, and other drug subsidies at the clinic
• Diagnostics at the village & Clinic level, and follow up care at the clinic
• Preventive and promotive services at the village level for OP insured clients at a discounted price– Soap
– Jeevan Drop (Potchlor )
– Mosquito Oil
– Hankies
– Mask
• Value Added Services– Discounts on X-ray, USG and Hospitalization
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DEMOGRAPHICS
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KEY POINTS
• Occupation : Almost 95 percent of the families are engaged either as a daily wage labourer (71 percent)
• Of the enrolled households, 39 percent of the households have purchased one or more items included in the PP package
• The average claim per household per month (for each household that claimed at all) was Rs. 40 ($ 0.8)
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PRODUCT UTILISATION
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Frequency
INCIDENCE RATE BY AGE
No. Indicator Incidence rate
1 0-18 years 102 percent
2 19-35 years 131 percent
3 36-55 years 126 percent
4 >55 years 94 percent
TOTAL 116 percent
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DISEASE BREAK UP
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Fever&
Cough, 27%
Body Ache,
16%Others,
15%Vomiting &
Diahorrea, 9%
URTI, 7%
PP package, 5%
Injury, 5%
Gastro Entritis,
5%
Joint Pain, 4%
Malaria, 4%LRTI, 4%
HEALTHWORKER – HANDHELD DEVICE
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mHEALTH APPLICATIONS
Patient care & Micro Insurance Application
Functions
• Patient Treatments
• Clinical Decision Support
System
• Micro Insurance
• Transactions System
• Survey
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INSURANCE EDUCATION AND
ENROLLMENT
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BIOMETRIC CARD LAUNCH
HEALTHWORKER – HHD
LAUNCH
BIOMETRIC CARD LAUNCH
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WINNER OF NASSCOM EMERGE CONCLAVE 2010
Care Rural Health Mission - Confidential
Microinsurance product ImpelCARE wins NASSCOM’s AppFAME Contest
WINNER OF mBillionth SOUTH ASIA AWARD FOR
mHEALTH 2011
Care Rural Health Mission - Confidential
GROWTH MAP
Yavatmal
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East and West
Godavari
Kalahandi
Angul , Rural
Hospital
Kakinada ,
Rural Hospital
Nagai, Tamil
nadu
Korba,
Chhattisgarh
Thank You
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