Download - Shepherd Tamilnadu, India
SHEPHERD – TAMILNADU, INDIA
August 2014
AOA CONFERENCE
SRI LANKA
26TH AUGUST 2014
Shepherd is a Social Development Organization Working with 70,000 low
income families in 7 districts of central Tamilnadu, India,
working with women (only)
Promoted 4865 Surabhis (SHG)Providing services like
Savings
Credit
Health initiatives
Micro insurance (Life & Health package)
Community Health Mutual
Livelihood Promotion
Surabhi (SHG) Meeting
Micro insurance started in the year 1999 because:
-Six women from surabhi died naturally with in one year.
-700 huts were burnt in communal riots.
- 40% of internal loans from surabhi had been spent for “curative” purposes.
Health Security: Three Attributes.
1. Prevention – Medical Camps
2. Protection - Micro / Mutual health insurance
3. Promotion – Health Education
WHY ?
Issues in Health Insurance Poor women are asking refund of premium, when there
is no claim
Poor people don’t know where to take treatment (hospital) during emergency.
Poor don’t have adequate money to pay as advance for treatment in hospitals
Insurance companies are asking all original reports and bills from hospitals
Bureaucratic approach (Top down)
Unable to get full pledged medical reports with bills from
some hospitals.
Poor women also don’t know how to collect all reports
The choice of hospital left with poor people??
Delay in claim settlement by insurance companies more
than 50 days
No fund for operational cost
Unsettled amount goes to ins. Company corpus
Un willingness of ins. Company to do rural micro
insurance (life & health)
HOW ?
Health Education -TOT
Health Education
Health Conferences
Community Mutual Community mutual is an initiative by women leaders
of Surabhi (SHG)
Objectives:
To share their knowledge, experiences and best
practices in order to provide quality health care
services to the poorest sections of the society in a
professional manner there by improving the overall
efficiency of health care delivery system.
Shepherd is promoting community based Health mutual
fund
The contribution (Premium) divided in to 3 parts
60% towards benefit (claim)
20% for operating cost
20% for Benefit (claim) reserve
Community Mutual Committee
Social Protection Committee consists of women leaders
Initially we work with surabhi (SHG)women on Health
Doctors are working as advisory group to the claim
(benefit) committee.
Operational Coverage
YEAR ENROLMENTCONTRIBUTION
RS.
NO OF
CLAIMS
BENEFIT
AMOUNT RS.
2011-12 3250 4,06,250 32 1,16,954
2012-13 5704 7,13,000 17 68,776
2013-14 2881 3,60,125 28 57,858
TOTAL 11,835 14,79,375 77 2,43,588
RATIO’S Average claim ratio – 27.4%
Average enrollment No.– 3,945
Claim rejection ratio – 12%
Renewal rate – 51%
OSS – 82.1%
Impact Claim settlement duration reduced
Timely assistance for post treatment services
Women are willing to take early treatment of disease
Moving towards self management approach (cost
coverage)
Health Camp
Health education created good awareness on primary
and secondary care
Transparent operation system fund managed by
women leaders (Self –reliance)
Mutual health insurance provide timely support to
women borrowers
Limitations Still willingness level is low
TN state Govt.’s free health insurance up to Rs.1,00,000
(US$ 1666) / family / year ???
Regulator is not considering people’s initiatives
(Mutual)
NGO’s/ MFIs are reluctant to do health mutual
(complications & paper work)
Yet to reach operational self sufficiency
Way forward Keen to upscale at least 20000 families / year
Establishing mutual as core programe
Sensitization of government officials towards
people’s initiatives (Regulations)
Capacity building of women staff
Networking among NGO/MFIs for larger coverage
Health Education Posters
THANK YOU…….
E-mail: [email protected]