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Micro-insurance in Bangladesh: risk protection for the poor?

Werner WJ - J Health Popul Nutr (2009)

Bottom Line: Micro-insurance for health is one method to address unmet health needs.Micro-insurance for health in Bangladesh targeted towards the poor and the ultra-poor provides basic healthcare at an affordable rate whereas the Indian micro-insurance schemes for health have been implemented across larger populations and include high-cost and low-frequency events.Results of analysis of the existing literature showed that micro-insurance for health as currently offered in Bangladesh increased access to, and use of, basic health services among excluded populations but did not reduce the likelihood that essential health-related costs would be a catastrophic expense for a marginalized household.

View Article: PubMed Central - PubMed

Affiliation: ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh. wendywerner@gmail.com

ABSTRACT
Health services and modem medicines are out of reach for over one billion people globally. Micro-insurance for health is one method to address unmet health needs. This case study used a social exclusion perspective to assess the health and poverty impact of micro-insurance for health in Bangladesh and contrasts this with several micro-insurance systems for health offered in India. Micro-insurance for health in Bangladesh targeted towards the poor and the ultra-poor provides basic healthcare at an affordable rate whereas the Indian micro-insurance schemes for health have been implemented across larger populations and include high-cost and low-frequency events. Results of analysis of the existing literature showed that micro-insurance for health as currently offered in Bangladesh increased access to, and use of, basic health services among excluded populations but did not reduce the likelihood that essential health-related costs would be a catastrophic expense for a marginalized household.

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Caesarean births by asset quintile, Bangladesh
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Figure 1: Caesarean births by asset quintile, Bangladesh

Mentions: Primary healthcare is extremely important to improve health at the population level in Bangladesh, and the micro-insurance schemes for health are focused on that segment of healthcare. However, there are unmet health needs for surgeries and more expensive medical procedures among the poor, which remain unaddressed by basic microinsurance for health. For instance, results of research in Bangladesh showed significant inequalities in access to caesarean birth services (Anwar I, Collins S, Ronsmans C. A decade of inequality in maternity care: trends in professional attendance and caesarean section in Bangladesh, 1991–2004. Dhaka: International Centre for Diarrhoeal Disease Research, Bangladesh, 2006 [Unpublished]). Among the general population, approximately 10–15% of deliveries are generally expected to require caesarean-section surgery. In Bangladesh, caesarean-section births among the poor are less than 1% (Fig.) (ibid). Public-sector services are not meeting needs, particularly of the poor and the poorest. As currently designed and offered in Bangladesh, the micro-insurance schemes for health cannot help address this unmet need. As a further example of the inability of micro-insurance for health in Bangladesh to address unmet medical needs, the average claim from VimoSEWA clients is greater than Rs 2,500 (US$ 57), which is above the maximum benefit for most micro-insurance schemes for health in Bangladesh (14).


Micro-insurance in Bangladesh: risk protection for the poor?

Werner WJ - J Health Popul Nutr (2009)

Caesarean births by asset quintile, Bangladesh
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2928102&req=5

Figure 1: Caesarean births by asset quintile, Bangladesh
Mentions: Primary healthcare is extremely important to improve health at the population level in Bangladesh, and the micro-insurance schemes for health are focused on that segment of healthcare. However, there are unmet health needs for surgeries and more expensive medical procedures among the poor, which remain unaddressed by basic microinsurance for health. For instance, results of research in Bangladesh showed significant inequalities in access to caesarean birth services (Anwar I, Collins S, Ronsmans C. A decade of inequality in maternity care: trends in professional attendance and caesarean section in Bangladesh, 1991–2004. Dhaka: International Centre for Diarrhoeal Disease Research, Bangladesh, 2006 [Unpublished]). Among the general population, approximately 10–15% of deliveries are generally expected to require caesarean-section surgery. In Bangladesh, caesarean-section births among the poor are less than 1% (Fig.) (ibid). Public-sector services are not meeting needs, particularly of the poor and the poorest. As currently designed and offered in Bangladesh, the micro-insurance schemes for health cannot help address this unmet need. As a further example of the inability of micro-insurance for health in Bangladesh to address unmet medical needs, the average claim from VimoSEWA clients is greater than Rs 2,500 (US$ 57), which is above the maximum benefit for most micro-insurance schemes for health in Bangladesh (14).

Bottom Line: Micro-insurance for health is one method to address unmet health needs.Micro-insurance for health in Bangladesh targeted towards the poor and the ultra-poor provides basic healthcare at an affordable rate whereas the Indian micro-insurance schemes for health have been implemented across larger populations and include high-cost and low-frequency events.Results of analysis of the existing literature showed that micro-insurance for health as currently offered in Bangladesh increased access to, and use of, basic health services among excluded populations but did not reduce the likelihood that essential health-related costs would be a catastrophic expense for a marginalized household.

View Article: PubMed Central - PubMed

Affiliation: ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh. wendywerner@gmail.com

ABSTRACT
Health services and modem medicines are out of reach for over one billion people globally. Micro-insurance for health is one method to address unmet health needs. This case study used a social exclusion perspective to assess the health and poverty impact of micro-insurance for health in Bangladesh and contrasts this with several micro-insurance systems for health offered in India. Micro-insurance for health in Bangladesh targeted towards the poor and the ultra-poor provides basic healthcare at an affordable rate whereas the Indian micro-insurance schemes for health have been implemented across larger populations and include high-cost and low-frequency events. Results of analysis of the existing literature showed that micro-insurance for health as currently offered in Bangladesh increased access to, and use of, basic health services among excluded populations but did not reduce the likelihood that essential health-related costs would be a catastrophic expense for a marginalized household.

Show MeSH