This study was conducted to develop an alternative financing scheme (CBVHI scheme) in Nyaungdon Township since 2003. For the feasibility of developing the scheme, the prerequisite conditions such as socio economic characteristics, health seeking behaviour, their desirability to become member and their willingness to pay were assessed by preliminary household survey. Various Participatory Learning and Action (PLA) methods were used to raise awareness, to create sense of ownership and to ensure sustainability. Ensuring community participation from the very beginning, focus group discussions were conducted among potential members to develop final scheme with set rules and regulations. Design features of the scheme in this study are household membership with prepayment contribution of K5000 per household per year. Payment was to be paid in 3 instalments within 3 months. The scheme also set benefit upper ceiling value of K9000. Benefit package consist of ambulatory care, some diagnostic test such as urine RE test, stool RE test, blood for malaria parasite test, chest X-Rays and benefit for hospitalisation. Scheme was to be self managed by members themselves through management committee with five selected members among themselves. Larger family, private earner, low income, high health expenditure and low non food non health expenditure are the predictor variables for membership. The scheme has (92.31%) of acceptability but compliance with membership due was (45.8%). The scheme is still in operation with 44 full-fledged members until April 2006.
Comments
Meeting the cost of health care is a pressing issue all over the world, especially so in low income countries. Nearly all patients have to bear the costs out of their pockets and many suffered, even leading to preventable deaths as they cannot afford the expenses. In many developed countries, especially in the western world, health care expenses are covered through insurance schemes. One needs to show evidence of health insurance in applying for a Schengen Visa to visit Europe.
The present abstract outlined an alternative financing scheme for health care in the form of Community Based Voluntary Health Insurance in a township in Myanmar. The scheme, if properly managed can provide some relief to insured families. The members’ contribution and the benefit ceiling will have to be adjusted to present costing and will certainly have to be higher. The approach employed by the researcher/author will provide an idea as to how communities can be mobilized to meet their needs for health care expenses.This financing scheme maybe of great assistance for low income families in the districts.
Professor Tha Hla Shwe
