Shameran Abed, Why Integrating Microfinance, Health Education, and Other Forms of Health Protection

Taking health to the people: comprehensive poverty reduction

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Shameran AbedBRAC

November 14, 2011

BRAC in 30 seconds

• Founded in: Bangladesh, 1972• Program coverage: 136 million worldwide

(110m in Bangladesh)• Working in: 10 countries

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• Working in: 10 countries• Bangladesh budget (2010): US$ 495

million• Self generated: 71%• Health budget as %: <10

Holistic Approach

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1970s: Health and poverty

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Health delivery for the poor

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Oral Re-hydration Therapy

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Tuberculosis

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Health Workers

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Health Forum

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Reducing maternal, child, and neonatal mortality

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2011: Health and poverty

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Why Health Insurance?

• Expenditure on health as % of GDP - 3.4• Government expenditure as % of total exp. on

health - 31• Out-of-pocket spending as % of total exp. on

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• Out-of-pocket spending as % of total exp. on health - 58.9

• Out-of-pocket spending as % of private expenditure on health - 86

Source: WHO 2007 and ILO 2007

In the Absence of Health Insurance

There are significant health costs:- Not seeking healthcare when needed- Seeking care very late (often when it is too late)- Poor quality of care

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And financial costs:- The financial shock of health expenditure could push people below the poverty line- Nearly one-third of defaulters for microfinance cite health shocks as primary reasons for defaulting on their loans

Challenges

• Is it possible to provide value for money and still make it viable?

• Supply side weaknesses

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• Supply side weaknesses

• Poor renewal rate

• Adverse selection/moral hazard

Opportunities

• Leverage extensive distribution network of MFIs to offer health insurance at low-cost

• Provide an additional suite of products to

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• Provide an additional suite of products to borrowers which will likely lead to lower default rates and better retention

• Potential for integrating technology to reduce costs of delivery

Thank You

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Thank You