Tony

Healthcare Initiatives

REACH Responsible, Empowering, Accessible Community Healthcare

An initiative of The Karis Group and members of the Transformational Business Network

Healthcare and Poverty

Poor health can be devastating to those in poverty. In one poor district in central India, it was found that average annual expenditure on healthcare was 130% of annual income. More than 40% of those hospitalized borrow money or sell assets to cover expenses.

The financial burden of poor health creates an unequal relationship between those in poverty and healthcare providers, even where healthcare provision is a charitable act. Poor individuals in poor health are extremely vulnerable to exploitation.

This relationship needs to be re-balanced. Those in poverty need to be able to manage the cost of healthcare by themselves and be empowered to determine who provides healthcare services.

A Vision For Empowerment

In empowering the poor, community responsibility is essential. Communities can share risk and provide an environment where healthcare can be better managed. Community solidarity is less intimidated by healthcare institutions and can negotiate better terms for provision. Consider how micro-finance has empowered individuals to access credit previously denied them.

The proposed mechanism for our vision is straightforward. Through financial management structures developed by micro-finance organizations, self-help group members will make a small weekly contribution (approximately Rs. 2 per week, or the equivalent of $2 / £1.50 per year) to a healthcare fund, in addition to their regular savings schemes. The fund generated is then combined with funds from other local self-help groups to finance a local healthcare worker (HCW). The HCW, a registered healthcare professional, will provide consultations for group members and their immediate families, including drugs from an agreed formulary. The groups will also provide access to the HCW for nonmembers by charging one-off consultation fees.

Such a mechanism would have an impact on the community in a number of ways:

• Create a channel through which effective healthcare services are accessible by the poor
• Empower self-help groups to manage healthcare services for themselves, their families and their wider community
• Ensure availability of healthcare services which are appropriate and efficient, removing the need to consult with exploitative healthcare providers
• Reduce the need for using credit services at high interest rates, and thereby decrease the debt burden on communities and individuals.
• Increase opportunities for public health education and preventative measures. The community will have an increased interest in ensuring all its members are addressing health needs

Making the Vision a Reality

  

The principles of the scheme have been established, and we are now seeking to recruit a project coordinator to develop a detailed business plan and test the concept through a pilot. We have provisionally identified a suitable location in the Karur district in Tamil Nadu, southern India.

We anticipate this individual being in place by early autumn, and to have initiated the pilot by the end of 2006. The estimated cost will be approximately US$20,000 / £12,000 to fund a coordinator for one year, based from The Bridge Foundation, Bangalore, and to initiate a HCW training and recruitment program.

The pilot project may also require funds for initial loans to groups to establish viable healthcare funds and allow further expansion of the pilot, although at this stage precise amounts are unknown. This may potentially offer a longer term investment opportunity.

If you would like to make a financial contribution towards the cost of the project coordinator or the fund for initial loans, or are interested in finding out further details, please contact Tony Dale (+1 512 845 4481, tdale@thekarisgroup.com) or Martin Morse (+44 7920 548692, martin@morse.org.uk).