“My Family’s Health”

The aim of My Family’s Health (MFH) is to build a sustainable not-for profit cooperative health insurance organization in Cambodia within the next 5 years. The health insurance scheme should take care of purchasing the required qualitative health care for its members against an affordable premium.With support of HealthNet TPO, the Reproductive and Child Health Alliance (RACHA) started implementing the MFH project in the Prey Veng Province in 2010. During the pilot phase in 2010, relevant staff members from RACHA and other stakeholders were trained on various aspects of micro insurance in January; an administrative system as well as a cooperative model for the organization were developed and finalized; the first 3 Health Centers (Poty, Prey Pnov, Kampong Popil), which in total cover 30 villages, were contracted and the first members were enrolled in June 2010. Overall, 557 families (2604 household members) joined the scheme between June and December 2010. This was equal to 5.6 percent of the total population of the catchment area.

During the scale-up phase in 2011 an additional six Health Centers were contracted (Kamong Russey, Chrey Khmum, Pnove, Prey Sralet, Roka and Kampong Russey). In March 2011, 964 families (4454 household members) were enrolled in the scheme. Prior to the scale-up phase, health care providers, Village Support Groups (VHSGs) and community leaders were trained. In addition, 14 agents were recruited and trained for promotion activities, member enrolment procedures and premium collection activities. The total number of members in June 2011 was 1402 families (6166 household members).

What happened since the start: An overview
Since the start of MFH the following activities have been accomplished successfully:

Preparatory phase in 2005 to 2008

• A feasibility study, house hold survey and two assessment studies (funded by the Rabobank) were undertaken in collaboration with ACHMEA, a Dutch insurance company.

Fundraising phase in 2009

• PSO, a Dutch donor organization, was identified and willing to support the first year of the scheme. There was a focus on the capacity building of RACHA staff members to implement the project.

Pilot phase in 2010

• An administrative system as well as a cooperative model for the organization (Business plan) have been finalized;
• Five RACHA staff members received a basic and specific micro health insurance training, organized by the Tata-Dhan Academy located in India;
• The pilot project was launched by contracting 3 Health Center’s;
• The first members were enrolled in the insurance scheme “My Family’s Health” in June 2010. The member enrollment continued steadily during the course of the 2010;

Scale- up phase in 2011

• The coverage area has been expanded in early 2011 by contracting an additional 6 Health Centers in Pearang OD;
• Agents were recruited and trained in promoting the insurance scheme, member enrolment and premium collection;
• HealthNet TPO received the commitment of ACHMEA Zorg to provide technical assistance during the roll-out of the scheme over the next 3 years. A joined mission with a team of ACHMEA Zorg was completed in April 2011;
• A SWOT analysis of the scheme was performed jointly by RACHA, HealthNet TPO and ACHMEA Zorg, during the mission in April 2011. This will serve as a basis for the formulation of a 3 year strategic plan of ACHMEA’s involvement during the roll out.

In Summary, over the last years the following important milestones have been met:

• Business plan developed in 2010
• First 3 Health Centers contracted in 2010
• Local NGO staff and staff from other stakeholder are trained in 2010
• First members enrolled in June 2010
• Agents trained and recruited in 2010
• Roll out started early 2011 by contracting 6 additional Health Centers

Achievements and challenges
A great achievement in 2010 was the successful implementation of the pilot project followed by its roll out in 2011. Another accomplishment which is worth mentioning is that by June 2011, 6166 household members were enrolled into the scheme “My Family’s Health”. This number does meet the first year enrollment target which was set by the 10 year business forecast. However, the decision of community members to join the scheme or not was revealed to be influenced by a range of factors (i.e. local treatment beliefs; level of trust in the quality of care provided by the Health Center staff; understanding of the benefits of the scheme; premium payment schedule, timing, etc.). Addressing these factors appropriately will be a real challenge in order to assure member enrollment and attainment. 

In addition, while membership growth is expected in 2011, another challenge will be to ensure that at the same time local capacity will be strengthened accordingly, in order to be able to absorb the increasing administrative, managerial and organizational burden. The challenge will be to enhance local capacity through creating active and effective community and village association and ensure that association representatives will receive the required training. In addition, solutions to minimize the administrative burden i.e. through mobile cash transfers will be explored.

In order to address and respond to the above mentioned challenges in the most professional and effective way, HealthNet TPO has achieved to obtain a partnership with ACHMEA, the biggest health insurance company in The Netherlands. This very unique public – private collaboration presents a very exceptional opportunity in reducing poverty in Cambodia through effectively scaling up the system. Over the next three years a designated team from ACHMEA has committed to provide technical assistance to RACHA and HealthNet TPO regarding the development of marketing and communication materials, premium payment review, product development, information system development and organizational procedures.