About our programs
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The Health Insurance Fund provides subsidized medical insurance for people in Sub-Saharan Africa. The programs are executed by local (African) Health Maintenance Organizations or insurance companies. Each Health Insurance Fund program consists of insurance schemes for one or more specific target groups.
Insurance tailored to the needs
A specific insurance benefit package is developed for each scheme in collaboration with the local executing partner of the program, which is tailored to the needs of the target population. For each target group the Health Insurance Fund and the local executing partner determine the level of premiums as well as the level of contribution to the premium (co-payment). The level of co-payment will be low in the initial phases of the program, but is expected to increase over time to enhance sustainability.
The insurance benefit package provides coverage for the most common medical problems that are found among the target groups and consists of primary care, limited secondary care and medication, including HIV/AIDS treatment.
Local clinics
PharmAccess, in collaboration with the local executing partner, selects local healthcare providers (clinics, hospitals, laboratories, pharmacies) on the basis of a set of pre-defined criteria through a medical due diligence. These providers can be either private or public.
Group Enrollment, family insurance
To ensure that the target population will participate in the schemes, an enrollment strategy is applied. Communities are, amongst other things, mobilized through community leaders, information meetings or radio messages. Special ‘marketing teams’ will undertake ‘on-the-spot’ registration and enrollment in the field.
Upon payment of their part of the premium, insurance scheme beneficiaries receive their insurance ID card. Enrollment is done on a yearly basis.
Quality measurement and operational research
A quality improvement program is part of each Health Insurance Fund program and provides the medical, administrative and financial upgrading of healthcare providers. For this purpose, an innovative quality measurement system has been developed.
Socio-economic and bio-medical operational research is also part of the programs. This research is carried out by the Center for Poverty-related Communicable Diseases (CPCD) of the Academic Medical Center (AMC) of the University of Amsterdam and the Amsterdam Institute for International Development.
First schemes
The first schemes were launched in Nigeria in early 2007, potentially targeting 115,000 market women and farmers and their families. A second program is currently being developed in Tanzania. The Health Insurance Fund is identifying target groups in other African countries. We strive to carry out programs in at least four African countries.