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Delivering Health Microinsurance through Savings and Internal Lending Communities: An Evaluation of CRS' Experience in Benin

Delivering Health Microinsurance through Savings and Internal Lending Communities: An Evaluation of CRS Experience in Benin   

In Benin, the average household spends more than 40% of its total budget on out-of-pocket health expenses each year.

Catholic Relief Services and partners piloted a health microinsurance product and delivered it through savings groups in Benin. We introduced a digital solution to improve efficiency and scalability. This document evaluates the project's ability to increase access to health services among rural households.

Read a summary
Download the full evaluation (PDF, 1.4 MB)

From the executive summary

In Benin, the average household spends over 40% of its total budget on out-of-pocket health expenses annually. Health costs disproportionately affect poor households as they face a higher burden of disease, which leads to higher health costs and a risk of increased impoverishment from "health shocks" or "crises presented by a healthcare need that jeopardizes the already fragile economic status of the poor" (Leatherman et al., 2012).

To support poor households in managing these costs, CRS, an international NGO founded by the U.S. Conference of Catholic Bishops; NSIA Assurances, a private health insurance company; and Caritas Natitingou, a faith-based development organization; piloted a health microinsurance (HMI) product delivered through savings and lending groups in northern Benin.

The HMI product covers health services including consultations, pharmaceutical products and medicines, local hospitalization, simple births, and small surgeries at two private, Catholic health centers in the area of intervention. The product also features a life insurance component.

From the product’s launch in March 2012 through December 2014, the number of persons covered has nearly doubled from 715 to over 1,300. In November 2013, CRS introduced a virtual information and communications technology (ICT) solution to improve the efficiency of the HMI management system to prepare for an expansion of the project to other regions of Benin.


Executive Summary
1. Introduction 8
1.1 Literature Review 8
1.2 Evaluation Context 9
1.3 Research Objectives 11
1.4 Methodology
2. Research Findings 13
2.1 Survey Findings 13
2.2 Discussion of Survey Results 18
2.3 Focus Groups with SILC Members 19
2.4 Interviews with Key Stakeholders 22
2.5 ICT Solution 28
2.6 Competitive Analysis 30
2.7 Financial Analysis and Projections
3. Recommendations 36
3.1 Improve Marketing and Messaging Strategies 36
3.2 Review Product Design 37
3.3 Strengthen Partnerships 37
3.4 Refine ICT Solution 39
4. Lessons Learned 39
Appendix A: References 41
Appendix B: NSIA's Health Microinsurance Terms and Conditions 43
Appendix C: Detailed Timeline 44
Appendix D: ICT4D E-system 45
Appendix E: List of SILC Groups 46
Appendix F: List of Key Stakeholders 47
Appendix G: Stata Output 48
Appendix H: Description of ICT Expertise Needed 51
Appendix I: Product, Access, Cost, Experience (PACE) Analysis 52
Appendix J: Financial Analysis 57


Publication details

Author: Angie Tyler
Publisher: Catholic Relief Services (March 2015)
Evaluation: 60 pages
Language: English
Dimensions: 8.5 x 11 inches

Posted on April 20, 2015

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