Microinsurance and the Anglican Health Network
by The Revd Paul Holley
Posted: 18 Mar 2011
The Anglican Church is opening up new markets for the insurance industry in Africa. In partnership with the leading microinsurance agency, MicroEnsure, the Anglican Health Network has developed a low cost health insurance policy for its members. The parishes of the Diocese of Dar es Salaam in Tanzania are providing the pilot for a marketing project that could spread throughout the continent.
The church is motivated to provide this service to reduce the financial risks of medical treatment. Unplanned expenditure on health care is one of the key risks that keeps low income families in poverty. Throughout the developing world statistics suggest that as many as 80% of those thrust into destitution are placed in this position because of medical bills. Health microinsurance is designed to pool the resources of the community to avoid this eventuality. The Anglican Church believes that this method will make a major impact on poverty in the communities it serves; not just its members but those of any faith who wish to join.
Moreover, the advent of health insurance in low income settings will improve the impact of the church's health care services. Churches in Sub-Saharan Africa provide between 40 - 60% of health services on the continent. Modest public subsidies and donor contributions help keep costs down, but treatment fees and charges are ubiquitous. Patients come to hospitals and clinics only when symptoms reach a critical point, often allowing disease to take a stronger hold. Insured members will access treatment more swiftly when first signs emerge and can thus recover more quickly. Their health outcomes will be improved. In addition, by providing church hospitals with an insured clientele, the Anglican Health Network believes that revenue will be more predictable, giving confidence to invest in new and better services.
The utility of low cost health insurance and community based risk pooling has been tested in various parts of the continent over past years with only modest success. The Tanzania pilot brings together three key elements that have not been in place before: a South African insurer that is bearing the risk, a specialist international microinsurance agency that manages health microinsurance in India and the Philippines, and a church community of 40 million members in Africa. With sophisticated yet inexpensive administrative systems, a fully sustainable business plan that has no need for public subsidy and a potential market of 10s of millions of people, the Anglican health microinsurance programme is a potential game changer.
A parallel initiative is currently in operation in the Church of South India amongst the clientele of its 550 bed teaching hospital in South Kerala. Insurance markets may be more developed in India but they have little to offer those on a low income. The church's hospitals have reputations for high quality at low cost but still run a business model that relies on fees for treatments. Thus their patients are similarly prone to significant financial strain in the case of serious ill health. The poor of India are estimated to outnumber those in Africa, so there is a major task ahead. The Indian government has initiated a health microinsurance scheme that has reached 10s of millions of people, but another half a billion people remain uninsured. The Anglican Health Network is supporting the Church of South India in developing its marketing strategy to locate the programme throughout the 700 Anglican hospitals and clinics dotted around the country.
Partnering the church with the insurance industry naturally
raises questions. How can profit and prayer sit so comfortably together? But
the Church always proclaims and enacts a holistic approach to its mission. It
does not simply rescue souls for heaven, but seeks a taste of God's promise on
Looking back at the development of risk pooling and savings in the European and American settings reveals just how concerned the churches were to implement safety nets for their communities. These may have been basic forms of insurance that avoided the attention of profit-hungry capital, but the intention and impact in modern emerging economies is no different. The Anglican Church has found partners with vision and philanthropic verve that are willing to take short term risks in the hope that they may open up markets in the long term. In the process, the church may be able to make a major contribution to the health of those whose lives are blighted by poverty and disease.
Background: Anglican Health Network
The Anglican Health Network (AHN) promotes and serves the health mission of the Anglican Church. Health microinsurance is its key initiative alongside a range of other interventions that will help renew the impact of its historic interests in health service provision. Parishes and dioceses everywhere are committed to some form of health or healing initiative. They are present in a wide range of settings, including for example: world class specialist facilities in the United States, small dispensaries dotted around rural Africa, parish nursing in New Zealand, or primary care programmes in India. The network provides a forum by which learning and resources can be shared between them. Based at the heart of the global health community in Geneva, Switzerland, the network is positioned to connect this extensive varied commitment to global health strategy.
The network assumes that Anglicans have a permanent role in and commitment to health mission. It assumes that this role can be understood as a valuable and constituent contribution to the action of national health systems. However, the capacity to deliver its own health services is not the only driver of Anglican health mission. AHN is seeking to secure improved health services from other providers for the communities served by Anglicans. It advocates for improvements in public services and provides greater access to private sector providers.
At the same time, AHN is promoting a deeper understanding of the holistic nature of health and well-being in individuals as members of communities. This includes a commitment to addressing the social determinants of health and to releasing spiritual and pastoral resources for well-being.
The opinions expressed in this article are those of the author, and do not necessarily represent the views of St Paul's Institute or St Paul's Cathedral.