Access to Health Care and Basic Minimum Services in Kerala, India The CBHSS Sali, 18 juin 2004 D. Narayana, S. Haddad.

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Access to Health Care and Basic Minimum Services in Kerala, India The CBHSS Sali, 18 juin 2004 D. Narayana, S. Haddad

UdeM-CDS /2001 Objective u To support Women’s Self Help Groups and other community organisations in building and implementing a Community Based Health Solidarity Scheme (CBMS)

UdeM-CDS /2001 The history of the CBHSS u Evidence of: u Exclusion of the poor, scheduled tribes and scheduled castes. u High inequalities in access to health care. u High burden of health care on poor households. u Use of SHG savings to help members overcome financial barriers to access to health care. u Reaction to CBMS u The CBMS: OK but what will be the benefits for us?

UdeM-CDS /2001 Development phase: Methodology u Process: u Consultation - needs assessment - preparatory studies. u Mobilisation of local partners (SHGs – NGO). u Workshop July, u Surveys u Purpose: estimates of risks, scenarios of risk coverage, and subsequently the specific design of the scheme u Measures: health condition, consumption of health care, access -exclusion, preferences for type of scheme. u Surveys u “baseline” census (3352 HH) u panel survey (534 HH – over sampling of tribes)

Location of the insurance schemes