1. Health Security Scheme (HSS) for rural artisans
March
May
June
April
July
February
A co-contributory health-financing scheme for Ayesha Abed Foundation artisans and their family members
Tanvir Hossain, Manager, Marketing & Sustainability
World Bank BEES Network Meeting – September 2015

2. Concept
Why HSS?
“Strengthen economic empowerment of all artisans by improving their financial security for catastrophic health shocks”
25 BDT
Artisan
AAF per artisan
50 BDT
HSS Fund
How?

3. Concept Who benefits? Artisans can register up to 4 family members
Children and either spouse or parents
Artisans who are active and active artisan’s family members
Active = has worked at least four out of six months

4. Concept
Eligible beneficiaries who seek emergency care or who are hospitalised at an empanelled hospital are provided with a fixed amount of money
Amount calculated according to type of admission and length of stay

5. Benefit 1,000 BDT 6,000 BDT* 10,000 BDT* Emergency: Medical: Surgery:
Complicated child birth:
1,000 BDT
up to 3,000 BDT*
(500 BDT per 48 hours)
6,000 BDT*
10,000 BDT*
*(Initial 1,000 BDT provided on admission)

6. Mother & Child Maternity Clinc
Manikgonj
Nilphamari
Empanelled Hospitals
Sadar Hospital
Mother & Child Maternity Clinc
Islamic Bank Hospital
Diabetics Hospital
Orthopedic Hospital
Dhaka Medical College
RangpurMedical College
Public Option
Maternity Public Option
Empanelled Pharmacies
Private Option
Public Tertiary Care Option

7. Operations In Event of Illness
Informs HSS Point-Person, who informs PO
Informs HSS Point-Person,
who bkashs payment
In Event of Illness
Admitted at Hospital
RPO/PO Verifies Admission Slip and Facilitates bKash Payment
Beneficiary Provides Admission & Discharge Slips at Centre with completed Verification Form
Informs Incharge to check if artisan is eligible
Receives First Payment
Visit Hospital & Meet RPO/PO

8. Sensitisation & Registration
Production centres:
Total Beneficiaries covered:
Artisans registered: 3
11,268
3,812
Manikgonj
Nilphamari
Kushtia
2.2 Family Members
Total Population Covered:
15,080

9. Artisan’s Unique Artisan Code: 7002WW011
BRAC Production Centre Code
Section Code
Artisan’s Original Code
Manikgonj Main Centre: 7002
Wood Work Section: WW
011 (three digit)
Artisan’s Unique Artisan Code: 7002WW011
Integration:
Main Centre Wage Reports
HSS ID Cards
HSS Database

10. Medical Hospitalisation
Original to Reality
Budget – Utility Rates
6.5% reality
Conservative 8% estimate
Medical Hospitalisation
1.7% reality
Conservative 3% estimate
Surgical Hospitalisation

11. Original to Reality Budget – Utility Rates Medical 3,000 BDT
Emergency 1,000 BDT
50% Emergency
44% C-Section
Surgical 10,000 BDT
C-Section 6,000 BDT

12. Case Study 1
7101HE080
Shahanaz
Her Son: Sagor
Son was hit in the eye with a cricket ball and was taken directly to eye specialists in Rangpur Medical College

13. Case Study 2
7030HE010
Shandona Rani
Artisan Herself
Artisan underwent an illegal abortion which caused severe bleeding. Artisan also suffers from anemia so the loss of blood was very dangerous. Artisan went to Islamic Bank Hospital and was referred to Dhaka Medical College. Her medical bill was excessively high partly due to requiring large amounts of blood from a rare blood group.

14. 80% of beneficiaries from Manikgonj
67 Cases
209,500 BDT
Cases
Nilphamari
47 Cases
72,000 BDT

15. Usage
69% Family Members
Registered
31% Artisans
52% Artisans
42% Family Members
Usage

16. Usage

17. 79% of all benefits directly to women and children
Usage
53% Female Beneficiaries Registered
79% of all benefits directly to women and children
47% Male
21% male adults

18. Usage 15 1 52 46

20. HSS Future
What’s next for HSS?
Upscaling to cover 80,000 people
Impact assessment by BRAC University
Out patient care (preventative care)
M-health
Prescription drugs coverage