In Cambodia, healthcare expenditure is one of the main causes of poverty. GRET offered to set up a health micro-insurance system when the Cambodian microfinance institution, Amret, realized that micro-loans secured incomes, but that they were not used for investments, but to cover healthcare expenditure. In 1999, the SKY project was thus launched, with the aim of covering all primary healthcare, hospitalization and surgery in their partner structures: public medical centers.
The premium for all this costs USD 5 per year and per member.
SKY is a project for rural communities, who make up 80% of the population and are particularly vulnerable. GRET created the product, then extended it to Phnom Penh, where the observation was made that one population particularly needed this system: women working in the textile industry. GRET therefore contacted the textile trade union, GMAC, in order to establish a partnership to introduce a specific product for women workers. 50% is paid for by the employer and 50% by the women workers.
From the outset, this was a pilot project for the Ministry of Labor, with the aim of rolling out a health insurance social coverage system.
The project is financed by AFD.
Slide show with a voice-over, based on an interview with Camille Bouillault, project manager for the French NGO GRET in Cambodia.
Improving the quality of healthcare services for the most vulnerable, establishing mobile centers, enhancing the skills of staff… Médecins du Monde is implementing a regional project to scale up access to primary healthcare in the Sahel region with support from AFD. In Mali, it is being implemented in the Mopti region.
Improving access to healthcare for pregnant women and the under-fives
Médecins du Monde is working in the Koro health district, in the Mopti region, to sustainably improve access to quality primary healthcare for the most vulnerable communities: pregnant women and the under-fives. The rate of maternal and infant mortality in the Sahel region is very high. The NGO’s mission is to improve the reception and healthcare capacity with the aim of receiving some 70,000 people.
Médecins du Monde intends to focus on several key areas in order to achieve this objective. They include financial access to healthcare and improving the structures and their locations so that a maximum number of people can be reached.
Consequently, mobile health centers will be set up for awareness-raising, prevention and treatment for communities the furthest away from urban centers.
© Copyright: Isabelle Eshraghi
Improving both the quantity and quality of healthcare
Increasing the number of health centers is not the only component of a sustainable health system: the skills of local stakeholders also need to be strengthened. The NGO aims to transfer its skills in order to ensure that healthcare quality does not deteriorate once the operation is over. Médecins du Monde’s second objective is therefore to increase the number of healthcare workers and train them, particularly for certain missions. The fight against malaria, malnutrition and epidemiological surveillance are the doctors’ priorities.
At the same time, Médecins du Monde wants to continually improve neonatal and perinatal care in the region. The aim is to reduce maternal and infant mortality in the region, which currently stands at over 10%, with 109.08 deaths for 1,000 births.
Addressing the crisis in Mali
There are three factors of instability in Mali: the loss of control over the Northern regions in February 2012; the coup that followed in March and the lack of political normalization since that date; the French and African military intervention since January 2013. These events have exacerbated the structural crisis (political, health, food), which already existed, and make the work of the NGO’s doctors difficult. The French military intervention in Mali also led to the evacuation of doctors from the Koro region and to their project being stopped for 8 weeks. Some team members were only able to return to the field in March.
The crisis did, however, allow additional humanitarian aid to arrive in the Mopti region. Médecins du Monde aims to establish partnerships with these new stakeholders in order to coordinate their action. The NGO also wants to gradually resume the scheduled missions, while remaining vigilant over the military presence in the initially planned intervention area.
© Copyright: Médecins du Monde
Characteristics of AFD’s support
Multi-country Program Agreement: “Promotion of Reproductive health”
Financing: EUR 2,700,000 (34% of the total program budget) for a 3-year period
Allocated in May 2010