This presentation was given by Bruno Meessen of the Institute of Tropical Medicine (Belgium) to a seminar on health insurance for the poor, November 2008. Bruno is part of the POVILL consortium (www.povill.com).

4. A highly fragmented health system Distribution of health seeking behaviors over respective providers (30 days recall period), RHS Public sector: 18%

9. Health Equity Funds: the basics

15. > 100 Genuinely poor!

17. HEF boosts utilization of public hospitals (Logistic regression (of likelihood to go to public hospitals (vs other option) for seriously ill people who got the advice from a qualified expert to seek inpatient care (N=1567) RHS) Odds for a HEF card holder to go to the public hospital are 2.4 higher than someone with a same profile without a HEF card!

18. Lessons learned

21. HEF: a bundle of functions Source: C.R. Men / M. Van Pelt

23. Pre-identification is a snap shot survey and does not address dynamic of poverty Poverty line The non-poor The near poor or relatively poor The poor The chronically poor or poorest Time Income/ consumption

27. Coping strategies with major illness 100 3068 Total of HH reported severe financial problem due serious illness 10.3 615 Seek additional work 3.9 234 Borrow money from credit institute 26.7 1594 Borrow money from informal money lender 15.2 911 Borrow money from friends/relatives 1.6 93 Sell land 5.3 317 Sell livestock 3.4 206 Sell production tools 1.7 99 Sell household assets 5.3 319 Sell stored food 0.3 19 Remove children from school 0.4 24 Reduce food expenditures 1.4 86 Using saving Percent Frequency