1. Taking health to the people:
comprehensive poverty reduction
Shameran Abed
BRAC
November 14, 2011
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2. BRAC in 30 seconds
• Founded in: Bangladesh, 1972
• Program coverage: 136 million worldwide
(110m in Bangladesh)
• Working in: 10 countries
• Bangladesh budget (2010): US$ 495
million
• Self generated: 71%
• Health budget as %: <10
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3. Holistic Approach
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4. 1970s: Health and poverty
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5. Health delivery for the poor
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6. Oral Re-hydration Therapy
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7. Tuberculosis
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8. Health Workers
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9. Health Forum
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10. Reducing maternal, child,
and neonatal mortality
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11. 2011: Health and poverty
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12. Why Health Insurance?
• Expenditure on health as % of GDP - 3.4
• Government expenditure as % of total exp. on
health - 31
• Out-of-pocket spending as % of total exp. on
health - 58.9
• Out-of-pocket spending as % of private
expenditure on health - 86
Source: WHO 2007 and ILO 2007
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13. In the Absence of
Health Insurance
There are significant health costs:
- Not seeking healthcare when needed
- Seeking care very late (often when it is too late)
- Poor quality of care
And financial costs:
- The financial shock of health expenditure could push
people below the poverty line
- Nearly one-third of defaulters for microfinance cite health
shocks as primary reasons for defaulting on their loans
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14. Challenges
• Is it possible to provide value for money
and still make it viable?
• Supply side weaknesses
• Poor renewal rate
• Adverse selection/moral hazard
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15. Opportunities
• Leverage extensive distribution network of
MFIs to offer health insurance at low-cost
• Provide an additional suite of products to
borrowers which will likely lead to lower
default rates and better retention
• Potential for integrating technology to
reduce costs of delivery
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16. Thank You
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