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Study of living conditions of and access to quality health care for the poor through a health micro-insurance fund in Bandalungwa health zone, Kinshasa (Congo) in 2008.

By Joseph Manzambi Kuwekita, Michèle Guillaume, Marie-Paule Balula Semutsari, Elysée Tshiama Kabongo, Judith Mayamba Kilela, Olivier Bruyère and Jean-Yves Reginster


This study investigates the conditions under which populations living in poverty are able to accumulate savings and contribute to a micro-insurance health system to improve their living standards and access quality health care. We carried out a comprehensive survey in 2008 in the Bandalungwa health zone of Kinshasa. It was based on the Manzambi Model for health financing and the extension of social protection to the poor in developing countries. Each day, the leader of the group hands the members’ contributions to a loan officer. Two micro -entrepreneurs (3%) paid by these funds have disappeared, with the help of a loan officer. The main results of this study show that of all those contributing to the scheme, 78.1% improved their living conditions. 50% were able to start saving while 71.9% of these regularly contributed 1 US$ to the micro-insurance fund. 40.6% regularly contributed 1 US$ to the health micro-insurance fund, 88.5% of these improved their access to health care. When micro-credit promotes significant compulsory savings, the obligatory contribution of one dollar a day to the micro-insurance fund becomes easier and results in improved access to care (p<0.000) for household members. 68% of micro-entrepreneurs who paid their dues improved their purchasing power. If we want to keep people out of poverty, we must find a way to help them with these compulsory savings. The results of this study show that micro-entrepreneurs who have improved their living conditions also saw an improvement in their access to care (86.4%) (p=0.003). The Manzambi model provides a sustainable solution to the problem of health financing and extends social protection to fragile populations in developing countries. It also brings us closer to the objective of "health for all".Peer reviewe

Topics: Manzambi model, savings and required contribution of 1 US$/day, health micro-insurance, access to health care for the poor, social micro-credits, Human health sciences :: Public health, health care sciences & services, Sciences de la santé humaine :: Santé publique, services médicaux & soins de santé
Year: 2013
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