Bangladesh NGO Provider-Based Prepayment Schemes Feasibility Analysis

Resource Type: Report
Authors: Yann Derriennic, Hamid, Syed Abdul, Andrea Feigl, Mursaleena Islam
Published: 05/2016

Resource Description: Bangladesh’s Health Care Financing Strategy (HCFS) identifies three target populations: the poor (below the poverty line – BPL); the informal sector; and the formal sector. These three type populations are to be covered using different approaches. For the BPL, a government scheme known as Shasthyo Shuroksha Karmasuchi (SSK) has achieved much progress to begin its operation. For the formal sector, a government employee contributive scheme is being designed, and several initiatives are being implemented in the garment industry.

The HCFS calls for community-based health insurance, micro health insurance, and other innovative initiatives for the informal sector. Global practice and knowledge identifies the informal sector population as the most difficult to reach with health protection coverage; these individuals are not classified as BPL and therefore do not qualify for government support, nor can they be easily reached through formal employment-based mechanisms.

In the fall of 2013, USAID Bangladesh asked the Health Finance and Governance project (HFG) to design and facilitate a one-day workshop focusing on Health Micro Insurance (including Community-Based Health Insurance (CBHI), micro health insurance, and other insurance mechanisms) to cover/reach the informal sector. The workshop concluded that the most promising area was Micro Health Insurance (insurance associated with microlending), followed by provider based insurance. Considering USAID’s support for the Smiling Sun NGO network, USAID Bangladesh asked HFG to explore how provider-based prepayment schemes could further the cost recovery/sustainability goals of the Smiling Sun NGOs. HFG proposed a feasibility study. Thus, HFG proposed, and USAID Bangladesh approved, the project to conduct a feasibility study (and thereafter, if feasibility is determined to be positive, design an NGO provider-based prepayment scheme).

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