ABSTRACT
Health services and modern medicines are out of reach for over one billion people globally. Micro-insurance for health is one method to address unmet health needs. This case study used a social exclusion perspective to assess the health and poverty impact of micro-insurance for health in Bangladesh and contrasts this with several micro-insurance systems for health offered in India. Micro-insurance for health in Bangladesh targeted towards the poor and the ultra-poor provides basic healthcare at an affordable rate whereas the Indian micro-insurance schemes for health have been implemented across larger populations and include high-cost and low-frequency events. Results of analysis of the existing literature showed that micro-insurance for health as currently offered in Bangladesh increased access to, and use of, basic health services among excluded populations but did not reduce the likelihood that essential health-related costs would be a catastrophic expense for a marginalized household.
ABSTRACT
According to social exclusion theory, health risks are positively associated with involuntary social, economic, political and cultural exclusion from society. In this paper, a social exclusion framework has been used, and available literature on microcredit in Bangladesh has been reviewed to explore the available evidence on associations among microcredit, exclusion, and health outcomes. The paper addresses the question of whether participation in group-lending reduces health inequities through promoting social inclusion. The group-lending model of microcredit is a development intervention in which small-scale credit for income-generation activities is provided to groups of individuals who do not have material collateral. The paper outlines four pathways through which microcredit can affect health status: financing care in the event of health emergencies; financing health inputs such as improved nutrition; as a platform for health education; and by increasing social capital through group meetings and mutual support. For many participants, the group-lending model of microcredit can mitigate exclusionary processes and lead to improvements in health for some; for others, it can worsen exclusionary processes which contribute to health disadvantage.
ABSTRACT
Background: Soc Son is mountainous, poorest district of Ha Noi, the rate of malnourished children was highest level (28,2% in 2003). Objectives: Description and assessment on the effectiveness of microcredit program for developing household economy and the impact of microcredit program on care for pregnant women, children and nutrition situation for children in 7 communes of Soc Son district in 3 years (2003-2006). Subjects and method: 167 poor households with malnourished child/children or pregnant women with low weight gain which were provided loans in 7 communes of Soc Son district; 169 children were born after 1/6/2001 and their mother in 167 households above. Method: cross-sectional descriptive method combine comparative analysis, using interview ballot, growth chart of National Institute of nutrition. Data processing by software EPI 6.0 and SPSS/PC 12.0. Results: The microcredit program had helped 95,0% households improve their economy remarkably, 54,5% of the households had improved income and food security. These improvements had influenced positively on practice of maternal and child care and malnutrition situation among children under 5 years old. The rate of pregnant women taking sufficient rest before birth delivery and having appropriate workload during pregnancy increased by 29,7%. Low-birth-weight newborns (<2,500 gram) had decreased by 11,5%. The rate of children with more than 3 complementary meals had increased by 8,5%. Malnutrition prevalence of children under 5 years old in 7 communes had decreased by 6,9%. Conclusion: The program has contributed to lower malnutrition prevalence of children under 5 years old in Soc Son district by 6,6%.