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Funding &Treatment &Universal Coverage Bill Brieger | 30 Dec 2010 06:32 am

Prepaid mechanisms can promote Malaria treatment and save lives

Tarry Asoka, a medical doctor and health development consultant, provides us a perspective on why health insurance is needed to meet malaria treatment gaps. Tarry is  Publisher/Editor of Health Insurance Affairs and Malaria Bytes

All across sub-Saharan Africa the poor utilization of modern health services usually reverses and begins to improve, reaching a tipping point as soon as there is confirmed indication that ‘treatment charges’ in health facilities have been removed. And politicians in the sub region are very quick to take good note of this phenomenon – often taking full advantage to develop populist ‘free health campaigns’ that are often not sustainable.

waiting-for-free-medical-treatment-rivers-state.jpgThe lack of continuity is not usually the result of faulty design but due to poor execution as many of these are mostly ad hoc initiatives rather than enduring programmes. But the fact that these campaigns continue to be popular especially among poorer citizens despite their lack of permanence and irrespective of who is organising it – government, NGOs or private – should give health planners some worry that something is not quite right.

Curiously, malaria is still the most common condition recorded by health professionals during such health jamborees. A recent free medical check-up drive to promote a new community-based health care programme in a high density area in Port Harcourt, Rivers State, Nigeria – noted that close to 30% of those who were seen had classical symptoms and signs of malaria that have not been treated for at least 2 days.

So what could have happened to such persons especially children if this event did not take place at that particular point in time? Your guess is as good mine.

But one fact is clear – the payments that are needed to be made at the point of accessing health services prevent large majority of the population from seeking medical care. A recent survey in Kenya, for example, found that “61.5% of individuals who did not seek (malaria) treatment reported that cash shortage was the main barrier.” Others coped by borrowing, selling household possessions, or buying cheap drugs from shops.

Therefore, any mechanism that enables people to access care ‘free at the point of delivery’ will improve treatment for life-threatening conditions such as malaria and save lives.

This is ‘no-brainier’, and does not require elaborate plans to be put in place. Apart from informal and community-based health insurance, which has been quite challenging to set up, other approaches such as vouchers and coupons have also proved to be useful alternatives.

The task now is to scale-up these options to achieve universal coverage.

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