The headline programme of AHN was to develop viable models for implementing health microinsurance with its partner MicroEnsure. In most developing countries, patients have to pay for each individual treatment. This inhibits their access to health services and too often leads to debt and deeper poverty. Implementing health microinsurance is a complex and challenging task amidst communities that have no understanding or experience of insurance.
The Diocese of Dar es Salaam launched its programme in September 2010. The Coordinating Board of AHN had direct involvement in managing this programme. A premium of $40 covered a family of 5, for 4 conditions: Malaria, maternity, diarrheal diseases and respiratory diseases. Having contracted with a range of health service providers throughout the city, this programme focused on the parish as the potential conduit for recruitment. Two sales strategies were employed to test appropriate methods. The service delivery systems worked effectively and remained viable for the 1100 people who were members. However, the membership needed to grow to a significantly larger scale before such a programme could be counted a success. A full evaluation has been produced to inform thinking and practice in the future. This can be downloaded here.
Additional experience has been gained through the programme run by the Diocese of South Kerala at its 550 bed teaching hospital in Karakonam. Launched in August 2009, the scheme attracted a government subsidy that allowed a fully comprehensive policy to be offered to families for an annual premium of $4. The programme attracted 40,000 people within 8 months. The hospital staff marketed the policy throughout the poorest villages in the region and saw major improvements in the uptake of treatments and consultations. However, the adverse selection of the sick in this process proved too great a burden on the programme and the insurer had to close the scheme to new members.
The Anglican Health Network continues to supply medical supply to Anglican hospitals in the developing world. With access to a wide range of surplus equipment in the United States, AHN has been able to supply three container loads of equipment to the Anglican Church of Tanzania.
A typical container load of medical equipment costs around $30,000 to collect, package and ship. However, the value of such equipment may be much greater depending upon the contents of a particular container, and the value methodology used. A wide range of medical supplies and equipment is available, although availability varies from time to time. AHN is not able to include any drugs or pharmaceuticals in these shipments. Combining such shipments with investments in skilled staffing, may well enhance the health services of a hospital or clinic.
The Faith in Health and Healing Conference took place on 24/25 April 2013 in Birmingham UK. It brought together medical professionals, health care chaplains, clergy and laity in congregational health projects, theologians and other academics, Christian healing agencies, and senior church leaders. With over 60 presentations and around 200 participants, the conference was a landmark event. As well as a majority from the UK, people came from the United States, Canada, South Africa, Israel, Barbados, New Zealand, Switzerland, Ireland, Germany, Norway, Zimbabwe and Australia.
For access to resources and presentations from the conference, check out the following website: https://faithinhealth.wordpress.com
During 2011/12, AHN worked in partnership with USPG (now Us.), the Liverpool School of Tropical Medicine, NHS Northwest and Our Mobile Health to institute a model that could significantly reduce the high rates of maternal and newborn mortality and morbidity in rural districts in Africa. The primary aim of the model is to increase the number of births supervised by skilled birth attendants (SBAs). Representing the public, private, academic and faith sectors, the partnership was designed to pool its constituent competencies to offer a comprehensive set of interventions to meet the classic three delays in care:
The approach can stimulate both demand and supply for health services, and include communities in the steps taken to improve those services. It can engage the health authorities in a partnership with the Anglican Church. This would provide a sustainable basis upon which communities can be accompanied and supported in their pursuit of better health, and it would strengthen service delivery by both public and church health facilities.
The model is designed to bring together those community based carers (CBCs) that already accompany pregnancy and birth, and incorporate them into the maternal health team. Following training and with the support of ongoing supervision, CBCs can encourage and accompany women to facility-based deliveries. As the understanding and confidence of the community improves, the model encourages and supports the development of community based SBAs. These changes are supported by mhealth applications, initially for CBCs and then to incorporate community based SBAs into the district information system.
Emergency obstetric care would be enhanced by a unique intervention to establish a district blood supply system. These improvements can be sustained by a health financing solution that will pool family health expenditure.
The model can illustrated thus:
