Private health insurance takes roots

The country’s pioneer mutual health initiatives today count over 21,000 subscribers and over FCFA 90 million in premiums in 2014.

Quality health care at low cost is the slogan and vision on many lips in the North West Region. The first of its kind in the country, the initiative, which began in 2004, is an inspiration and alternative to many who cannot afford the high cost of handling their health issues with poverty to blame.

In effect, mutual health organisations or cooperatives for quality and low cost services promoted by the North West Regional Fund for Health Promotion (PIG) and the Catholic Church have emerged as a blessing.

The new experience, which covers metropolitan Bamenda, Boyo and Bui Divisions in the North West Region for now, is summed up as a community-based health insurance scheme at the service of its members.

It is all about families who contribute annually into a common fund to solve their health problems. The Administrator of the North West Regional Fund for Health Promotion, Dr Richard Fondoh Mbarika, says the mutual health scheme reduces financial barriers to access to quality health care.

The Section Head for Health Promotion and Partnerships, Mildred Kongla Njamnsi, sounds off about the scheme which reimburses 25 per cent, 50 per cent, 75 per cent or nothing at all, depending on the nature of care. On the other hand, HIV/AIDS patients receive a maximum of FCFA 30,000 for CD4 Counts and opportunistic infections each year.

The scheme covers amongst others, emergency surgeries, hospitalisations, planned surgeries, deliveries and a special out-patient package that covers consultation fees, laboratory charges and drugs in health facilities with which the scheme keeps memoranda of understanding. It is however a no-go scheme for chronic conditions that require regular consultations.

Beneficiaries are families who pay annual contributions for at least four members. Mildred Kongla Njamnsi told Cameroon Tribune that the Kumbo Mutual Health Cooperative leads the scheme with 3,890 beneficiaries worth FCFA 33.5 million from the total regional FCFA 40.3 million contributions by about 9,000 members in 2014.

Still last year, the Boyo Mutual Health Cooperative collected FCFA 17.4 million in premiums while FCFA 8.2 million was spent on bills for 1,270 members. The Bamenda Mutual Health Organisation spent FCFA 3.1 million on bills for 335 members from contributions of FCFA 8.2 million for the same year.

Conceived and launched by the then German International Cooperation (GTZ), now GiZ, in 2004, the scheme later became the product of the North West Regional Fund for Health Promotion. Staring the scheme in the face is skepticism by some who are yet to see the government stand by it.

Away from that; it faces resistance from some staff of public hospitals who see the scheme as a speed brake to their clandestine, fraudulent and corrupt business in drugs.

Away from the Regional Fund for Health Promotion, the seven-year-old Bamenda Ecclesiastical Province Health Assistance scheme (BEPHA) helps members to pool health risks to be able to pay hospital bills. This is how with little or no money, members receive health care. It is about charity and solidarity with emphasis on primary health care, which covers para-clinical tests, out/in-patient consultations and drugs.

Others are hospitalisation, deliveries, planned and unplanned surgery operations. The exemptions include tertiary and non-clinically-motivated services. BEPHA sounds off with some 12,784 members in the North West with Rev. Fr. Joseph Ateh as the Coordinator. Members contribute FCFA 4,000 annually, with premiums in last year standing at over FCFA 51.1 million.