International Centre for Development and Research (CIDR-Uganda) Community Based Health Prepayment Programme, Luweero, Uganda - Notes from a Visit 24-25 June 2002

This paper reviews the ‘Community Based Health Prepayment Programme’ of the International Centre for Development and Research (CIDR) in Luweero, Uganda.

The paper states that:

• In the CIDR program in Uganda, members choose between an insurance-based and a credit-based option for financing health care;
• The objective is that members have full ownership of the product;
• The members technically design the products but CIDR provides a basic product guideline;
• CIDR associations offer one of two health care financing options: a mutual insurance product and a health credit product;
• The insurance option requires members to pay a set premium annually to receive care that the association has paid for;
• The credit option requires a single capitalization payment upon commencing membership and subsequent annual payments to cover the operating costs of the association.

It discusses the following aspects of the program: health promotion, institutional structure, operations, accounting, marketing, likelihood of sustainability, management and governance, partnerships and levels of member satisfaction with the product, risk management, incentives.

The paper concludes that:

• The migration of member groups from the insurance-based to the credit-based system offers important lessons to microfinance institutions (MFIs) considering the value of emergency credit to their clients;
• The assessment of the unlikelihood of members being able to manage their own program, the core of the mutual approach, provides an interesting insight into the mutual model.