Health care around the world

By Kelly Demo, CFCA preacher

As the health care debate in this country rages on, I began to wonder about insurance and government-run health programs in the countries in which CFCA works. Do they have insurance at all? What do government-run programs look like? Are they working, and is there anything that we can learn from them?

The British began large insurance companies in India back in the 1800s to cover their nationals living there. In 1870, Bombay Mutual Life was formed as the first native insurance provider. Since that time, the government-run programs have been by far the largest provider of health insurance. However, since 1999, government deregulation has allowed for more private companies to enter the market. Only .2 percent of Indians are covered by insurance.

A CFCA clinic in IndiaAccording to Dan Pearson, CFCA director of program development and operations, ìThe cost of health care tends to be a lot lower in some countries. When we lived in India, we took my son to a private clinic for stitches. They put him under with anesthesia and everything, and the whole bill was under $40. Even those prices are way beyond what most of the CFCA families can afford, so they let injuries and illnesses go untreated, unless they are life threatening. Preventive health care is not even on the radar for most of the families.î However, CFCA mothers groups in India use their shared resources to respond to familiesí medical needs.

In hearing from many of our families in various projects around the world, not only is insurance not an option for them, but the government-run hospitals and clinics where care is more affordable are of very poor quality.

This is certainly true in Kenya, Tanzania and Uganda. There is a mandated government-run health care system of which most CFCA employees are a part. However, the care provided is often sub-standard.

Surprisingly, one bright spot in the health care struggle is Madagascar. According to USAID, the agency gave a grant to the government of Madagascar who began five community-based insurance programs in five counties. This was started because often those living in rural communities will have an influx of cash during the harvest and have more ability to attend to health issues, but will be cash poor later in the growing season.

Members of the community make an annual contribution to the insurance fund that can be paid in cash or crops. All of their health care expenses are then covered for that year. In 2005, the child mortality rate in these areas dropped to an astonishing 5 percent because of access to preventive health care and immunizations. The program has been so successful the government is expanding the program across the country.

Clearly, without sponsorship money most of the CFCA families around the world would be without health care benefits. Fortunately, because of sponsorship and special funds like Healthy Communities Fund and Project Needs Fund, CFCA field staff are given the flexibility and resources to help families in times of medical emergencies.

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