Co-Authored by James Kaggwa & Rebecca Calderara
2014 – 2015 Co-fellows at Spark Microgrants
As GHC Fellows at Spark Microgrants, we are working with five remote communities in the foothills of Mt. Elgon to establish community-run health centers. Working with communities to develop innovative solutions to health financing, including the model below at Bufuma, has been one of the most rewarding and enriching parts of our fellowship.
Financial instability is the biggest challenge faced by many rural, low-resource community health centers, including the ones at Spark. To combat this challenge several Spark communities have developed a membership-based community health financing and insurance program.
In this model, community members pay a membership fee in exchange for free and reduced health services. Membership fees pay for the free and reduced health services while also providing revenue for the operating cost of the clinic.
Health clinic revenue and health-seeking behavior among community members are increased through the model. Community members also develop a strong sense of ownership and commitment to the survival of the health center. The model works best in low-resource, community health clinics that do not have external funding, and in cohesive communities where members have some income.
Bufuma, a rural coffee-growing community in Uganda and a Spark community, is employing this model as a way of providing healthcare to the community and financing their health center.
Seventy-five community members will each pay a 20,000 UGX (6.65 USD) fee each year in order to join the membership program. Members are able to pay this annual fee with cash or agricultural products they grow in their farms including, beans, coffee and onions. The health clinic committee later sells the produce to generate additional revenue.
Member benefits include reduced patient fees, monthly free health services and access to a savings and loan group. Members at the clinic pay 2,000 UGX (0.66 USD) whereas non-members pay 3,500 UGX (1.16 USD) each visit. Members are also entitled to free health services, including family planning, deworming for children, health education events and preventative health exams. Another benefit of the program is access to a savings and loan group, which enables members to withdraw loans that can protect a family in case of a medical emergency, requiring advanced treatment at a larger health facility.
