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TAMPAKAN,
South Cotabato—A health-care fund in the barrios?
There’s one in some remote barrios in eastern Mindanao,
and the poor villagers are showing through their years
of practice that health-care financing can actually work
even in the remote areas.
From
Davao del Norte to South Cotabato, some villages helped
by the nongovernment group Institute of Primary Health
Care (IPHC) have shown how dedication, caring for the
poor and looking after their welfare, can sustain a
community financing scheme that can be easily accessed
during an emergency. Yes, even when it rains hard, and
at dawn.
In South
Cotabato, at least two barangays, San Isidro and Danlag,
have applied this scheme to increase their self-reliance
in matters of health, a major concern in many
health-starved and underserved rural areas.
In the
case of Danlag, some 13 kilometers east of this interior
town in South Cotabato, the idea was already being
discussed as early as 1999 by the association of
barangay health workers (BHW). The idea was to create a
self-help fund among the more than 1,700 residents of
this rural village, which subsists on farming and doing
labor in a mining company.
“The
idea of providing loan to families during emergency came
up, something of a health-care financing,” said Rosalina
Lejarso, one of the BHW pioneers in the barangay, and
currently a barangay kagawad in charge of the committee
on health.
Under
the scheme, a member of the community fund can borrow as
much as P1,000 during an emergency, including needs for
hospitalization, medication or doctors’ consultation.
Members
of the fund include workers of the barangay government
or residents of the community, and the requirement is
that the borrower must be a member first before he or
she avails himself/herself of the loan privilege.
The
health-care financing provides loans to members; with
availment computed on the total contribution. This is
different from another model, also being applied in
neighboring San Isidro, Tampakan, South Cotabato, and in
New Corella, Davao del Norte, which adapted the form of
an insurance fund.
Members
in the Danlag project can immediately borrow as much as
P1,000, depending on the evaluation by a team from the
Danlag Association of BHWs. In one case, Lejarso
remembers the team approved as much as P2,000.
It was
given to the family of a child who needed
hospitalization for a severe case of diarrhea.
“On the
average, loans are in the average of P500, which are
spent on medicine and includes food,” Lejarso said.
She also
recalls the first client of the Danlag Health Care
Financing as a woman who borrowed P500 to treat her
fever and cough and pay for a checkup with a private
doctor.
In New
Corella, Edil Bermejo, former barangay captain of
barangay Poblacion, recalls starting the project in
2003, although the advocacy to gain support and
membership began a year earlier.
“There
was no problem with the Barangay Council. They supported
my idea,” Bermejo said. “In fact, they were the first
members of the Health Care Fund.”
A member
in the fund can borrow 50 percent of one’s capital
infusion, which has three levels or categories from
which a member can select, depending on one’s capacity
to pay.
Options
and Categories
THE
health-care financing and insurance fund are actually
options contained in the various trainings on
health-care services, financial management and
management of health centers conducted by the IPHC, the
outreach unit of the Davao Medical School Foundation in
Davao City.
The
first successful attempt at a rural health-care
insurance fund was made in barangay San Isidro of this
town, where card-bearing members can access local
clinics and hospitals for treatment and confinement.
In
Danlag, members have to pay P20 for membership and
contribute only P5 each month.
In New
Corella’s barangay Poblacion, three categories of
monthly contributions are P50, P75 and P100. Each
category can already allow the member to access hospital
care, including admission.
“We
started with only P10 in the bottom category to attract
the farmers and farm laborers, and even those who work
on seasonal basis,” Bermejo said. The P10 contribution
then could already pay for the transportation and some
immediate medicines for the patient when they reach the
hospital.
“We
raised it to P30, and later to P50, to ensure that we do
not really drain out of funds.” The barangay council has
allocated P10,000 in 2005-07, and P15,000 in 2008, to
keep the fund going, in what has since become an annual
practice to help fund what is seen as a noteworthy
cause.
“The
council knows its importance,” she said.
The
program was started in the project sites of IPHC to
address the problem of indigents having to beg around
for transportation and medicine support in going to the
hospital, and even for daily consultations in the
barangay health clinics.
“We are
always helpless seeing these people wanting to take home
some medicines after being checked in the clinics.
That’s always the problem with our barangay,” said Myrna
Lastima, the midwife detailed to barangay Danlag.
To
answer such needs, if only partly, IPHC aided pilot
areas in the Davao Region and in the underserved areas
of Central Mindanao to also put their own Botika sa
Barangay, the insurance fund and the health-care
financing to empower the poor areas to access hospital
services.
Drawbacks
SKEPTICISM in the early part of the health-care program
in the rural areas had and continued to pull back growth
in membership, due largely to choices between spending
the usual meager income on food or on preneed
preparation.
What
usually happens is that almost all members of the
health-care projects are often the BHWs and employees of
the barangay government, who have regular income.
In
Danlag, membership has only reached 39 today, since the
project started in 1999. The number reached a high of 72
in early 2000, with the additional members coming mostly
from volunteeers of the barangay government.
“The
number dwindled due to the transfer of some members to
other areas,” Lejarso said.
In New
Corella, the number stands at 130.
But
Bermejo sees it differently. “In many houses that we
visited during our advocacy, we have always told the
parents to stop their vices, and their being hooked on
cockfights,” she said. “We know that they can afford
these rates if only they want to prepare.”
She
asserted that the program would stay, if only to hold on
to the concept of empowering the blighted and rural
communities. “Advocacy will continue to invite more
people to avail themselves of the program. There’s no
[worthier] investment for our people than investing in
their health.”
In
Danlag, the regular barangay assembly always provides
the avenue to spread the good news about health-care
financing. “Where we saw skeptical and frowning faces
before, we can now see interested faces, inquiring on
the details of how a neighbor was being helped in a
health emergency,” said Lejarso.
“One
asked us why she should pay back the loan when it was
the money she put into the fund,” she added. “We have to
tell her that it is the only way to beef up the fund and
to continue the project.”
She said
the members have about three months to pay back their
loans, much of it guaranteed, though, by the
wage-earning members. “Some of the loans are still being
paid, though, but we are holding on.” |
