Introduction:

​In a world where healthcare accessibility often seems like a privilege rather than a basic right, the BAIF Swayamsahayata Vima Samiti initiative stands out as a beacon of hope. Established in 2002, this innovative health insurance programme responds to the health needs of 1,281 women from 81 self-help groups (SHGs) across 30 hamlets covering 10 villages of Haveli and Daund in Pune district of Maharashtra. By facilitating discussions on the problems encountered by these women in accessing reliable health care services, BAIF Development Research Foundation has addressed the critical issue of lack of priority towards women’s health due to financial constraints.

Identifying the Problem:

During a workshop attended by representatives of various SHGs, it became evident that women’s health concerns were not mobilising adequate attention. The analysis revealed two significant challenges:

1. Lack of Designated Health Funds: Rural households often did not allocate any funds for addressing the health of women in the household expenses.  In the absence of financial support, the health of women was generally neglected.
2. Neglect of Minor Health Problems: Many minor health problems were ignored, resulting in their escalation. This neglect created a deterioration in the health condition which could have been prevented with timely intervention.

Realising the urgent need for a structured approach to health care of women, the Swayamsahayata Vima Samiti (Self-Help Insurance Committee) was constituted at the wadi-vasti as well as village level.

Collaborative Effort and Support:

Swayamsahayata Vima Samiti was formed due to the joint effort of BAIF, GTZ Germany (a government-owned organisation for international cooperation), Maharashtra State Health Department and Life Insurance Corporation of India (LIC). This effort enabled women to receive priority attention and to access affordable health insurance benefits.  For a nominal annual premium of Rs. 200 to Rs.250, women could secure themselves against ill health and ensure coverage of various health care expenses.

Health Coverage Benefits:

​The scheme enabled women to manage and benefit from their health insurance collectively. All the 21 villages participating in this health scheme, elected a representative to establish an insurance committee. This committee managed funds by opening bank accounts for the members in nationalised banks and facilitated the payment of the annual premium. The scheme offered the following health coverage for rural women:

1. Hospitalisation Coverage: In the case of hospitalisation for conditions covered under the scheme, insured women could access financial support up to Rs.5,000, including coverage for expectant mothers.
2. Accidental Coverage: Minor injuries from accidents were covered with women receiving Rs.25,000 as assistance along with medical expenses.
3. Permanent Disabilities: In the unfortunate event of a permanent handicap resulting from an accident, the affected individual was entitled to receive up to Rs.50,000.
4. Death Benefits: The scheme offered Rs.20,000 for natural deaths and Rs.50,000 for accidental deaths thereby providing significant support to the bereaved families.

Additional Benefits​:

This unique health insurance scheme also provided the following additional benefits to its members:

1. Scholarships for Children: To encourage education among children, the scheme provided Rs.100 per month scholarship for children of committee members scoring high marks in 9^th to 11^th standards. This initiative not only recognised academic excellence but also supported unfortunate families to continue the education of their children.
2. Subsidised Treatment: Committee members who availed of treatment at the Nisargopachar Ashram at Uruli Kanchan near Pune, benefitted from subsidised boarding and treatment expenditures while benefitting from nature cure.
3. Loan Facilities for Claims: For those applying for claims, a loan of either Rs.3,000 or 50% of the claim amount (whichever was lower) was available at half the rate of interest charged by SHGs thereby providing immense financial relief during emergencies.
4. No-Claim Bonus: To reward members who had not claimed any benefits for consecutive five years, a no-claim bonus of Rs. 300 was instituted. This initiative encouraged health management and preventative health care through counselling by doctors and regular health check up.

Claim Process:

The process for claiming benefits was simple and efficient. Each village-level representative collected the claim documents every month, ensuring that all the committee members could have access to their entitled benefits. Claims were settled on the last Saturday of every month, with payments issued to the claimant or their dependents and deposited immediately in their bank accounts.

Impact:

The impact of the Swayamsahayata Vima Samiti initiative has been far-reaching. Improved health outcome for women members of various SHGs have led to visible changes in their livelihood and well-being of their families. The programme has fostered a sense of community solidarity and empowerment and equipped women with the much needed awareness and resources for assured health care.

Financial Overview and Sustainability:

A crucial aspect of the success lies in its financial structure. The cost break up of the Jeevan Beema Yojana (JBY) demonstrates a clear allocation toward health sustainability.

• Medi-claim: Rs. 135
• LIC JBY: Rs. 50
• Medical Check Up: Rs. 30
• Field Guide: Rs. 30
• Administrative Charges: Rs. 30
• No-Claim Bonus: Rs. 25
• Total: Rs. 300

This structured financial approach ensures that the programme remains sustainable while maximising benefits.

Conclusion:

The BAIF Swayamsahayata Vima Samiti is a transformative initiative for women’s health care in rural India. By prioritising healthcare expenses, empowering women through collective action and providing accessible health insurance, the programme has created a resilient community capable of reaching out to one another in times of need.   As more and more women join SHGs and take part in this initiative, the impact on the families and communities will continue to grow. The path towards health equity and empowerment is lit up by the commitment and collaboration of women determined to take control of their health and well-being.

Call to Action:  

​For more details on the Swayamsahayata Vima Samiti initiative or to learn how you can support similar programmes in your community, please contact Mr. Hanumant Bhosale (E-mail: bhosale.hanumant@baif.org.in). Together, we can pave the way for a healthier future of rural women and their families.