Healthcare is one of the most fundamental aspects of human lives being addressed by NGOs and non-profits. Programs are regularly forced to choose between addressing acute and chronic conditions, or proving preventative services. The Foundation for International Medical Relief of Children (FIMRC) has been implementing a Micro Health Insurance program that offers mostly preventative services while providing limited treatment. The innovative aspect is that it does so at zero cost to the beneficiary while guaranteeing high levels of participation. Carefully selected families in communities are offered workshops on essential skills and practices for preventing illness and infection. They address immediate and long-term health issues in their respective communities. As families participate, they accrue health credits that can be used to purchase goods such as clean water filters and concrete floors. House visits and regular testing ensures that families employ the skills they are learning and encourages positive behavior. At the same time, it encourages positive-deviance within the community as others see how these practices lead to tangible benefits to the families.
Cash has often been seen as the most successful mechanism for encouraging good behavior, but lately NGOs have been devising alternate approaches to reward-based programming. By offering health related goods, FIMRC is able to reward families with goods that will further improve their beneficiaries quality of life. By working with selected members of the community, they are employing principles of positive deviance that should have resounding affects on the community as a whole. Capacity building activities like these sometimes lack a mechanism to evaluate long-term improvements. The provision of services such as fecal testing and medical check-ups allows FIMRC to keep in contact with their beneficiaries over an extended period of time.
One drawback that hampers every reward-based program is the concerns over scope. While the Micro Health Program ha demonstrated gains in health for their beneficiaries, it would be hard to measure impacts on the community. If others see the physical benefits as t
he only outcome, they may be hesitant to adapt the best practices. This may not matter to an NGO, but it does influence its overall impact.
FMRIC has been implementing this project in Las Delicias, El Salvador, for several years. They are set to release the results of the project’s evaluation in the near future. Check back soon as we continue to cover this project.
The Foundation for International Relief of Children