Emerging Issues in UHC:

SEWAs experiences in expanding health insurance

and other services

By Mittal Shah
Coordinator, SEWA Social Security
Presented at Asia-Pacific Social Protection Week, ADB
August 1st 5th , 2016
Manila, Philippines
DISCLAIMER: This presentation does not necessarily reflect the views of ADB or the Government concerned, and ADB and the Government cannot be held
liable for its contents.

Key Principles To Ensure Coverage

Doorstep
Need-based
Contributory
Holistic and comprehensive
Integrated Approach with Social Determinants
Womens Leadership
Through Workers/Peoples Organisations

VimoSEWA: SEWAs Insurance Cooperative

Services offered:
Product development
Insurance education
Linking with insurers
Selling products
Claims processing
Maintaining data base
Linking with other SEWA
cooperatives: SEWA Bank
(savings, credit, pension)
Lok Swasthya (primary health
care)
3

Setting priorities How?

Survey to determine needs, affordability

Consultations with women in various for a
Workshops with women to develop products
Discussion, consultation with Cooperative board
and members

Examples of products developed

Health Insurance
Family floater cover against hospitalization costs.
Prompt reimbursement in Ahmedabad City
Income Loss
Serves as add on to governments health insurance (RSBY)
Profits under the scheme are shared with members (policyholders)
Life
Term-life cover at a very low premium
Savings- linked insurance that offers protection as well as
asset- building.
Bundled products
Covers life, health, accident and asset at an affordable price.
5

Example of services
SEWA Shakti Kendra (Workers Facilitation
Centre)
Referral services (developed a network with
government., trust and private providers)
Emphasis on preventive, promotive care
through health education and services
Chain of drug shops

Policy Action by SEWA Social Security

Unorganised Sector Workers Social Security Act,
2008

Health and Maternity Benefit

Life and Disability Coverage
Old age protection
Skill upgradation

Rastriya Swasthya Bima Yojna (RSBY)- National

Health Insurance (for Below Poverty Line families
& some special workers catergories)
High-level Expert Group on UHC

Lessons Learned
1. Minimum social security for informal workers includes: health
care, child care, insurance, pension, housing with tap, toilet,
electricity. Services must evolve and develop; start with
minimum or floor level benefits and keep adding on.
2. Work and social security intertwined one without the other
does not make sense.

3. Organising
and
collective
action
are
essential.
Entitlements/services cannot reach the last mile unless
workers are organised and act together to enable and ensure
access.
4. Local workers are key service providers. They can implement
social security best of all efficiently, at low cost and with
commitment. Providing social security is empowering for the
individual workers and their organisations.

Lessons Learned
5. Worker-run social security organisations could be entrusted
the running of programmes and services ensure
entitlements/services reach, empowering for workers,
strengthens their organisations.
6. Local social security organisations are a must. Small and
medium size and/or federations of small organisations are
preferable. Could be only worker-run or tripartite (e.g.
Workers Facilitation Centres).

7. These organisations can be sustainable; more so if supported

by state and employers (especially needed for health, child
care, housing).

THANK YOU