‘Health Insurance Fund is the only provider that helps to improve the clinics’
Interview with Pharles Yikobela Director of Arafa Mbagala Kuu clinic in Dar es Salaam.
‘I am very happy with the Strategis Community Health Insurance Program (SCHIP),’ says Pharles Yikobela, Director of the Arafa Mbagala Kuu health dispensary. His health facility is one of the clinics participating in the recently launched Health Insurance Fund program SCHIP in Tanzania. ‘I know how health insurance works, but the Health Insurance Fund is the only provider that not only protects the clients against unexpected healthcare costs but helps to improve the clinics as well.’
Pharles, as he introduces himself, is dedicated to improving his clinic to provide better care for his patients. Arafa Mbagala Kuu is a private health dispensary in the high-density district of Mbagala in Dar es Salaam ,a relatively poor district where many families are dependent on the small business entrepreneurs of the micro-credit organization PRIDE. The members of PRIDE are the first target group to be offered health insurance in the program and, including their dependents, the fund will reach approximately 40,000 people. The insurance covers primary health care, secondary health care as well as treatment for HIV/AIDS, tuberculosis and malaria.
‘My clinic is very important for the provision of health care for the surrounding community. The nearest other health facility is 10 kilometres away and the public hospital is all the way in the centre. The public hospital is already overcrowded and cannot handle the demand; with just one bed for every three patients. Improving my services would really help this community.’ His clinic has six beds, a small laboratory a drugstore, providing mainly primary care.
Although his clinic will be improved under the program in the coming months, he has already started making the first changes himself. He proudly shows his newly refurbished reception and drugstore. Pharles explains that it was not easy saving up to make these investments in his clinic. ‘I’m serving a lot of people, I think we treat over 60 patients each day, but most of my clients have a low-income and cannot afford to pay for the treatment. For example the HIV/AIDS patients struggle to pay for the expensive highly active anti-retroviral therapy.’ Most payments he receives are in cash, which forms an irregular income for his clinic.
Pharles has a lot more ideas on how to improve his services, ideas that are born out of the demand from the surrounding communities. ‘A lot of pregnant women come to my clinic, but at the moment we don’t offer maternity services because we don’t have the equipment. I have to refer these women to a clinic quite far away.’ Another need he sees is the provision of Voluntary Counselling and Testing for HIV/AIDS as the virus is widely spread in the community.
He is therefore really thankful for the opportunity the Health Insurance Fund has created and the financial burden it has alleviated for the community he serves. His patients can now present their insurance cards and access the health care they require without the added financial concern. The clinic sends the bill to the insurance company Strategis, the local implementing partner of the Health Insurance Fund. This will mean a regular cash flow, which will make his clinic financially sound and will allow him to start planning ahead.
In addition, the Health Insurance Fund together with its implementing partner PharmAccess will help him to improve his services. ‘In the coming months my staff will be trained by a team from PharmAccess’ Pharles explains. ‘This adds value to my staff and improves the quality of care. And they have already started installing basic equipment, like new malaria nets.’ An important element of the training will be installing and using new equipment such as a computer system for patient filing or a new microscope.
Pharles is optimistic about the future. He believes that the combination of a financially sound system, the interactive training and the upgrading can help him to address many of the community’s needs in the future. ‘In the coming two years the health dispensary will expand its services, which means that we can increase the amount of patients we treat.’