The path to health
Erik: “CGAT is a local umbrella organisation for local health insurance funds, which also offers health insurance. BRS partnered with Wereldsolidariteit several years ago, to help them develop a financially healthy structure so that CGAT and its affiliated health insurance funds can become independent in the long term. I travelled to the DR Congo with Paul Van Heuverzwijn of the BRS Institute and KBC volunteer Patrick Tulpin to follow up on previously-made agreements and offer support.”
A more than robust challenge
Erik: “CGAT faces a tremendous challenge. Average life expectancy in the DR Congo is 48.8 years. The population, which is poor, barely has access to health care, with one doctor per 10,000 population and only a handful of reliable health care centres. Poor is a criterion that applies to 80% of the Congolese population because that is how many people find themselves living below the poverty line there. They earn USD 100 to USD 150 a month working in the informal economy while a doctor’s visit costs USD 10 or more. CGAT tries to offer as many Congolese people as possible health insurance in this difficult context. Obviously, ensuring the financial health of these health insurance funds is a priority.”
Choices and opportunities
Erik: “Scale is everything. That is why CGAT recently combined several health insurance funds into one entity, cutting costs and spreading the risks. At the same time, they are also targeting a completely new market because the Congolese government now obliges companies to take out group insurance for their employees, which is an opportunity. Companies can take out insurance with the existing health care funds. If CGAT requests payment for this service, there are definitely some opportunities worth considering and we will assist them in this regard.
Another important aspect that we examined with CGAT was the strategic planning of the health insurance funds. They know where they want to be in the long term, but to date they had no idea where they stood in relation to this goal. We drew up an Excel sheet together with them, which they can use to list performance indicators. In this way they know where they stand in relation to their goal and whether they need to take action.”
Social mission takes precedence
Erik: “I also had the opportunity to speak to the control doctors at length. They are very matter of fact because of their practical experience and have a good idea of which improvements need to be made to become self-sufficient. This is useful input for management.
These doctors have elected to work for the health insurance fund because they believe that their work can help promote access to health care. I observed that same passion in other employees of the health insurance funds. For them it’s not about profit. They have a social mission, which they strongly believe in. My first mission for BRS was a very positive experience. I feel that I was able to make a structural contribution, in a spirit of cooperation and while drawing on the great passion of all the parties involved.”