Practical matters

I've had some inquiries after what I actually do while at work. When I am not surreptitiously blogging or writing emails, I amuse myself by contemplating the mechanics of Community Based Health Insurance, known henceforth as CBHI. A seasoned NGO employee (that is, one who works with a non-governmental organization) would use such acronyms prolifically in order to speed the typing process, retard reading comprehension, and, as is usual all respectable NGO circles, to legitimize any and all documents by increasing their resemblance to official government rubbish.

CBHI, then, is intended to alleviate poverty and improve health among the rural poor by making reliable health care more accessible. RACHA (the Reproductive and Child Health Association, my place of work) started the project--they make contracts for payment with health centers, advertise the program, and try to get villagers to join, with varying degrees of success. Basically, RACHA is the insurrance agent and broker; they attempt to pool the health risks among the rural poor, asking a phenomenally low premium that is subsidized by interest earned in a micro-credit program that they run in the same village.

The CBHI pilot program in Pursat province has been in place for a year, and it is time for the yearly review. The program is losing money faster than they are taking it in, which is causing people to worry. Their solution is to expand the program but charge a higher premium in the new areas. My original plan was to get information on health indicators and find out if RACHA had been successful in targeting the poor and in improving their health by improving access to care, and to measure how people respond to changes in price--somewhat generic, but interesting to the economics geek in me, because it is a unique sort of program and scholarly works on Cambodia, and CBHI, are slim.

Well, it has transpired that, rather than taking an ex-post gander at CBHI to determine if it works or not, I am now responsible for analyzing the existing program, improving it, and implementing the improvements in the new area. So, with my 3 semesters of training in economics, I am designing a financially solvent insurrance scheme that will actually be put to work at the end of July. Undergraduates aren't really supposed to do this sort of thing....it somewhat resembles turning a chem major loose in the lab, telling him to experiment with alternate uses of gunpowder, and giving him a box of matches. Adult supervision recommended. But, as previously noted, normal rules don't apply in this country, and since 3 semesters of economics is better than none, I am in charge. I'm just hoping nothing explodes. How is that for an objective?

Anyways, current tasks include working with the monitoring and evaluation unit to design a survey that will theoretically tell me the things I need to know about the village economic and health status, the Health Centers that are supposed to treat people, and the CBHI scheme that is supposed to make treatment affordable. Also on the docket are figuring out how to get vital documents translated in English, discovering whether the aforementioned vital documents actually exist (the Cambodian health system has some issues with transparency in accounting and record keeping), and finding a way to procure the information requested in the beginning of this paragraph.

In the next week, I will venture bravely away from my desk, computer, and swivel chair to visit villages and health centers in order to see first hand what I'm talking about....right now it is all just paper, which isn't very exciting. I'll probably have more questions and fewer answers, but that is the fun part of this game.