Background

SKY Micro Health Insurance

SKY (‘Sokhapheap Krousar Yeung’ – ‘Health for our Families’) is an innovative micro health insurance scheme implemented by the French NGO, the Groupe de Recherche et d’Echanges Technologiques (GRET). The scheme is an innovative attempt to extend health insurance to Cambodians, with special initiatives reaching out to both the rural and urban poor.

SKY is being implemented in selected rural districts in four provinces (Kampot, Kampong Thom, Kandal and Takeo) and selected populations such as garment workers and market vendors in Phnom Penh. It offers insurance to households from USD 0.50 to USD 1.83 per month depending on the household size. Lower premiums (one month free) are offered during the first 6 months to households joining SKY for the first time to encourage uptake. Benefits include totally free access to all contracted health centres for primary health care or emergencies, and contracted referral and provincial hospitals when referred by the health centres.

The SKY Impact Evaluation

In 2008, the Agence Française de Développement (AFD) contracted Domrei Research and Consulting in collaboration with the University of California, Berkeley, to conduct a longitudinal impact evaluation of SKY micro health insurance covering over 5000 households in Kampot, Kandal and Takao provinces. The objectives of the impact evaluation are:

  • to estimate the impact of the SKY programme on health and economic outcomes and health care utilisation;
  • to understand the determinants of take up of health insurance;
  • to identify potential effects of health insurance on public health care facilities;
  • to contribute to the body of knowledge on micro health insurance in developing countries.

As part of the SKY impact evaluation, baseline and follow-up household surveys were conducted in 2008 and 2009. This evaluation provides the first rigorous evidence on the effectiveness of SKY micro health insurance to protect the rural poor’s economic well-being and livelihoods while maintaining access to quality health care.

Background documents:

Accessing the Effects of Health Insurance: The SKY Micro-Insurance Program in Rural Cambodia By David I. Levine, Rachel Polimeni and Rachel Gardner from UCL Berkeley, California and Ian Ramage and Gabriel Pictet from Domrei Research and Consulting

Protocols:

Randomized controlled evaluation of SKY health insurance in Cambodia: Survey Protocol David I. Levine, Rachel Polimeni and Rachel Gardner from UCL Berkeley, California and Ian Ramage and Gabriel Pictet from Domrei Research and Consulting