Often a buffalo is the major asset of a family that is used for plowing the rice fields and can be rented out to other farmers for use. When a family member falls sick, often this is the only resource that can be sold to pay for medical expenses, plunging the family into financial ruin. The community-based health insurance program that CHC is pioneering in Siem Reap is working to ensure people access timely health care and to protect them from financial ruin during family illness. -- A former TB patient who is a rice farmer in Svay Rieng Province.

From the founding of the Cambodia Health Committee (CHC) it was recognized that poverty and rural debt were closely linked to tuberculosis and other diseases. In response, CHC created the village banking initiative in 1995, based on the Grameen bank model, to provide loans for small income-generating projects in Svay Rieng and Kampot provinces linked to its community-based TB programs. In a novel first-of-its-kind program, this village banking program focused on TB patients and other particularly vulnerable villagers. The program resulted in extremely high rates of TB cure and adherence and reached more than 13,000 people across two provinces achieving very high payback rates before it was spun off as an independent microfinance institution in 2006.

Health costs are the major cause of rural debt in Cambodia as in other resource-poor countries. In a practical response to this predicament, the CHC implemented an expansive community-based health insurance program in 2011. As of December 2012, the program had nearly 34,000 clients, approximately 10% of the total population served by 26 of the 39 health centers in the two operational districts of Siem Reap province where the CHC program operates.

The program entitles members to health care coverage for a wide range of medical services incurred at contracted health centers and referral and provincial hospitals. The program also covers non-medical costs such as emergency transportation and funeral expense should a member pass away. Underscoring the great need that this program addresses, more than 6,460 families took advantage of the program during 2012, receiving a subsidy for their health care, thus protecting their family economy and assets.