Since the 1980s when HIV/AIDS was first acknowledged as a major public health concern, the fight against the HIV/AIDS epidemic evolved from being centred on medical action to being focused on both medical action and communities’ participation. There is now general consensus that the most effective strategies for combating the pandemic include a community-based dimension and rely on various actors (health care, communities, schools, households, the media, associations of People living with HIV/Aids, etc.). Indeed, the majority of prevention and care activities are undertaken within households and communities and – typically – the majority of resources for these actions come from the communities themselves.

Decentralized Systems of Social Protection (DSSP) generally, and Health Micro-Insurance Schemes (HMIS) in particular, are typically thought of as mechanisms to overcome financial obstacles to accessing health care and are often referred to as systems of community financing for health. Indeed, they can make an important contribution in this realm.

However, many DSSP also perform a social role that may be as important, and potentially more important, in the fight against HIV/AIDS. This social role strengthens community capacity to take collective action relating to prevention and care. Indeed, HMIS differ from commercial health insurance schemes in fundamental ways. They are typically not-for-profit and hence do not have the selection of risk as a central strategy.  They are also typically characterized by a high level of social cohesion among the members, stemming from and being part of the same community. They are therefore more likely to take collective action and to engage in mutual help activities.

DSSP also facilitate linkages of individuals and households affected by HIV/AIDS to support structures that provide a variety of social services. DSSP can create a bridge to social services and national programmes enabling these to channel resources to the local level. Thus, they can increase the capacity of national HIV/AIDS programmes to penetrate deeper into communities and reach individuals and families in need.

For more information, please read: Contributing to the fight against HIV/AIDS within the informal economy: The existing and potential role of decentralized systems of social protection, ILO, 2002

• The role of microinsurance schemes in the field of prevention
  
  
• Linkages models of micro insurance schemes fighting HIV/AIDS

1. The example of Rwanda: The diagonal approach of the Global Fund
2. The example of Cambodia: The initiative of GRET, a French NGO

• Examples of microinsurance schemes including HIV positive persons