Micro-health insurance in dentistry: the road less travelled

Naz-E-Farha Hakeem, Shruthi Eshwar, B. K. Srivastava, Vipin Jain


Oral health is indeed a challenge for the urban poor. Majority of the patients spend from their pocket, which aggravates their financial condition. It is paramount for the government and the healthcare industry to adopt a value-based approach to redress the oral health lapses for the underserved population. Micro health insurance (MHI) can have a game changing effect on the oral healthcare space too, if concerned stakeholders build the right partner network. Aim of the study was to discuss the principal features, basic structure, and functioning of a few MHI schemes, and presents a hypothetical model of MHI which can be implemented in dentistry. Literature search was conducted in two main databases, pubmed and cochrane, using key phrases such as “community based health insurance,” “micro health insurance,” micro or community based health insurance,” and “health insurance and financial protection”. Articles published in last ten years with full texts were considered. 23 schemes were eligible for the systematic review. Our analysis shows that MHI, in the majority of cases, contributes to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, household borrowings and poverty. However, the studies did not affirm oral health benefits. The importance of oral healthcare in India is superficial. Focus on oral healthcare can be achieved only if the impending cost due to out of pocket payments can be supplanted with a more affordable and dynamic payment model. With MHI extended to oral healthcare, India can certainly achieve its SDG goal. It’s time to look beyond. 


MHI, Community health insurance, Financial protection

Full Text:



Pauly MV, Zweifel P, Scheffler RM, Preker AS, Bassett M. Private health insurance in developing countries. Health Aff. 2006;2:369–79.

Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus J, Murray CJ. Household catastrophic health expenditure: a multicountry analysis. Lancet. 2003;362:111–7.

Ranson MK, Sinha T, Chatterjee M, Gandhi F, Jayswal R, Patel F, et al. Equitable utilisation of Indian community based health insurance scheme among its rural membership: cluster randomised controlled trial. BMJ. 2007;334:1309-12.

Dror DM, Radermacher R, Khadilkar SB, Schout P, Hay FX, Singh A. Microinsurance: innovations in low-cost health insurance. Health Affairs. 2009;28:1788-98.

Davenport C, Elley K, Salas C, Taylor-Weetman CL, Fry-Smith A, Bryan S. The clinical effectiveness and cost-effectiveness of routine dental checks: a systematic review and economic evaluation. Health Technol Assess. 2003;7(7):1-127.

Anita J. Emerging Health Insurance in India–An overview. In: 10th Global Conference of Actuaries. 2008;81-97.

Devadasan N, Criel B, Van Damme W, Lefevre P, Manoharan S, Van der Stuyft P. Community health insurance schemes & patient satisfaction-evidence from India. Indian J Med Res. 2011;133(1):40.

Michielsen J, Criel B, Devadasan N, Soors W, Wouters E, Meulemans H. Can health insurance improve access to quality care for the Indian poor?. Int J Quality Health Care. 2011;23(4):471-86.

Ranson M. Reduction of catastrophic health care expenditures by a community based health insurance scheme in Gujarat, India: current experiences and challenges. Bull World Health Organ. 2002;80:613-21.

Balarajan Y, Selvaraj S, Subramanian SV. Health care and equity in India. Lancet. 2011;377(9764):505-15.

Dror DM, Radermacher R, Khadilkar SB, Schout P, Hay FX, Singh A, et al. Microinsurance: innovations in low-cost health insurance. Health Affairs. 2009;28(6):1788-98.

Ahuja R. Health insurance for the poor in India. Indian Council for Research on International Economic Relations. 2004;1-28.

Lu C, Chin B, Lewandowski JL, Basinga P, Hirschhorn LR, Hill K, Murray M, Binagwaho A. Towards universal health coverage: an evaluation of Rwanda Mutuelles in its first eight years. PLoS One. 2012;7(6):e39282.

Haddad S, Ridde V, Yacoubou I, Mák G, Gbetié M. An evaluation of the outcomes of mutual health organizations in Benin. PLoS One. 2012;7:e47136.

Roth J, Ramm G. Microinsurance demand and market prospects: India. Available at: Accessed on 6 January 2019.

Berman P, Ahuja R, Bhandari L. The impoverishing effect of healthcare payments in India: new methodology and findings. Economic and Political Weekly. 2010;65-71.