Objective

• Create broad access to healthcare for low-income households
• Improve sanitation and waste management
• Organise communities to create sustainable financing from their own resources

Challenge

In a country where 18% of the population live below US$1 a day, even the most basic medical provisions can be beyond reach for low-income groups in Indonesia. Despite escalating costs of medication and healthcare, investing in health insurance is often overlooked as it is not affordable and coverage remains low. Exacerbating the problem is improper waste management at the municipal level, which has been linked to serious illnesses and diminished quality of life.

As the fourth most populous country in the world, innovative solutions to address these issues can significantly impact social welfare and development, starting at the grassroots.

Social Enterprise

The Garbage Clinical Insurance (GCI) programme was started by health development company Indonesia Medika Foundation in Malang, East Java as a two-in-one solution to the district’s growing health and waste problem. Households here are typically required to pay a monthly collection fee for government-run waste management services, but GCI accepts recyclable waste as monthly premium for its health micro-insurance model. This encourages low-income households to mobilise their unused resources and learn how to recycle, while gaining free access to medical services. Apart from basic healthcare and medication at a GCI clinic, the insurance also covers house calls, preventive and rehabilitative care. GCI is financed from the sale of collected garbage to a formal waste management company.

To replicate the model and widen its impact, AirAsia Foundation has awarded Indonesia Medika Foundation a social enterprise grant to establish the programme in another community in Malang by funding:

• a new clinic equipped with medical staff, equipment and medication, and a waste collection centre
• marketing efforts to encourage participation from more community members and schools
• educational health awareness campaigns and talks
• research activities such as surveys to improve the programme and increase its effectiveness

A city like Malang produces over 55,000 tonnes of garbage every day, with only about half of which gets collected. GCI changes perceptions and habits of the community towards garbage, contributing to local sanitation improvement and encouraging communities to take an active role in managing health-financing.

Organisation

Indonesia Medika is a health company founded in 2013 with a vision to improve and broaden health access in Indonesia. Apart from Garbage Clinical Insurance, its main programme, it has also designed health solutions such as Homedika (an online platform that connects health workers and facilities to communities) and SiapaPeduli.com (a social health crowd-funding platform), often working closely with hospitals and medical organisations to identify areas for innovation in healthcare.