An Overview Of Our Solution
Garbage Insurance Clinic is a micro health insurance program which uses garbage as a financial resource. With this program, the community pays for health services by using garbage in an insurance scheme. This way could make the community mobilize their own unused resource to improve health access and breakdown the barrier between health facilities and community. This program is able to solve 2 kinds of problems simultaneously, health problem and environmental problem. Garbage Clinical Insurance is also able to become a social engineering to increase public awareness and community willingness about waste management from household level. On the other hand, it is expected to improve environmental health through community-based waste management.
- Population Impacted: 500
- Continent: Asia
Last name
Organization type
Context Analysis
It is started from a hearth-breaking story named Khaerunnisa, occurred on June 5, 2005. She was the daughter of a scavenger, Supriyono, who only earned 10,000 every day. She got diarrhea, but she could not get access to health services due to unaffordable health cost. We started to think, how we could create health financing system which permits all people to get health access from their house hold level. This motivates us to develop garbage insurance scheme as health financing that we call Garbage Clinical Insurance. Garbage Clinical Insurance (GCI) is a micro health insurance program which uses garbage as a financial resource. With this program, the community pays clinical services by using garbage in an insurance scheme. This can make the community mobilize their own unused resources to improve health access and breakdown barriers between health facilities and community members.
Describe the technical solution you wanted the target audience to adopt
The main principle of Garbage Clinical Insurance is organizing communities to create sustainable financing from their own resources in order to improve the access and the quality of public health program from the promotive, preventive, curative and rehabilitative aspects. On the other side, it becomes an incentive for the community to start a proper waste management and waste entrepreneurship from household level. To a certain extent, it also contributes to local sanitation improvement. Garbage Clinical Insurance increases garbage value exponentially, so Garbage Clinical Insurance empowers every individual to mobilize overlooked resources and take an active role in managing health financing. Practically, in general, residents must pay fee to government to dispose of their garbage, but we offer residents to submit their garbage worth 10,000 IDR or around $0.85 to us. It is then is used to cover their health care in a holistic manner, cover the patient's treatment(curative),etc.
Type of intervention
Describe your behavioral intervention
Garbage Clinical Insurance is able to solve 2 kinds of problems simultaneously, health problem and environmental problem. Garbage Clinical Insurance is also able to become a social engineering to increase public awareness and community willingness about waste management from household level. On the other hand, it is expected to improve environmental health through community-based waste management.
In empowering a communal organization, GCI has two steps, namely, initiation phase to building the system and stabilization phase to ensuring the sustainability. In developing GCI, we concern on the 3 main factors, namely, (1) coverage; (2) benefit package; and (3) financial sustainability. We always focus on these steps because we have a principle that every program which wants to achieve big implications should have the power of sustainability. To build sustainability, we must build a sustainable financing system, service system, quality control, and prepare resources. Managing financial system is essential to maintain company’s key resources ranging from company’s inventory, human resource, as well as for operational purpose. In doing so, quality control aspect is another main concern to make sure the business running well, based on planning, and give high satisfaction to customer. Most importantly, maintaining our great resources is an important aspect to consider, since it really drives us to perform better and maximum.
As needed, please explain the type of intervention in more detail
Practically, in general, residents must pay fee to government to dispose of their garbage, but we offer residents to submit their garbage worth 10.000 IDR (around US$0.75) to us. It is then is used to cover their health care in a holistic manner, cover the patient's treatment (curative), make health care quality improvement programs (health promotion), prevent illness (preventive), and provide rehabilitative health care, such as free treatment, in-clinic counseling, laboratory check, etc.
Funds in starting our clinic are achieved in various ways, ranging from using private funds, cooperation with land owners, making arrangements with the owner who has the spirit of social entrepreneur, and making arrangements with the stock system.
Describe your implementation
Households that are provided with government-run waste management services pay a monthly collection fee between $1.10 and $3.20 in Indonesia. GCI re-purposes or disposes ofits members’household wastefor a monthly fee of 10,000 IDR ($0.75). The fees collected from members combined with the profits from selling or repurposing the waste collected is used by GCI to provide members with quality healthcare.
GCI’s principal source of revenue is derived through the trading of waste, or ‘waste entrepreneurship’. There are three main revenue streams attached to the waste management programmes GCI runs. These are derived from the sale of: Garbage collected from the customers, Fertilisers made from organic waste, Products up-cycled by the community, Recyclable waste
Members bring garbage to their local clinic on a regular basis, usually once a week. Here it is sorted into biodegradable and non-biodegradable waste.
Biodegradable waste includes kitchen waste, animal remains and agricultural waste, specifically cattle manure. This waste is either composted using the Takakura method, a process that purifies organic waste through fermentation introduced from Japan. Non-biodegradable waste is separated into recyclable waste which includes plastic, paper and clothing, and non-recyclable waste. GCI works with the community toup-cycle some of this waste, turning it into new products to sell, including bags and clothes. The remainder of the recyclable waste is sold to formal waste management companies.
The strengths of our programs will be described following these points: (1) Lower fees for waste collection and zero charge for access to health services (2) Should members not be ill or injured and so not require treatment, they still benefit from preventative services (3) Should members not be ill or injured and so not require treatment, they still benefit from preventative services.
External connections
Garbage Clinical Insurance’s main stakeholders are scavengers (waste collector), community members, school, government, and health workers. The insurance system with garbage gives broad access to the community because almost every day, every house produces garbage that is not used, so this means that all citizens can join the program. The active roles and participation of individuals and communities will determine the success of this Garbage Clinical Insurance. However, their roles must not be separated from health workers’ endeavors to build health awareness and knowledge.
Garbage Clinical Insurance has already owned a clinic located in suburb area of Malang. Since in the first operation of Garbage Clinical Insurance to date, we have achieved approximately 250 active members with membership cards system. In the future, Garbage Clinical Insurance will aim at replicating its program in other places to enhance and spread its usefulness in broader zones.
Physicians run this program on Monday to Saturday at 7 am to 9 pm. In order to increase the program sustainability, human resources in GCI are recruited from all clusters of health workers, such as, doctors, midwives, nurses, pharmacists, dentists, and health volunteers. GCI has approximately 250 volunteers coming from different cities in Indonesia. All of the programs that are paid with garbage from the community independently make GCI have sustainability in financing and have long-term effect.
Who adopted the desired behaviors and to what degree?
Since in the first operation of Garbage Clinical Insurance, we have been settled in one clinic namely Klinik Bumiayu, located in the suburb area of Malang City where almost problem related to garbage, health, and poverty can be found here. However, as the program is growing bigger, we are targeting to set up a new clinic which potentially could attract another people to participate. We estimate within the next 4 years, Garbage Clinical Insurance will own at 9 clinics. Furthermore, In the end of 2016, We established a new clinic giving service for people around Lowokwaru.
GCI team consists of young people aged 22-35 years with an educational background of college or graduates of bachelor and master degree. Teams are divided into Experts Team, Replicators Team, Field Team, and Research and Development Team. In respect to this, we assume that it is worthwhile for the team to optimize the IP management of GCI projects.
How did you impact natural resource use and greenhouse gas emissions?
Members bring garbage to their local clinic on a regular basis, usually once a week. Here it is sorted into biodegradable and non-biodegradable waste.
Biodegradable waste includes kitchen waste, animal remains and agricultural waste, specifically cattle manure. This waste is either composted using the Takakura method, a process that purifies organic waste through fermentation introduced from Japan, or turned into liquid fertilizer and compost using a tube composter. The fertilisers are sold via a third party fetching prices of up to $0.41 per kilogram. Non-biodegradable waste is separated into recyclable waste which includes plastic, paper and clothing, and non-recyclable waste. GCI works with the community toup-cycle some of this waste, turning it into new products to sell, including bags and clothes.
In conclusion, by dividing and collecting garbage behavior, we stimulates society to take a part to concern with daily environment cases.
What were some of the resulting co-benefits?
Garbage Clinical Insurance always tries to maintain its positive usefulness by enabling every region to replicate this new mechanism of micro health insurance. We assume GCI can be utilized as an open source, enabling future partners to replicate our project, as a means to raise the social willingness between our company and many potential partners. In general, replication can be done through the funding either from Garbage Clinical Insurance core business entities or partners. Moreover, the management team who will take the responsibilities toward the success replication can also be either from Garbage Clinical Insurance core business entities or partners.
Sustainability
The total product categorized by organic garbage, anorganic garbage and recycled producst is about 25500 IDR (2.55 US$). On the other hand, Following the development of GCI, there were many achievements ranging national and international level, as follows: The HRH Prince of Wales Young Sustainability Entrepreneur, Unilever Sustainability Living Young Entrepreneur Award, Sustainable Housing Campaigners Habitat Award Category Creative Idea 2014, Inventors Creative Waste Management from Mayor of Malang City, AusAID Indonesian Social Innovator Award 2013, etc
Return on investment
The total fixed cost reported about 8,480,000 IDR (848 US$) that is achieved by several activities such as store and transport, operating cost, expert prof cost, rent cost and other cost. Furthermore, the company revenue in 2018, 2019 and 2020 will be predicted about 39,752.96 US$, 45,906.09 US$ , 53,1,70.90 US$ respectively.
How could we successfully replicate this solution elsewhere?
The success with which the GCI model can be replicated is entirely dependent on local context. Community needs have to be aligned with the ability to obtain sufficient revenue from waste to pay for the delivery of quality healthcare. We assume GCI can be utilized as an open source, enabling future partners to replicate our project, as a means to raise the social willingness between our company and many potential partners. Organization wishing to replicate GCI outside Indonesia that are interested in furthering the model as a whole are asked to sign a memorandum of understanding (MOU) with GCI. By far, we have gained invaluable supports from national and international government, private companies, and owned-state enterprise. Several organization with social willingness to provide grants or funding are (1) BNI Syariah(2) Aqua (3) Danone (Milkuat) (4) Asian Development Bank (5) University of Brawijaya (6) British Council (7) Boehringer Ingelhem; (8) Buckingham Palace; and (9) GDN.