“Typically I simply work till the ache will get too sturdy.” – Casual employee, Namibia
Casual staff typically delay or keep away from searching for well being care till the sickness turns into important or ache turns into acute. Fundamental medical insurance may present well timed safety for these staff to entry higher high quality well being care, but present merchandise not often mirror how they earn, work, or search care.
What if the most important limitations to medical insurance protection for casual staff aren’t those insurers assume? In Guatemala and Namibia, members of A2ii’s fifth Inclusive Insurance coverage Innovation Lab discovered that casual staff typically flip to pharmacies first for recommendation and therapy, may doubtlessly afford medical insurance however not the fastened month-to-month premiums, and face well being methods that don’t match with their working hours.
These experiences challenged among the assumptions insurers and authorities had about why well being safety gaps exist – and knowledgeable their options.
Difficult widespread assumptions: A deeper understanding of buyer habits
In the beginning of the Lab, key private and non-private sector stakeholders working in inclusive insurance coverage held sure assumptions about buyer wants – however direct engagement revealed a unique actuality. In Guatemala, the crew interviewed 593 home and casual staff in addition to small enterprise homeowners. In Namibia, the crew engaged with semi-informal staff, together with safety guards, taxi drivers, and hospitality staff. What they heard challenged a few of their fundamental assumptions and adjusted the way in which they designed options to deal with the actual wants.
Assumption: Individuals can’t afford insurance coverage
Many casual staff can and need to pay, however irregular incomes make fastened month-to-month premiums unworkable. In Namibia, heavy out-of-pocket spending stays widespread regardless of widespread reliance on public healthcare. In Guatemala, individuals spend between $3 and $20 USD per well being incident on the pharmacy. This means there’s each willingness and a few capability to pay, however merchandise and cost schedules should align with irregular incomes.
Assumption: Individuals do not find out about insurance coverage
Consciousness is low, however the extra revealing discovering was summed up by an interviewee. “I haven’t got insurance coverage as a result of it hasn’t been provided to me.” – Enterprise proprietor, Guatemala. The hole is due to this fact not merely considered one of consciousness; it is usually considered one of distribution, belief, and product relevance. Present merchandise don’t at present attain these staff by means of channels they belief.
Assumption: Individuals solely care in regards to the worth level
Worth issues, however so does the way in which insurers deal with clients. Throughout each international locations, individuals constantly emphasised the worth of respect, dignity, and clear communication. In Guatemala, mistrust of insurers contrasts with belief positioned in native shopkeepers: over 60% take into account their tendero a pal. In Guatemala, potential clients considered very low premiums with suspicion, assuming they could sign poor high quality. This tells us that worth isn’t solely a barrier – it additionally indicators high quality.
This tells us that worth isn’t solely a barrier – it additionally indicators high quality.
Assumption: When individuals are sick, they go to the hospital
Pharmacies – quick, reasonably priced, and trusted – are the place individuals go first when well being wants come up. “Once I get sick, I’m going to the pharmacy as a result of it’s quicker and cheaper.” – Male carpenter, Guatemala. For insurers, that is greater than a behavioral perception – it’s a distribution alternative. To succeed in underserved clients, merchandise have to be made accessible the place individuals already search care.
Assumption: Smartphones are ubiquitous, so insurance coverage apps will work
Cell utilization is excessive in each international locations, however the channels individuals already use and belief are WhatsApp, SMS, and calls – not advanced apps. Digital insurance coverage should due to this fact use channels individuals already depend on. “Simply give me a textual content message.” – Feminine home employee, Namibia.
How can progressive options be designed to higher handle well being dangers?
Buyer insights helped the groups determine who wants safety most urgently, and the widespread wants a single answer may deal with.
In Guatemala, the crew recognized tenderos as an underserved phase. These small store homeowners run their nook shops from daybreak to nightfall, unable to shut with out dropping revenue. What do tenderos want? Fundamental protection for the well being episodes they’re already paying out of pocket. The product due to this fact must be accessible and payable in a approach that matches an irregular revenue. Protecting these restraints in thoughts, the Guatemala crew mirrored on the problem and got here up with the next: How would possibly we promote well being safety to and thru tenderos as merely as they already promote a photo voltaic top-up or an web code?
The prototype the Guatemala crew developed is known as ”Salud en la Tienda“, and bundles telemedicine, sickness protection, and a every day allowance when the store has to shut. Due to their trusted place locally, the crew is exploring tenderos as a distribution channel for the medical insurance product. For this to occur, regulatory change could also be wanted, as advanced guidelines and paperwork at present put a burden on promising distribution channels aiming to succeed in underserved populations.
In Namibia, the crew recognized safety guards, taxi drivers, and hospitality staff as weak teams they need to innovate for — individuals in semi-formal jobs whose non-standard working hours make daytime clinic visits pricey. They want quick, reasonably priced entry to care and drugs with out taking half a break day. Protection for acute circumstances, power illness administration, and emergencies, delivered merely, with dignity – and versatile funds. The crew distilled the challenges right into a single query: How would possibly we design an reasonably priced and sustainable product beneath the Monetary Establishments and Markets Act (FIMA) that offers casual staff quick, dignified, and efficient therapy?
The prototype the crew developed is known as Atushe (which means “all of us” in Oshivambo), a voucher-based well being answer for employed however uninsured Namibians, bought at grocery shops and submit places of work and providing entry to telemedicine, consultations, and drugs. Some regulatory questions nonetheless must be resolved. Beneath FIMA, in drive since Might 2026, solely registered non-profit medical assist funds might cowl the precise value of well being companies. Personal insurers, in contrast, are restricted to outlined advantages. We’re assured that involving supervisors all through product design, as we do within the Inclusive Insurance coverage Innovation Labs—not solely on the finish—can widen the scope for options that shut the safety hole.
Chatting with potential clients in each international locations confirmed that even when contexts and livelihoods differ, the core wants to shut the safety hole are the identical: reasonably priced, accessible safety designed round individuals’s realities. Guided by buyer insights, the groups in Guatemala and Namibia will now refine their prototypes and pilot their options.
