ANGONO, Rizal, Philippines (ILO Online) - Emily Villamayor works hard for her family. But the 48-year old mother of six is worried.

A home-based worker who makes Christmas decorative balls, Emily is painfully aware that what she earns is not enough for her family's healthcare needs. "We simply have no protection when anyone gets sick. Where will we get the money to buy the medicines and pay doctors' fees?" she says.

Josie Lipio nods in agreement: "Most of us are forced to borrow money because we cannot afford the cost of health care for our families". Thirty-eight-year-old Josie has five children. She is a home-based worker who weaves beads onto clothes and makes chocolate to earn a living.

"Most of the time, we only need outpatient services", explains Mary de la Cruz, a 44-year-old home-based worker and vendor with four children. "Unfortunately, our rural health centre rarely has adequate medical supplies and the occasional medical mission can only provide limited supplies".

"Based on consultations and surveys, we identified that one of the most urgent needs of the informal sector in Angono, Rizal is access to health care", explains Rey Tan, Officer-in-Charge of the Mayor's Extension Office and a member of the Angono Informal Sector Task Force.

Sixty per cent of the 80,000 households in Angono belong to the informal sector, most likely comprising the biggest sector in the municipality's population.

The government may lack funds, but not commitment says Rey. "The people in the informal sector who work so hard to put up a micro-health insurance scheme do not receive any salary, but they persevere day in and day out. With their help and government's commitment, I think financial constraints will not be a problem."

Rey feels confident that once people realize that the project provides long-term and meaningful benefits to the informal sector and their families, they will join and work with our team".

The project Rey is referring to is helping allay the fears of Josie, Emily, Mary and other women like them who comprise the informal sector in Angono, Rizal.

"Extending Social Protection through Health Micro-Insurance Schemes to Women in the Informal Economy" was funded by the Norwegian Government and implemented by the ILO in Nepal and the Philippines. The project which ended recently worked with the Department of Agrarian Reform in assisting five farmers' cooperatives providing health insurance benefits to their members; it also collaborated with the Local Government Unit of Angono, Rizal to help workers' associations establish a health insurance programme.

Angono, Rizal is where STEP has been involved in all phases of the project from inception to setting-up and implementation. STEP assiduously worked with existing social capital, integration of services, skills and knowledge of all possible stakeholders, mainstreaming gender, and developing the scheme so it could eventually link with the national health insurance program through the LGU.

The ILO's Strategies and Tools against social Exclusion and Poverty global programme (STEP) supports the design and dissemination of innovative systems intended to extend social protection to excluded populations, particularly in the informal economy.

STEP focuses in particular on systems based on the participation and organization of the excluded. STEP also contributes to strengthening links between these systems and other social protection mechanisms. In this way, STEP supports the establishment of coherent national social protection systems, based on the values of efficiency, equity and solidarity.

STEP has recently published the second volume of a guide (Note 1) which encourages and supports efforts to conduct systematic feasibility studies prior to the establishment or further development of a health micro-insurance scheme.

"The guide does not offer a 'magic formula' for successfully conducting a feasibility study. Feasibility studies depend, above all, on the creativity of the promoters of the health micro-insurance scheme. Rather, the guide is intended to provide a basis for reflection and a toolbox that may be used to define and implement a procedure that is adapted to the particular context or situation in question", explains Christian Jacquier, head of the STEP programme.

STEP combines different types of activities: studies and research, the development of methodological tools and reference documents, training, the execution of field projects, technical assistance for the definition and implementation of policies and the development of networking between the various actors.

The programme's activities are carried out within the framework of the ILO's Global Campaign on Social Security and Coverage for All.

Note 1 - Health Micro-Insurance Schemes: Feasibility Study Guide, two volumes, STEP programme, International Labour Office, 2006, ISBN 92-2-116573-6. Also available in French.