HealthPartners has received a $7.9 million federal grant to extend and expand a project that builds health insurance cooperatives in African nations where access to medical care is limited

The Bloomington-based insurer and health care provider has been providing assistance in Uganda since 1997 and will now expand that work into three additional countries.

Using grants from the U.S. Agency for International Development (USAID), HealthPartners has helped establish 12 insurance cooperatives that provide basic and catastrophic health care coverage for about 50,000 people in Uganda.

Under the new grant, also from USAID, HealthPartners will shift focus in Uganda, creating care centers that focus on the health and well-being of young women and children. It will develop similar care centers in Madagascar, Kenya and Guatemala, although the bulk of the grant funds will be directed toward Uganda.

"We will be connected to the co-ops, but we are not going to have that responsibility like we had in the past," said Scott Aebischer, senior vice president of customer service and product innovation at HealthPartners. "The [co-op] boards will look to us but we don't need to be running them anymore."

HealthPartners, which itself started as a small health care cooperative in 1957, began its Uganda work under former chief executive George Halvorson. He had been approached by Land O'Lakes, the large Minnesota farmers' co-op, which helped run dairy cooperatives in Africa, to extend the co-op model to health care.

Co-op members in Uganda pay premiums and co-payments, providing the income that funds clinics and hospitals.

"We have it set up where we could actually train the Ugandans in those communities ... to run the programs," said Aebischer. "The [Ugandan] Ministry of Health was really interested in how to get health care in a rural setting to be self-sufficient," he said.

Because incomes are so low in rural Uganda, co-op members can pay part of their premiums through barter — contributing milk from dairy cattle, for example, or part of their harvests of tea or bananas.

Poor health statistics

Uganda has one of the lowest life expectancy rates in the world at 55.9 years. Infant mortality is high: For every 1,000 births, 56 babies die within the first year. By comparison, U.S. life expectancy is 80 years and the infant mortality rate is 5.8 deaths per 1,000 births, according to the CIA World Factbook.

About 6 percent of the Ugandan adult population is living with AIDS. Diseases such as malaria, dengue fever, sleeping sickness and rabies infections are common.

The health co-ops, which are governed by their members, have also partnered with other co-ops and organizations such as the Peace Corps, which promote education about safe drinking water, safety and sanitation practices.

In its new role, HealthPartners will work with local governments and private groups to set up the care centers. "We need young women's centers where girls feel safe and comfortable to have mentors, learn how to be more independent and make contributions to society," Aebischer said.

The health centers will connect girls ages 10 to 19 with adult mentors, who will help them learn about reproductive health but also income generation and money management, nutrition, leadership and other life skills that improve health and well-being.

With the new USAID grant, HealthPartners will expand these efforts to Guatemala, Kenya and Madagascar, a place where HealthPartners has had some previous involvement.

"The reason we chose those countries is because of existing co-op development efforts," Aebischer said.

HealthPartners has two staff dedicated to the foreign development work. Their salaries are paid entirely by the federal grants. Aebischer, who still talks with Halvorson about the Uganda work, volunteers his own time on the project.

Halvorson, who left HealthPartners in 2002 to become chief executive of Kaiser Permanente in California, still "gets so excited hearing about the work that we are doing there and how it has taken on a whole life of its own," Aebischer said.