Most widowed households in rural Ebonyi State pay for healthcare out of pocket, at the point of treatment. When income is irregular and already committed to food and school costs, that means care is delayed until an illness becomes severe.

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Delayed treatment costs more. It also removes the woman from farm work or trading during the period she is unwell, which reduces the household income further at the point it is least able to absorb the loss. For many families, an untreated illness is what moves them from managing to not managing.

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The Ebonyi State Health Insurance Agency scheme addresses this directly. The cost is fixed and paid once, in advance. After enrolment, a widow can seek treatment at an accredited facility without an unpredictable charge at the point of care.