Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali

Touré, Laurence; Boivin, Pauline; Diarra, Yacouba; Diabaté, Seydou; Ridde, Valéry

doi:10.1136/bmjgh-2022-011055

Cited by 4 publications

(2 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In their search for solutions to provide their citizens with health insurance, African countries face many challenges and have tested various strategies [1]. In Francophone West Africa, community-based health insurance (CBHI) has long been the preferred instrument for including populations in the informal and rural sectors [2][3][4]. While evidence shows CBHIs protect their members [3,5], their penetration rates are very low.…”

Section: Introductionmentioning

confidence: 99%

Mandatory membership of community-based mutual health insurance in Senegal: A national survey

Ridde,

Gaye,

Ventelou

et al. 2023

PLOS Glob Public Health

Self Cite

View full text Add to dashboard Cite

With the low adherence to voluntary mutual health insurance, Senegal’s policymakers have sought to understand the feasibility of compulsory health insurance membership. This study aims to measure the acceptability of mandatory membership in community-based mutual health insurance (CBHI) and to understand its possible administrative modalities. The study consists of a national survey among a representative population sample selected by marginal quotas. The survey was conducted in 2022 over the phone, with a random composition method involving 914 people. The questionnaire measured the socio-economic characteristics of households, their level of acceptability concerning voluntary and compulsory membership, and their level of confidence in CBHIs and the health system. Respondents preferred voluntary (86%) over mandatory (70%) membership of a CBHI. The gap between voluntary and compulsory membership scores was smaller among women (p = 0.040), people under 35 (p = 0.033), and people with no health coverage (p = 0.011). Voluntary or compulsory membership was correlated (p = 0.000) to trust in current CBHIs and health systems. Lack of trust in the CBHI management has been more disadvantageous for acceptance of the mandatory than the voluntary membership. No particular preference emerged as the preferred administrative channel (e.g. death certificate, identity card, etc.) to enforce the mandatory option. The results confirmed the well-known challenges of building universal health coverage based on CBHIs—a poorly appreciated model whose low performance reduces the acceptability of populations to adhere to it, whether voluntary or mandatory. Suppose Senegal persists in its health insurance approach. In that case, it will be essential to strengthen the performance and funding of CBHIs, and to gain population trust to enable a mandatory or more systemic membership.

show abstract

Section: Introductionmentioning

confidence: 99%

Mandatory membership of community-based mutual health insurance in Senegal: A national survey

Ridde,

Gaye,

Ventelou

et al. 2023

PLOS Glob Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…In their search for solutions to cover their citizens with health insurance, African countries face many challenges and have tested various strategies (1). In Francophone West Africa, community-based health insurance (CBHI) has long been the preferred instrument for covering populations in the informal and rural sectors (2)(3)(4). However, while evidence shows CBHIs protect their members (3,5), their penetration rates are very low.…”

Section: Introductionmentioning

confidence: 99%

Mandatory membership of community-based mutual health insurance in Senegal: A national survey

Ridde

Gaye

Ventelou

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

With the low adhesion to voluntary mutual health insurance, Senegal’s policymakers have sought to understand the feasibility of compulsory health insurance membership. This study aims to measure the acceptability of mandatory membership in community-based mutual health insurance (CBHI) and to understand its possible administrative modalities. The study consists of a national survey among a representative population sample selected by marginal quotas. The survey was conducted in 2022 over the phone, with the random composition method among 914 people. The questionnaire measured the socio-economic characteristics of households, their level of acceptability concerning voluntary and compulsory membership, and their level of confidence in CBHIs and the health system. Respondents preferred voluntary (86%) over mandatory (70%) membership of a CBHI. The gap between voluntary and compulsory membership scores was smaller among women (p=0.040), people under 35 (p=0.033) and people with no health coverage (p=0.011). Voluntary or compulsory membership was correlated (p=0.000) to trust in current CBHIs and health systems. No particular preference emerged as for the preferred administrative channel (e.g. death certificate, identity card, etc.) which could enable to enforce the mandatory character. The results confirmed the well-known challenges of building universal health coverage on the basis of CBHIs, a model which is poorly appreciated and whose low performance reduces the acceptability of populations to adhere to it, be it on a voluntary or mandatory basis. Suppose Senegal persists in its health insurance approach. In that case, it will be essential to strengthen the performance and funding of CBHIs, and to gain population trust to enable a mandatory or more systemic membership.

show abstract

Community health insurance in low- and middle-income countries

Michielsen,

Verstraeten,

Vervoort

et al. 2024

Reference Module in Biomedical Sciences

View full text Add to dashboard Cite

Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali

Cited by 4 publications

References 37 publications

Mandatory membership of community-based mutual health insurance in Senegal: A national survey

Mandatory membership of community-based mutual health insurance in Senegal: A national survey

Mandatory membership of community-based mutual health insurance in Senegal: A national survey

Community health insurance in low- and middle-income countries

Contact Info

Product

Resources

About