françois diop abdoulaye ba christine ortiz abt associates inc. a framework for success: comparative...
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François Diop Abdoulaye Ba Christine OrtizAbt Associates Inc.
A Framework for Success: Comparative Analysis of African Community-based Health Insurance Initiatives
APHA 2010, Denver
Why improve health insurance coverage through community-based initiatives?
Social Inclusion Increased access to care Income protection
Members of the MUSADA scheme in Burkina Faso
Health financing in sub-saharan Africa
Where does the money come from? Public sector – national programs Individuals – out of pocket
What types of mechanisms are used? Social health insurance Subsidized or free care public systems Community-based schemes (MHOs,
CBHI, mutuelles)
Senegalese women
Senegal
Ghana Benin
Niger
Cameroon
Rwanda
Africa
Comparative table
Country Total pop % RuralGDP/ capita
Per capita total
expend. on health
Gov’t % of total expend.
OOP as % of total health
expend.
Total expend. on H as % GDP
%
population with
health insurance
Benin9,025,40
259.2 $328.08 $29.00 13.1 46.7 5.3 18%
Cameroon
18,532,799
44.1 $696.75 $51.00 28.1 68.2 5.2 19%
Ghana23,461,5
2350.7 $306.80 $35.00 6.8 50.0 6.2 40%
Kenya 37,530,7
2678.7 $459.58 $29.00 6.1 41.4 4.6 20%
Mali12,334,1
6868.4 $289.10 $30.00 12.2 48.1 6.0 8%
Niger14,195,0
8583.5 $168.70 $10.00 10.6 40.3 4.0 <5%
Rwanda9,735,54
181.9 $271.31 $32.00 27.3 22.7 10.4 74%
Senegal12,411,0
9457.9 $509.03 $40.00 6.7 61.9 5.4 20%
Tanzania40,432,1
6374.9 $354.17 $18.00 13.3 34.0 5.5 16%
Zambia11,919,8
7064.7 $386.05 $49.00 10.8 37.8 5.2 22%
Why focus on mutual health organizations?
Comparative advantage of community-based initiatives: a way to reach rural and informal sectors in Africa
Can provide a link between local level and central government + public resources
Mutuelle members in Rwanda
Rwanda Ghana
Success stories
Women at a primary health clinic in Rwanda proudly hold up their mutuelle membership cards
Functional methodology
Dear Ma Claudia, please paste in the graphic from the article you did (English version). The word copy I have is ugly. http://www.hs2020.org/content/resource/detail/2523/
p5 Thanks
How to increase health insurance coverage in Africa
Bottom-up + Top down
A patient proudly displays his insurance membership card after visiting the Mulindi health center in Byumba, Rwanda
Reports related to this presentation are available at www.healthsystems2020.org
Thank you
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