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Francophone Health Insurance Workshop - Extending Health Insurance, How To Make It Work

Jun 4 2010

Many countries subscribe to the Millennium Development Goals, and are committed to ensuring access to essential, quality health services for their citizens. Risk sharing is one mechanism for removing financial barriers. Extending health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well to provide financial risk protection.

Extending Health Insurance - How To Make It Work

May 30 - June 4, 2010, Kigali, Rwanda

Serena Hotel in Kigali, Rwanda

Many countries subscribe to the Millennium Development Goals, and are committed to ensuring access to essential, quality health services for their citizens. Risk sharing is one mechanism for removing financial barriers. Extending health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well to provide financial risk protection.

Worldwide, many countries have already spent scarce time, money, and effort on initiatives in this direction. In Africa, several countries have been particularly active in health insurance reforms (Benin, Mali, Burkina Faso, Rwanda, and Ghana, to name a few). Many of these schemes, both public and private, cover only a small proportion of the population, and countries are focusing on scaling up coverage.

The desire of policymakers and technicians to develop and scale up health insurance is laudable, but the journey is challenging, long, and risky. Despite the many possible benefits that health insurance can offer, many countries face great challenges as to how to increase their financing capacity, extend health insurance coverage, expand benefits packages, and improve the performance of existing health insurance schemes.

Following the success of the Anglophone African Health Insurance Workshop, held in Accra, Ghana, in October 2009, we organized a hands-on workshop to help Francophone African countries chart an informed and responsible path to expanding the form of health insurance that fits their needs and resources. Participants worked through a "handbook" that outlines the critical pathways to strengthening and expanding health insurance in their country, looking at their current position, their long-term goals, and identifying next steps for key operational aspects. Workshop participants had the opportunity to discuss with their peers and experts the critical issues to successful health insurance implementation and scale-up, such as population coverage, benefits package, and financing options. Representatives from USAID, the World Bank, the WHO, the Bill and Melinda Gates Foundation, the Rockefeller Foundation, and the International Labour Organization were present. The handbook, originally developed for the Anglophone workshop, was adapted for this event, and refined and updated based on the inputs from the earlier workshop participants.

Six country teams (Benin, Burkina Faso, Burundi, Cameroon, Mali, and Senegal) were invited to work on the health insurance handbook materials. Representatives from Rwanda provided case study examples of successful implementation of their risk sharing models.

This workshop was planned by USAID's Health Systems 20/20 project in collaboration with the World Bank and WHO and focused specifically on scaling up health insurance in Africa. Other institutional partners were involved in the organization of this event including the Ministerial Leadership Initiative.

Acknowledgements

Health Systems 20/20 is very grateful to the Rwandan Ministry of Health for their extensive support that was critical to the success of the Workshop. The participants benefitted enormously from the presence of representatives from the Rwandan Ministry of Health, the RAMA (Rwandaise d’Assurance Maladie) and MMI (Military Medical Insurance). These experts took significant time out of their busy schedules to serve as presenters, moderators, and resource people over the six days; and receive the field trip groups in their offices and facilities to observe the Rwanda health insurance scheme “in action.”

The Project also thanks USAID/Rwanda for their participation; and the World Bank Senior Health Economist in Rwanda for his valuable assistance to liaise with the Rwandan officials.

Key workshop materials