Scaling Up Community-Based Health Insurance in Mali
For more than 20 years, community-based health insurance (CBHI) has been a component of the health financing system in Mali. Known as mutual health organizations, or mutuelles in French, CBHI schemes are not-for-profit mechanisms of health financing grounded in principles of solidarity and risk sharing. The Government of Mali uses mutuelles to address limited access to and low utilization of priority health services. Although the legal framework was adopted by the Government in 1996 to support mutuelles, it was only in 2010-2011 that a national strategy for CBHI was developed and formally adopted. The development and adoption of the national strategy for CBHI is a major milestone in strengthening risk protection for the population. The implementation of the strategy will strengthen mutuelles from their initial status as isolated, individual community initiatives to a standardized national network.
In support of strengthening the Government’s risk protection framework, technical assistance was requested by the Government from partners including Health Systems 20/20, the Gates Foundation and Packard Foundation-funded Ministerial Leadership Initiative for Global Health (MLI), and the World Bank. All three partners collaborated closely to accompany the government-led process of building consensus to reach a national strategy for the roll-out of CBHI. The partners leveraged resources to respond to the technical requests made by the Government to strengthen the application of CBHI as a platform for increased social protection.