Mutual Health Insurance (MHO) - Five Years Experience in West Africa - Concerns, Controversies and Proposed Solutions

This paper discusses the development of mutual health organizations (MHO) in Sub Saharan Africa. The paper describes the history and the current health financing situation in the region.

It elucidates different concepts for promoting MHO including:

• Pilot project model;
• Government agency model;
• Provider - purchaser Co development model;
• Entrepreneurial approach CHIC model.

The paper presents the following problems and challenges in MHO promotion:

• Institutional weakness;
• Low quality of care provided by the health care offer;
• Ineffective support from promoting agencies and Government.

As per the paper, some key issues for MHO development include:

• Establishment of schemes within existing geographical and sociocultural groups;
• Community participation and responsibility in the MHO system;
• Subsidy for facilitating the introduction of mutual health insurance systems.

The paper then provides recommendations for MHO development:

• Setting up of processes consisting of desirable preconditions and awareness raising activities;
• Carrying out sensitization activities through members participation in management;
• Establishing management and administration system consisting of:
  • Administration system based on volunteer work,
  • Marketing and communication system;
• Providing details of design features with information on:
  • Membership and coverage,
  • Premium setting and collection,
  • System to control fraud and abuse.

Finally, the paper concludes that MHO experience is a necessary step to:

• Sensitize the population to the concept of health insurance;
• Build up the capacity of the state to organize and regulate the sector;
• Improve the general conditions for health care provision.