Mutual Health Insurance: 5 Years of Experience in West Africa

Health system and health financing reforms in sub-Saharan Africa promoted by international donors since the 1970’s have not resolved the problem of reduced access to care. Locally developed self-governing Mutual Health Organisations (MHOs) were seen to have great potential to enhance access to quality health care and contribute to the social and institutional development of society. Looking at the results of 10 years of MHO development, it seems that the idea is implemented in a community only with great difficulty. The majority of schemes reach only a fraction of the population, and do not solve the problem of access by the poorest segments of the population. Schemes are often poorly managed and poorly designed.

The authors intend to contribute to the current discussions on MHO promotion by making available the concerns, opinions, controversies and experiences of major protagonists, taking into account experiences from MHO promotion and implementation activities of the last 5 years. The intention of this paper is to benefit from the experiences currently available in order to confirm and/or re-formulate concepts and strategies for MHO promotion.