Mutual Health Organizations: Lessons from 20 years of experimentation in Cameroon between 2000 and 2020
Downloads
The direct payments which became widespread in Cameroon in the 1990s deteriorated the problem of financial inaccessibility to the health care services and medicine. To provide a solution to this problem, the National Health Development Plan 1998-2008 and the Health Sector Strategy 2001-2015 have planned to promote Mutual Health Organizations.
The present study had as objective to evaluate the experimentation process of Mutual Health Organizations in Cameroon between 2000 and 2020 and to draw lessons learn from it.
The methodology was based on a literature review and information gathering in the field.
The results show that the 2000-2010 period saw the number of Mutual Health Organizations increased from 9 to 158. However, this number fell from 158 to 58 between 2010 and 2014. The reasons of this failure are: Projects financing problems, managerial failure, mistrust of the population, poverty, non-adaptation of the model to the culture and difficulties to collaborate with health facilities.
Due to this failure of Mutual Health Organizations, we suggest experimenting with another way of promoting them and to professionalize the management. Indeed, in the perspective of the promotion of universal health insurance covering the poor or the informal and rural sector, the study suggests to professionalize and experiment the networking of Mutual Health Organizations leaned on Organizations of mutual aid and solidarity or of the social and solidarity economy which are very wide-spread and which ally with a certain success the activities of micro-insurance (including health) to those of microcredit.
Downloads
Aboubakar K Y, Develtere P. 2003. Mutuelles de santé au Cameroun : Etude comparative ; Rapport réalisé pour la Coopération Technique Belge. Coopération Technique Belge, Yaoundé, Cameroun.
Basaza R, Criel B & Van der Stuyft P. 2008. Community health insurance in Uganda: why
does enrolment remain low? A view from beneath. Health Policy, 87, 172-184.
BIT. 2014. Rapport de l’inventaire des dispositifs de protection sociale en santé au Cameroun. Publication du Bureau International du Travail, Yaoundé, Cameroun.
BIT/STEP. 2001. Contribution actuelle et potentielle des mutuelles de santé. Publication du Bureau International du Travail / Stratégies et Techniques contre l’Exclusion Sociale et la Pauvreté, Genève, Suisse : 12-3,17.
Blas E, Limbambala M. 2001. User-payment, decentralization and health service utilization in Zambia?. Health Policy and Planning 16(12):19-28.
Criel B & Waelkens M P. 2003. Declining subscriptions to the Maliando Mutual Health
Organisation in Guinea-Conakry: what is going wrong? Soc Sci & Med, 57(7), 1205-1219.
De Allegri M, Sanon M, Bridges J & Sauerborn R. 2006. Understanding consumers’
preferences and decision to enrol in community-based health insurance in rural West Africa.
Health Policy 76, 58-71.
EPOS, SAILD. 2010. Rapport provisoire de l’étude diagnostique et cartographique des mutuelles de santé au Cameroun. Service d’Appui aux Initiatives Locales de Développement, Yaoundé, Cameroun.
Feuzeu M. 2000. Bases des données sur les mutuelles de santé et leurs structures d’appui : Travaux de recherche dans onze pays d’Afrique, le Cameroun. Bulletin d’information de la Concertation, Abidjan, Cote d’Ivoire.
Franco L et al. 2006. Equity initiative in Mali: evaluation of the impact
of mutual health organizations on utilization of high impact services in Bla and Sikasso
Districts in Mali. Bethesda, MD: Partners for Health ReformPlus, Abt Associates Inc.
Gbedonou P et al. 1994. L’Initiative de Bamako : Espoir ou illusion. Réflexions autour de l’expérience Béninoise. Cahiers Santé 4 : 281-8.
James C D et al. 2006. To retain or remove user fees? : Reflection on the current debate in low and middle-income countries. Applied Health Economics and Health Policy 5(3):137-53.
Kamuzora P & Gilson L. 2007. Factors influencing implementation of the community health
fund in Tanzania. Health Policy and Planning, 22, 95-102.
Kipp W et al. 2001. User fees, health staff incentives and service utilization in Kabarole District, Uganda. Bulletin of the World Health Organization 79(11):1032-7.
Kotto H E. 2004. L’extension de la sécurité sociale aux populations non couvertes : Rapport du Cameroun présenté au Colloque des directeurs d’institutions de sécurité sociale des pays francophones d’Afrique, Limbe-Cameroun du 28 au 30 janvier 2004. Association Internationale de la Sécurité Sociale, Genève, Suisse.
Mc PAKE B et al. 1993. Community financing of health care in Africa: An evaluation of the Bamako Initiative. Social Science and Medicine 36(11):1383-95.
Mubyazi G et al. 2006. User charges in public health facilities in Tanzania: Effect on revenues, quality of services and people’s health-seeking behavior for malaria illnesses in Korogwe district. Health Service Management Research 19(1):23-35.
OMS. 2010. Rapport sur la santé dans le monde 2010 : Le financement des systèmes de santé, le chemin vers une couverture universelle. Organisation Mondiale de la Santé Genève, Suisse : 45-59.
OMS. 2006. Rapport sur la santé dans le monde 2006 – Travailler ensemble pour la santé. Organisation Mondiale de la Santé, Genève, Suisse.
PROMUSCAM/SAILD. 2011. Plaidoyer pour la mise en place d’une assurance maladie universelle au Cameroun. Service d’Appui aux Initiatives Locales de Développement, Yaoundé, Cameroun.
République du Cameroun. 2006. Plan Stratégique de Promotion et de Développement des Mutuelles de Santé 2006-2010. Edition 2006 Yaoundé, Cameroun : Ministère de la santé publique.
République du Cameroun. 2002. Promotion du partage du risque maladie dans le financement de la santé. Dans : Stratégie Sectorielle de Santé 2001-2010. Edition 2002 Yaoundé, Cameroun : Ministère de la santé publique, p130.
République du Cameroun. 1998. Promotion des mutuelles de santé. Dans : Plan National de Développement Sanitaire 1998-2008. Edition 1998 Yaoundé, Cameroun : Ministère de la santé publique.
République du Cameroun. 1993. La Réorientation des Soins de Santé Primaires. Ministère de la santé publique, Yaoundé, Cameroun.
Ridde V. 2003. Fees-for-services, cost recovery and equity in a district of Burkina Faso operating the Bamako Initiative. Bulletin of the World Health Organization 81(7):532-8.
Ridde V, Girard J-E. 2004. Douze ans après l’Initiative de Bamako : Constats et implications politiques pour l’équité d’accès aux services de santé des indigents africains. Santé Publique 16 (1) : 37-61.
The Rockefeller Foundation. 2010. Case studies: Health Insurance Reform in Ghana 2004-2009 and Health System Reform in Rwanda 1999-2005. Rockefeller Foundation, New York.
Tizio S, Flori Y-A. 1997. De la gratuité à la tarification des soins en Afrique Subsaharienne : grandeur et décadence de l’objectif « santé pour tous ». INIST CNRS n°9711.
Turcotte-Tremblay A-M, Haddad S, Yacoubou I et Fournier P. 2010. Rapport de recherche, Mutuelles de santé : stratégies pour améliorer pour améliorer l’adhésion et la fidélisation au Bénin. Centre de recherche du CHU de Montréal.
Wiesmann D, & Jütting J P. 2001. Determinants of viable health insurance schemes in rural
sub-Saharan Africa. Quarterly Journal of International Agriculture. 40 (4), 361-378.
Yoder R A. 1989. Are people willing and able to pay for health services?. Social Science and Medicine 29(1):35-42.
Copyright (c) 2022 International Journal of Scientific Research and Management
This work is licensed under a Creative Commons Attribution 4.0 International License.