• Operational Review of the National Health Insurance Scheme in Zambia

    Southern Africa Zambia
    Start activities
    18-04-2022
    End activities
    30-09-2022
    Partner Institution
    National Health Insurance Management Authority
    Type of Assistance
    Institutional capacity building
    Code
    2022-02
    Description
    The purpose of this action was for the National Health Insurance Management Authority (NHIMA) to optimize the management of the National Health Insurance Scheme (NHIS). NHIMA was established by the National Health Insurance Act No.2 of 2018. The Act provided for the establishment of a compulsory National Health Insurance Scheme under the management of NHIMA. The Scheme, as part of the Health Care Financing Strategy of the Ministry of Health, is aimed at providing sound financing of the national health system and enhance universal access to quality insured healthcare services for all Zambians. NHIMA wished to understand where they stand after two years of implementing the Scheme, where are their strengths or weaknesses, and identify potential bottlenecks. NHIMA also wished to gain more knowledge and guidance on strengthening their current health-financing system, as well as to understand possible health financing options in view of attaining universal health coverage. Mobilized experts from Estonia, Finland, France, and Germany accompanied the partner’s reflection in the framework of 3 activities.
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  • Feasibility study for the establishment of a compulsory or voluntary health insurance mechanism in Kongo Central

    EASTERN AFRICA Congo, Republic of
    Start activities
    05/04/2021
    End activities
    30/06/2022
    Partner Institution
    Kongo Central Provincial Government [Gouvernement provincial du Kongo Central]
    Type of Assistance
    Institutional capacity building
    Code
    2020-06
    Description
    SOCIEUX+ has been solicited by the Ministry of Health and Social Affairs of the Province of Kongo Central to formulate a feasibility study regarding the establishment of a compulsory or voluntary health insurance mechanism in the Province. To this end, SOCIEUX+ facilitated exchanges (on site and on-line) between the national partners (including mutualist organizations) and European experts in the field of health systems (financing, governance and health care delivery). Several experts from France delivered an inventory of the health system’s components in place in the province of Kongo Central, then a study on the financial feasibility of the health insurance system, and a prospective study on how such a health insurance system should be governed and organized.
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  • Support to the International Forum on health coverage in the CIPRES area

    Western Africa TOGO
    Start activities
    03/03/2019
    End activities
    03/05/2019
    Partner Institution
    Conférence Interafricaine de la Prévoyance Sociale (CIPRES)
    Type of Assistance
    Code
    2018-32
    Description
    The Conférence Interafricaine de la Prévoyance Sociale (CIPRES) is a long-standing partner of SOCIEUX+. It gathers social security entities from 18 countries, mainly from Francophone Africa. In this circumstance the CIPRES Secretariat requested SOCIEUX+ to mobilize two public experts to share their country experiences and models on the occasion of the annual Forum on health coverage in the CIPRES area. Experts from France and Luxembourg have covered the following themes: an intervention of the financing of universal health coverage and good practices on the governance of organizations running health insurance schemes. The Forum took place in Lomé (Togo) in March 2019.
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  • Improving technical management tools available to INAM

    Western Africa Togo
    Start activities
    02/04/2018
    End activities
    02/08/2019
    Partner Institution
    National Health Insurance Institute (INAM)
    Type of Assistance
    Organisational management (structures & functions)
    Code
    2017-39
    Description
    The experts’ contribution targeted several dimensions of organizational capacities and tools that are key to allow the Institut National d’Assurance Maladie (INAM) of Togo to efficiently run an extension of health insurance coverage to private sector’s workers and aim to full, universal coverage. Among the matters tackled by mobilized teams of experts from France, Italy, and Romania were contracting capabilities and management of agreements with health care providers, costing of medical procedures, and economic and actuarial analysis. The technical assistance has thus provided very specific, methodological and operational recommendations that aim to enlarge INAM’s set of tools and knowledge necessary to efficiently run health insurance.
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  • Santé

    Building capactiy of the UTM to enable the management of universal health insurance coverage

    Western Africa Mali
    Start activities
    oct-2015
    End activities
    jun-2016
    Partner Institution
    Technical Unition of Mutual Health Insurance [Union Technique de la Mutualité] (UTM)
    Type of Assistance
    Institutional Strengthening
    Code
    2015-14
    Description
    The Technical Union of Malian Mutual Insurers (UTM) is one of three functioning bodies responsible for health insurance coverage. The UTM functions as an umbrella organisation for about 30 (of 164) voluntary mutual health insurance schemes. The UTM supports the creation, development and technical supervision of schemes and the management of a common health insurance platform for all its members. The National Strategy to Extend the Coverage of Mutual Health Insurers was adopted in 2011 to improve the accessibility to healthcare of populations in the rural and informal sectors. It is backed by a 10-year Health and Social Development Plan for 2014-2023, which aims at increasing insurance coverage to 20% of the target population and, in the long-term, universal health coverage. In this context, UTM began to redefine its strategies to improve its capacity and political position in the perspective of shouldering responsibility in achieving universal health coverage. At an operational level, it produced an internal organisation reform plan for 2014-2016. Organisation and individual capacity building was essential to enable the implementation of this plan. Experts mobilised by SOCIEUX worked with the UTM staff on outlining scenarios for strategic options and organisational structure. To do this, they started by assessing the existing institutional strategy and corporate capacities. An outline of the needed structures and competences followed. A first draft of a guideline to develop the UTM’s Strategic Development Plan resulted from this work, which set preliminary core objectives, mission, vision and main working axes for the UTM.
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