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Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali
BACKGROUND: Many Sahel countries in Africa are looking for solutions for universal health coverage (UHC). Mali is in the process of adopting the Universal Health Insurance Plan, which allows for the mutualisation of existing schemes. Its operationalisation requires numerous adjustments to the curren...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439339/ https://www.ncbi.nlm.nih.gov/pubmed/36898725 http://dx.doi.org/10.1136/bmjgh-2022-011055 |
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author | Touré, Laurence Boivin, Pauline Diarra, Yacouba Diabaté, Seydou Ridde, Valéry |
author_facet | Touré, Laurence Boivin, Pauline Diarra, Yacouba Diabaté, Seydou Ridde, Valéry |
author_sort | Touré, Laurence |
collection | PubMed |
description | BACKGROUND: Many Sahel countries in Africa are looking for solutions for universal health coverage (UHC). Mali is in the process of adopting the Universal Health Insurance Plan, which allows for the mutualisation of existing schemes. Its operationalisation requires numerous adjustments to the current mutualist proposal and innovations in the system. The study focuses on innovations experienced in mutuality and their conditions of scale for UHC in Mali. METHODS: This is qualitative research by multiple case studies. It is based on the collection of data by interviews (n=136), at a national and local level, on the analysis of documents (n=42) and a long field observation (7 months). The analytical framework concerns the dissemination and maintenance of health innovations (Greenhalgh et al, 2004). RESULT: The analysis of this innovation shows an interest in the technical and institutional viability that determines its performance and scale-up. The procrastination and scepticism displayed at the highest level of the state and the international level, the reluctance, both financial and ideological, to renew the old mutualist proposal, penalise this Malian experiment. CONCLUSION: This innovation is a decisive step in ensuring the health coverage of Mali’s agricultural and informal sectors. The reform will need to be amplified and supported in the future to expect the scale-up of a cheaper, technically and institutionally more efficient system. Without a political intention to mobilise national resources and accept a fundamental paradigm shift in health financing, the search for the financial viability of mutuality may, again, be at the expense of the performance. |
format | Online Article Text |
id | pubmed-10439339 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-104393392023-08-20 Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali Touré, Laurence Boivin, Pauline Diarra, Yacouba Diabaté, Seydou Ridde, Valéry BMJ Glob Health Original Research BACKGROUND: Many Sahel countries in Africa are looking for solutions for universal health coverage (UHC). Mali is in the process of adopting the Universal Health Insurance Plan, which allows for the mutualisation of existing schemes. Its operationalisation requires numerous adjustments to the current mutualist proposal and innovations in the system. The study focuses on innovations experienced in mutuality and their conditions of scale for UHC in Mali. METHODS: This is qualitative research by multiple case studies. It is based on the collection of data by interviews (n=136), at a national and local level, on the analysis of documents (n=42) and a long field observation (7 months). The analytical framework concerns the dissemination and maintenance of health innovations (Greenhalgh et al, 2004). RESULT: The analysis of this innovation shows an interest in the technical and institutional viability that determines its performance and scale-up. The procrastination and scepticism displayed at the highest level of the state and the international level, the reluctance, both financial and ideological, to renew the old mutualist proposal, penalise this Malian experiment. CONCLUSION: This innovation is a decisive step in ensuring the health coverage of Mali’s agricultural and informal sectors. The reform will need to be amplified and supported in the future to expect the scale-up of a cheaper, technically and institutionally more efficient system. Without a political intention to mobilise national resources and accept a fundamental paradigm shift in health financing, the search for the financial viability of mutuality may, again, be at the expense of the performance. BMJ Publishing Group 2023-03-10 /pmc/articles/PMC10439339/ /pubmed/36898725 http://dx.doi.org/10.1136/bmjgh-2022-011055 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Touré, Laurence Boivin, Pauline Diarra, Yacouba Diabaté, Seydou Ridde, Valéry Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali |
title | Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali |
title_full | Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali |
title_fullStr | Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali |
title_full_unstemmed | Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali |
title_short | Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali |
title_sort | innovations in mutuality: challenges and learnings for the universal health insurance plan in mali |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10439339/ https://www.ncbi.nlm.nih.gov/pubmed/36898725 http://dx.doi.org/10.1136/bmjgh-2022-011055 |
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