Expanding community coverage
Mali’s health system is largely centered on Mutuelles – non-profit groups that largely rely on dues from their members. Participation in Mutuelles is largely voluntary and organized at the community level.
Summary of UHC Journey
Mali’s approach to health insurance reform reflects two major geographic and demographic factors: the geographic dispersion of Mali’s population and the high level of informal and agricultural sector employment.
In 2000, institutional reforms created the National Social Protection and Economic Solidarity Department to strengthen the structural framework for the health insurance system. In 2002, the government of Mali adopted a national social protection policy, followed in 2004 by a national action plan to expand social protection between 2005-2009.
In February 2011, the President of Mali and the Board of Ministries adopted a universal health insurance scheme to provide comprehensive health care by merging three existing systems: coverage for the formal sector, medical assistance for the indigenous population, and community health insurance organizations for the informal sector.
The implementation of this national health insurance policy was challenging, with new agencies and systems required to collect and manage resources, purchase services, develop regulations, and monitor and evaluate performance.
Activity as a JLN Member
Mali was one of nine founding members of JLN. Members of the Malian delegation contributed to the following knowledge products:
- UHC Primary Health Care Self-Assessment Tool
- Open Health Data Dictionary
- Software Comparison Tool
- Connecting Health Information Systems for Better Health
- Compendium: 12 country approaches to covering poor and informal populations to achieve UHC
- Health Benefits Policy Summary Report
- Mali: Approaches to covering poor, vulnerable, and informal populations to achieve UHC
- JLN Population Coverage Technical Initiative Workshop Summary
- JLN IT Initiative at AeHIN Conference in Bali.
Implementing the JLN’s Knowledge
In June 2011, managers of the Union Technique de la Mutualité Malienne (UTM) participated in their first JLN Workshop in Mombasa, Kenya, where they learned about the Kenya National Hospital Insurance Fund’s use of M-Pesa to collect health insurance premiums from informal sector populations. Upon returning to Mali, UTM managers were inspired to explore mobile money as a potential tool to collect health insurance premiums in Mali, and in September 2013, UTM launched its mobile money application for premium payments into the community-based health insurance (CBHI) scheme.
As of June 2014, 300+ CBHI members from across the country had paid premiums via mobile money, resulting in 500+ mobile money transactions. UTM and Mali’s CBHI aim to increasingly use mobile money to collect and manage premium payments, particularly as the mobile money ecosystem continues to develop in Mali and membership in CBHI expands. UTM is also exploring a mobile-based payment mechanism to send claims payments to health providers.