Second African Decent Work Symposium Yaoundé 6th - 8th October 2010 Panel Discussion 3 The Social Security Extension Challenge in Africa: Income security and health benefits 1

The Context Deprivation, poverty and vulnerability Insufficiency of income Numbers in poverty Depth of poverty Insufficiency of access to health care Insufficiency of employment opportunity Income maintenance, especially in old age

Health Care Influence on poverty Catastrophic costs of health care Prevalence of Out-of-pocket payments Provision for formal and informal economy participants Maintaining productivity of workers and enterprise Infrastructural issues Human resources, facilities, supplies

Income and livelihoods Formal economy and enterprise “traditional” social security schemes Convention 102 Informal economy and enterprise Basic package of social protection Life-cycle approach Particular vulnerable groups Women Migrant workers ......

Towards a Coherent Approach Two dimensions Horizontal - framework of Social Protection Floor Vertical - formal schemes Basis of rights In constitution or law Affordability Adequacy Fiscal space Technical capacities Administration, statistical, accounting, actuarial,...

Some Subjects for Debate How can a realistic national strategy to bridge the coverage gap between the formal and informal economies, and build the social protection floor, including achieving universal coverage and access to health care be defined? How can fiscal space be preserved, freed and/or extended to ensure the financing of adequate benefit levels? What is the role of social dialogue in addressing issues linked to financing, defining priorities and benefit packages of social security? What activities supporting the reinforcement of capacities for policy-makers, administrators, social partners are needed the most?

Asking the questions…