SOCIAL SECURITY ORGANIZATION LAO PDR MINISTRY OF LABOUR AND SOCIAL WELFARE SOCIAL SECURITY ORGANIZATION Country Presentation By: Manola Daravong Veomany Khamphay Tel: +856 21 241 280-1; Fax: +856 21 241 279, Website: www.ssolao.gov.la, email: ssohq@ssolao.gov.la,

Presentation Outline Country profile and health indicators Challenges Social Security principle Social Security Schemes in Laos Benefits package of SSS Women entitlement under SSS benefits Other benefits and social protection development

Country profile and Health indicators - Population 6.7 Million - Country area 236,800 sq.km - Pop. Informal Eco. 75% - Poverty 25% - GDP per capita $ 1,645 - GDP growth 8.1% Health indicators: - MMR/100,000 375 - IMR/1,000 48 - U5MR/1,000 61 - Life expectancy at birth 68 year: - Males: 66.5 - and Females: 69.2 Source: world Bank and WHO 2012 Tel: +856 21 241 280-1; Fax: +856 21 241 279

Challenges Poor maternity protection for women in rural areas High vulnerability to loss of income and maternity related cost Limited access to qualified health care provision (economic, physical, cultural) Maternity Mortality Rate (MMR) remains very high compared in the region Lack of awareness and limited access to information and counseling Gender inequalities Tel: +856 21 241 280-1; Fax: +856 21 241 279

Social security principle Promote gender equalities Improving access to quality health care Better condition /environment of working Reducing vulnerability to income loss and social economic empowerment of women Improving access to information, prevention and counseling Promoting breastfeeding arrangement or opportunities Tel: +856 21 241 280-1; Fax: +856 21 241 279

Social Protection Systems in Lao PDR The social protection system in Laos is formed by three social security schemes and one safety net The four schemes are implemented in a fragmented way whereby two are run by Ministry of labour and two by Ministry of Health, as follows: - State Authority for Social Security (SASS) - Social Security Organization (SSO) - Community-Based Health Insurance (CBHI) - Health Equity Fund (HEF)

State Authority for Social Security (SASS) Established in 2008 and a compulsory scheme Under Ministry of Labour and Social Welfare Covers civil servants and their dependant spouse and children under 18 years or 23 if continue to study Health care benefit is 1 of 8 benefits provided by the scheme, including health insurance, working injury benefit and short and long term benefits.

Social Security Organization (SSO) Established in 2001 under Ministry of Labour and Social Welfare Covers private and state-own enterprise employees and their dependant spouse and children under 18 years or 23 if continue to study Provide 8 benefits (short and long term benefits) It’s a so-called mandatory scheme, therefore very low compliance with approx. 36% of targeted employers enrolled From F.Y 2014-2015 the SASS & SSO will be merged to be the National Social Security Fund

Community-Based Health Insurance (CBHI) Lunched as pilot project by Ministry of Health in 2002 It is a voluntary social health insurance scheme for informal economy Members are eligible for health package obtained from primary health care providers and referral hospital at provincial level Low enrolment and high drop-out rate

Health Equity Fund (HEF) Financed by government and donors launched in 2004 Targeted at the poor Run by Ministry of Health and some HEFs are administered by Non-state Partners (e.g: the lao Red Cross/Swiss Red Cross) Using either reimburse providers or a combination of capitation and case-based reimbursement Utilization of services trend to increase

Social Security Systems in Laos Target Source of fund Benefits State Authority Social Security (SASS) Public sector Contributions: - 8% from state employee - 8.5% from Government 8 type of benefits Social Security Organization (SSO) Private sector - 5.5% from employee - 6% from employer Community Based Health Insurance (CBHI) Community Contributions based on family size in a fixed amount, (13,000 to 33,000 LAK/month/family Health Insurance Health Equity Fund The poor Government and NGOs pay capitation to CBHI

Source: National Health Insurance Bureau, MOH

Benefit Package 1. Employment injury and occupational disease; 2. Health Insurance; 3. Sickness benefit; 4. Maternity benefit; Short-term benefits 5. Funeral grant; 6. Old age pension; 7. Survivor pension; Long-term benefits 8. Unemployment benefit.

Women entitlement under social security benefits Health care services including pregnancy and delivery services Sickness benefit Maternity benefit: replacement of income of an insured working woman for a period before and after confinement Qualify period : Have contributed to the SSO fund at least 8 months within the last 12 months Calculation of maternity Benefit: equivalent of 100% of the insured salary for a period of three months Survivor benefit Tel: +856 21 241 280-1; Fax: +856 21 241 279

Other benefits Exemption of charges for MNCH Equality for health care services (rich and poor) 1 hour/day for breastfeeding Women entitle to maternity leave of 105 days per child (if twin will be 120 days) Tel: +856 21 241 280-1; Fax: +856 21 241 279

However, the coverage of all schemes is still low about 22 However, the coverage of all schemes is still low about 22.47% of total population Maternal, neonatal and child health services is still limit in some areas. Tel: +856 21 241 280-1; Fax: +856 21 241 279

Social protection development The government committed to extend social protection universally by 2025 Expand the exemption of charges for MNCH national wide Merging social security schemes in to the national social security fund Expand the scope of social security coverage to informal sector including self employed and common people. Tel: +856 21 241 280-1; Fax: +856 21 241 279

MANY THANKS FOR YOUR ATTENTION Tel: +856 21 241 280-1; Fax: +856 21 241 279