1. François Diop Abdoulaye Ba Christine Ortiz Abt Associates Inc. A Framework for Success: Comparative Analysis of African Community-based Health Insurance Initiatives APHA 2010, Denver

2. Why improve health insurance coverage through community-based initiatives? Social Inclusion Increased access to care Income protection Members of the MUSADA scheme in Burkina Faso

3. Health financing in sub-saharan Africa Where does the money come from? Public sector – national programs Individuals – out of pocket What types of mechanisms are used? Social health insurance Subsidized or free care public systems Community-based schemes (MHOs, CBHI, mutuelles ) Senegalese women

4. Senegal Ghana Benin Niger Cameroon Rwanda Africa

5. Comparative table CountryTotal pop% Rural GDP/ capita Per capita total expend. on health Govt % of total expend. OOP as % of total health expend. Total expend. on H as % GDP % population with health insurance Benin9,025,40259.2$328.08$29.0013.146.75.318% Cameroon18,532,79944.1$696.75$51.0028.168.25.219% Ghana23,461,52350.7$306.80$35.006.850.06.240% Kenya37,530,72678.7$459.58$29.006.141.44.620% Mali12,334,16868.4$289.10$30.0012.248.16.08% Niger14,195,08583.5$168.70$10.0010.640.34.0<5% Rwanda9,735,54181.9$271.31$32.0027.322.710.474% Senegal12,411,09457.9$509.03$40.006.761.95.420% Tanzania40,432,16374.9$354.17$18.0013.334.05.516% Zambia11,919,87064.7$386.05$49.0010.837.85.222%

6. Why focus on mutual health organizations? Comparative advantage of community-based initiatives: a way to reach rural and informal sectors in Africa Can provide a link between local level and central government + public resources Mutuelle members in Rwanda

7. Rwanda Ghana Success stories Women at a primary health clinic in Rwanda proudly hold up their mutuelle membership cards

8. Functional methodology Dear Ma Claudia, please paste in the graphic from the article you did (English version). The word copy I have is ugly. http://www.hs2020.org/content/resource/detail/2523/ http://www.hs2020.org/content/resource/detail/2523/ p5 Thanks

9. How to increase health insurance coverage in Africa Bottom-up + Top down A patient proudly displays his insurance membership card after visiting the Mulindi health center in Byumba, Rwanda

10. Reports related to this presentation are available at www.healthsystems2020.org Thank you