Learning and knowledge sharing are fundamental to the LHSS Project. We invite you to search LHSS knowledge products and resources for the latest approaches, insights, and learning in the field of integrated health systems strengthening.
In Madagascar, community-based health insurance programs, known as mutuelles, are helping make health care more affordable for vulnerable populations. Through regular contributions, community members build a shared pool to cover health service costs when needed. Since 2023, LHSS has been supporting the Malagasy government in piloting this approach.
Le gouvernement de Madagascar s'est engagé à atteindre la couverture sanitaire universelle (CSU) à travers la mise en œuvre de la Stratégie nationale de financement de la santé de 2015. Cette stratégie prévoit d'accroître le financement national de la santé et de la protection financière des usagers des soins de santé. En mai 2022, le gouvernement a annoncé son intention de promouvoir le développement de l'assurance maladie de proximité (CBHI).
Pour répondre à cette nouvelle politique, l'Unité d'appui à la CSU, rattachée au Secrétariat général du ministère de la Santé publique, a initié un processus participatif de conceptualisation et de mise en œuvre d'un modèle de CBHI. Cette note technique présente des options pour la conception et la mise en œuvre de la phase de démonstration de CBHI prévue dans le district de Fénérive Est, en tenant compte des enseignements tirés des résultats de l'étude de faisabilité CBHI à Madagascar et des expériences que les pays d'Afrique subsaharienne, en particulier le Sénégal, ont eues avec CBHI. Cette note complète d'autres notes techniques que la LHSS a élaborées pour l'Unité d'appui à la CSU afin d'éclairer le processus d'établissement de la CBHI à Madagascar, notamment la Note technique sur le modèle de CBHI à Madagascar (LHSS 2022).
The Government of Madagascar is committed to achieving universal health coverage (UHC) through implementation of the 2015 National Health Financing Strategy. This strategy plans to increase domestic financing for health and for the financial protection of health care users. In May 2022, the government announced its intention to promote the development of community-based health insurance (CBHI). To respond to this new policy, the UHC Support Unit, attached to the General Secretariat of the Ministry of Public Health (MOH), has initiated a participatory process to conceptualize and implement a CBHI model. This technical brief presents options for the design and implementation of the demonstration phase of CBHI planned for Fénérive Est District, taking into consideration the lessons learned from the results of the CBHI feasibility study in Madagascar and the experiences that countries in sub-Saharan Africa—particularly Senegal—have had with CBHI.
This brief compliment other technical briefs that LHSS has developed for the UHC Support Unit to inform the process of establishing CBHI in Madagascar, including the Technical Note on the CBHI Model in Madagascar (LHSS 2022).
The Ministry of Health in Madagascar, with support from LHSS and WHO, launched the 2022 Health Accounts exercise, a milestone for regular health resource tracking.
This technical note will be updated based on the decisions and progress made in implementing CBHI or other health financing mechanisms, other governmental decisions, and the capacity of the CA-CSU and other actors in implementing the SNFS.
LHSS identifies the information gaps and disparities to achieve the SN-CSU objectives with the data from key UHC-related documents in Madagascar.