Achieving Progress Towards Universal Health Coverage Through Community-Based Health Insurance: Considerations for Madagascar

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).