[Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].
This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.
Centre lillois d'études et de recherches sociologiques et économiques, UMR, 8019, Faculté des sciences économiques et sociales, Université Lille 1, GISPE (groupe d'intervention en santé publique et épidémiologie), Lille, France. Bruno.boidin@univ-lille1.fr.
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D000349:Africa; D002050:Burkina Faso; D019058:Community Networks / Q000191:economics / Q000458:organization & administration; D005869:Ghana; D006295:Health Resources / Q000191:economics / Q000458:organization & administration; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics / Q000458:organization & administration; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D008302:Mali; D011203:Poverty; D011634:Public Health / Q000191:economics / Q000706:statistics & numerical data; D012432:Rwanda; D012675:Senegal; D019472:Universal Health Insurance / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data
Burkina Faso; Community based health insurance schemes; Ghana; Health insurance; Mali; Rwanda; Senegal; Sub-Saharan Africa; Universal coverage