Mali
Arrival of WHO regional adviser on health financing policy
November 2012 - As part of the WHO contribution to the P4H joint support plans in Benin, Burkina and Mali, an international adviser on health financing policy is deployed in Ouagadougou (based in WHO-IST Intercountry Support Team). The WHO adviser will help build national capacity in the area of health financing and support the national processes related to drafting a national health financing strategy in the above-mentioned countries.
WHO study on bridging health financing schemes
October 2012 – WHO carries out a study on bridging existing health financing schemes in response to P4H joint scoping mission carried out in November 2011 which revealed extensive health financing fragmentation.
The study report recommends: cancelling certain payment exemptions and instead integrating [the services subject to payment exemptions] into existing mandatory and voluntary schemes; combining the efforts and technical work of the Caisse d’Assurance du Mali (CANAM) and the Agence Nationale d'Assistance Médicale (ANAM); increasing efficiency through the simplification of the different funding channels, and using third party payment mechanisms for displaced population in Mali.
Joint P4H scoping mission
November 2011 - A joint P4H scoping mission comprising WHO, France, Switzerland and the P4H Coordination Desk runs from 21 to 25 November 2011. The mission notes that among Mali’s strengths in moving towards Universal Health Coverage (UHC) are strong political backing, and an institutionalized, long term development plan for the social and health sectors. Mali also has a mandatory health insurance scheme (Assurance Maladie Obligatoire - AMO), which includes a non-contributory assistance scheme for the poor (Régime d'Assistance Médicale - RAMED), and functioning exemption mechanisms. Finally, Mali has valuable experience with decentralized, innovative approaches to the management of local public health services.
The main recommendations of the scoping mission team include: to proceed without delay in the elaboration and drafting of a national UHC strategy which should be placed at the heart of the new 2012-2022 social and health sectors' development plan; to improve the provision of health services through strategic purchasing, including shifting from fee for service to flat payment mechanisms, contracting and performance-based financing schemes; to improve the efficiency of public health expenditures by the systematic publication of data, better drug procurement management, health services costing studies and better allocation of health staff throughout the country; to simplify the highly fragmented health financing system by merging several existing schemes; to better regulate and coordinate efforts through intersectoral collaboration and to invest significantly in UHC communication and capacity building.
Launch of a UHC scheme targeting the poor
October 2011 - A non-contributory UHC scheme targeting the poor, the Régime d'Assistance Médicale (RAMED) is formally launched. RAMED will target approximately 600,000 people, roughly 5% of the total population, during the first phase of implementation.
Ministry of Social Development request for P4H support
August 2011 - A joint P4H scoping mission comprising WHO, ILO, World Bank, GIP-SPSI and the P4H Coordination Desk runs from 7 to 14 September 2011. The mission team attends a 2-day workshop with various staff from the Ministry of Social Affairs, the Divisions of Internal Revenue and Customs (MoF), the National Institute for Statistics and union representatives. There is a basic review of the existing health system financing mechanisms and the long term vision of the Ministry of Labour is shared with the other national and international stakeholders, a core aspect of which is the extension of the coverage provided to civil servants under the national health insurance scheme Institut National d'Assurance Maladie (INAM) to all categories of the population as quickly as possible, paying particular attention to the contributing capacity of the different categories to be covered.
UHC situation analysis report
June 2011 - With technical support from WHO, the Ministry of Social Development (Ministère du Développement Social, de le Solidarité et des Personnes Agées - MDSSPA) carries out a situation analysis of Mali's health financing system and assesses progress on the road to UHC. The report could be an important contribution to the development process of a future national UHC strategy.
Formal launch of a mandatory health insurance scheme
May 2011 -A mandatory health insurance scheme, Assurance Maladie Obligatoire (AMO) is formally launched by the President of the Republic of Mali. Unfortunately, some parts of Mali civil society movements campaign against the scheme, and force the government to modify some of its core characteristics.
Legislation passed calling for national mandatory health insurance
June 2009 - Law No 09-015 calling for the establishment of a national mandatory health insurance scheme is passed on 26th of June 2009. It envisions covering all Mali citizens for their needed health services.