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TRANSCRIPT
Zina – Mutual health schemes in Madagascar
European Microfinance Week
November 19th 2015
AGENDA
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The great majority of the population in Madagascar
does not benefit from any form of health coverage.
Medical consultation is often forgone. Among the
most recurring reasons declared:
55% - sickness deemed not serious enough
23% - costs are too high
In between 2010 and 2012, on behalf of Sanofi,
Positive Planet carried out 5 feasibility studies in order
to assess the potential for building a mutual health
insurance scheme in Madagascar.
Microentrepreneurs in the informal sector displayed a
strong interest towards the opportunity of joining a
mutual health scheme.
In between 2012 and 2013, Positive Planet, in
partnership with Sanofi, contributed to the creation of
, and of a common management
platform,
of the population
resort to self-
medication*
of working-age
population does not
have access to social
protection at all*
of the population lives
further than 5 kms
away from the Centre
Santé de Base*
*Source: Declaration by the Malagasy President
during the International Symposium on Social
Protection (Anosy, May 11th 2014)
*Source: Enquête Périodique auprès des
ménages, INSTAT, Madagascar, 2012-2013
*Source: Health Districts Directorate, 2014 ;
Stratégie de Coopération, OMS, 2009
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in
Madagascar
in charge of
technical support, consulting, training and
development
(August 2015)
:
Pharmacies
Drug stores
Public and private hospitals
Centre de santé de base (CSB)
Healthcare centers
Private clincs
Doctors
Partners : Fondation Mérieux, Marie Stopes
International (MSI), Population Services
International (PSI), Programme Mahefa
(USAID)
Diana
Sofia
Sava
Analamanga
Itasy
Bongolava
Vakinankaratra
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To contribute to the enhancement of healthcare access for informal sector workers in
Madagascar.
To foster synergies among public and private actors, as well as civil society organizations,
within the scope of the National Health Strategy (Stratégie Nationale de Santé).
To favour the protection of the resources of farmers and microentrepreneurs.
To participate to the implementation of a durable health coverage in Madagascar.
To expand the offer of the 3 MHOs to 67.000 beneficiaries, through geographic extension,
diversification of their services, institutional anchorage and the achievement of sustainability.
: 3-year cycles : 2010 – 2012 ; 2013 – 2015; 2016 – 2018
: 7 regions : Analamanga, Itasy, Vakinankaratra, Amoroni’mania, Diana, Sofia, Sava
: informal sector workers, microentrepreneurs, farmers, hotel staff, MFIs members
and the overall population of the intervention zones
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- Subsidizing subscriptions
- Financing development
activities
- Providing direct
intervention with regards
to health, mobile
telephony, cash transfer,
etc.
Subscriptions
Management
Healthcare
services
Subscriptions
(subsidized or
direct)
Operating
expenses of the
MHOs and of the
platform
Contribution by
donors
MHOs
development
activities
(Third party payment)
Subscriptions are due
to match total costs
starting from 2018
Reimbursement
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emprunteurs et épargnants) de l’IMF OTIVTANA
:
Partner: OTIVTANA (IMF)
Target: Borrowers and savers at OTIVTANA
Types of membership: Borrowers of over 1million Ariary, voluntary subscribers
Treatements covered
: Hospitalization and Surgery
: Consultation, Drugs
Subscription Conditions
Borrowers :
Savers:
Required formalities
Subscription fees: 2.000 Ar
Copy of the National Identity Card
Copy of the Family Register
Identity photo for every beneficiary of the MHO
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emprunteurs et épargnants) de l’IMF OTIVTANA Partners: ADAPS, Symrise (FIMPALA), Association of hotel personnel, MFIs, AFDI
Target: Vanilla and cacao producers, market gardeners , borrowers and savers, hotel
staff, overall population in the target zones, municipal association
Types of membership: Subsidized (100% or partially), voluntary
Treatements covered
: Hospitalization and Surgery
: Consultation, Echography, Laboratory, Radiography, Delivery,
Dentistry
: Drugs
Subscription Conditions
Membership fee: (7 pers)
Additional contribution: (for family members over 18,
exceding the 7th)
Extra fee:
Required formalities
Copy of the birth certificate
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emprunteurs et épargnants) de l’IMF OTIVTANA Partners : SYMRISE
Target : Vanilla producers
Types of membership : Subsidized 100%
Treatements covered
Hospitalization, Surgery, Maternity
Consultation, Routine Treatements, Radiology, Echography,
Ophtalmology, Laboratory, Dentistry, Stomatology
Drugs
Subscription Conditions
Membership fee: (7 pers)
Additional contribution:
Required formalities
Copy of the birth certificate
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Borrowers
Savers
Rural Population
Urban Population
Subsidized
Voluntary
Subsidized
Voluntary
Rural Population
Urban Population
Rural Population
Urban Population
Contracted healthacare providers
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12
(Jan-Jul 2015)
(end of August
2015)
(end of August 2015)
1 doctor* per
352
beneficiaries
1 doctor* per
158
beneficiaries
1 doctor* per
44 beneficiaries
* Private doctor, centre de santé de base, centre de santé, private clinics
Almost healthcare services were coverd under third party payment
since the beginning of 2015
Gastrointestinal
Infections
Influenza-like
illness
Parasitic disease
Gastrointestinal
Infections
Influenza-like
illness
Parasitic disease
Gastrointestinal
Infections
Influenza-like
illness
Parasitic disease
(end of August 2015)
Drugs
Consultation
Hospitalization
Phase 3 – Objectives 2018
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• Developping the offer for
each MHO
• Raising thr number of their
• Extension of their
• Reinforcement of the
services provided to the
MHOs :
•
• Viability of the
Participation to the
implementation of the
MHOs Plateform Institutional Anchorage
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Antanimora
Antananarivo - Madagascar
Tel /Fax: +261 20 22 640 01
www.positiveplanet.ngo
Antanimora
Antananarivo - Madagascar
Tel /Fax: +261 20 22 640 01
www.plositiveplanet.ngo
Tel: +39 347 32 44 266