LA MISE EN OEUVRE DE L'ASSURANCE MALADIE OBLIGATOIRE AU MALI, DÉFIS ET PERSPECTIVES

Abstract

Abstract

Accessibility of people to quality health care remains a major objective for Mali's national
health policy. Real progress has been made in terms of geographic accessibility, in contrast to
affordability, which is reflected in the low use of care facilities linked to the low purchasing
power of households. After the exemption of payment and free policies, Mali introduced the
compulsory health insurance plan in 2009, which became operational in 2011 with the start of
clinical services. This study, conducted from April to June 2018, provided an overview of the
implementation and functionality of compulsory health insurance in two health facilities. It
has thus appreciated the availability of means of production of care, the satisfaction of users
and those of service providers through in-depth and semi-structured individual interviews,
documentary operations and observations. As results of the study, the availability of the
means of production is satisfactory in both structures with a resource index of 4 out of 5. For
the process of care, the study obtained in each of the two structures a process index equal to 2,
considered unsatisfactory linked to the insufficient motivation of the providers and the
insufficiency of the monitoring mechanism. Users are 60% satisfied in each of the two
structures. As for providers, their satisfaction is estimated at 40%. Thus, in total the study
resulted in a satisfactory level of implementation of AMO in both institutions evaluated with a
performance index of 3 out of 5 for each of them. Efforts remain, however, to be undertaken
for the reinforcement of the technical platforms and the motivation of the service providers,
the reinforcement of the capacities in reception, the sensitization of the insured persons on the
use of the services, the regular follow-up

Keywords: mandatory health insurance, health facilities, inventory.