The well-being of populations is a fundamental pillar of the growth and sustainable development of States. In this sense, health insurance plays a vital role in providing protection against health risks. However, in sub-Saharan Africa, the implementation of these mechanisms is still at an embryonic stage. The region has one of the lowest morning coverage ratesere health insurance with less than 10% of the population covered on average in 2020 according to the Federation of Companies‘African National Law Insurance.
These figures are alarming and require an in-depth analysis of the challenges facing the transport sector.‘health insurance in sub-Saharan Africa as well as concrete solutionseyour to overcome them.
Challenges of adapting to realitys socio-economic
Health insurance remains widely perceived in sub-Saharan Africa as a privilege reserved for a wealthy elite. This perspective, both justified and erroneous, stems in part from the historical exclusion of the informal sector, but also from the difficulty, even the impossibility, for vulnerable groups to access the most basic care. Workers in the informal sector are kept outside social security in most countries in the region. A deplorable reality, when we consider the importance of this sub-sector in sub-Saharan Africa.
In sub-Saharan Africa, the informal sector contributes to GDP in a proportion ranging from 25 to 65% depending on the country. It employs more than half of the working population. This exclusion is concerning because it deprives a large portion of the population of the benefits of health insurance, leaving them vulnerable to the high costs of medical care.
Furthermore, our insurance companies were founded several decades ago on a model designed on the paradigm of prevailing extreme poverty. This approach no longer reflects the reality of our continent. The emergence of a dynamic and expanding middle class opens up new opportunities for the health insurance sector.
Unfortunately, policies to increase market share often continue to be based on the obsolete paradigm of extreme poverty, thus excluding a significant part of the African population who could benefit from these services.
Overcoming overconsumption and exclusion of essential care
In addition to the narrow market, other challenges hamper the health insurance sector in sub-Saharan Africa.
One of these major challenges lies in the very nature of health insurance, which is an adhesion contract. It offers little flexibility to contractors regarding the services offered. This limitation often results in the exclusion of services, such as chiropractic, alignment, naturopathic, etc. care. It limits beneficiaries’ access to care adapted to their real needs. For example, workers who perform physically demanding tasks may need specific care to prevent or treat posture disorders or muscle tension. Exclusion from these types of care limits individuals’ ability to care for their health holistically and preventatively. The same goes for office executives in the daily management of their stress, aches, headaches, herniated discs (etc.)
Another major challenge facing the health insurance sector in Africa is the overconsumption of certain beneficiaries. This overconsumption leads to increased costs for insurers. It puts a strain on the funds available to cover the health expenses of all policyholders. As a result, insurers may be forced to increase premiums or limit the services offered, which negatively affects the quality and accessibility of healthcare for all of their customers.
Reinventing health insurance in Africa through‘adaptation and‘innovation
Faced with these challenges, a profound review of health insurance in Africa is essential. It is essential to adapt existing models to respond more adequately to the specific needs of local populations. This requires an inclusive approach, where a greater diversity of services would be taken into account, and where subscription processes would be simplified to allow wider access to these services.
Actions, on a national scale, involving authorities with the power to modify standards will be necessary for the inclusion of the informal sector, for example. One of the possible solutions is the Health Insurance for the Strengthening of Human Capital (ARCH) project implemented in Benin by the Government. The initiative offers a promising solution to the problem of insurance for employees in the country’s informal sector, with subsidies favoring the subscription of the poorest (or low-income) populations.
Furthermore, encouraging innovation in the health insurance sector is essential. It is imperative to develop products and services that meet the emerging needs of African populations. This involves rethinking current policies and offers to make them more financially accessible, while ensuring their relevance and effectiveness.
Adequate tools also exist to limit overconsumption in order to ensure optimal management of the policies taken out by companies.
A promising approach is to consider complementary solutions to traditional health insurance. This could include the implementation of prevention and health promotion programs, as well as the development of telemedicine services accessible to all.
