Table 1 Descriptions of the five (5) major MHO promoters included in the study

Starting year for MHOs

1995

1999

2006 (previously PHRplus)

1996

2003

# of MHOs

30

25

28

13

6

Type

Third-party payment

Third-party payment

Third-party payment

Combines personal health savings for small risks with third-party payment for big risks

Third-party payment

Members in good standing (premiums paid up to date)

Insurance for Families = 20 118

2 353

2 823

2 750

11 808

Student Insurance =16 434

Other products: 565

Premiums (variations exist for each MHOs)

Insurance for Families: Fees based on family size

200 F CFA per person per month

200 F CFA per person per month (annual payment is encouraged)

Three options available between 15 000 and 25 000 F CFA per family per year

For the one (1) MHO affiliated with the State: 600 F CFA per person per month

Student Insurance: 350 F CFA per student per year

65% of the premium is for individual health savings, 30% for the solidarity fund (risk sharing), 5% for management. In addition, members must replenish any health savings paid out during the previous year.

Maternity without Risks: 350 F CFA per individual in the village per year

Method of enrolment

Insurance for Families:

Voluntary individual enrolment

Voluntary family enrolment

Voluntary family enrolment

For the MHO affiliated with the State: individual enrolment and automatic enrolment of members of groups that joined the MHO

Voluntary family enrolment

Families of up to 11 members.

In some cases, families must join a small subgroup of MHO members in their neighbourhood to enrol

All collective products:

Automatic enrolment of members of groups that joined the MHO

Coverage

Depends on MHOs, but Insurance for Families usually covers 75% of fees for ambulance, prenatal consultations, hospitalizations, urgent surgeries and complicated deliveries in hospitals, deliveries and observation in local health centres

Covers 75% of services in health care centres and 60% of services in hospital.

Covers from 75% to 80% of services offered in the government’s Minimum Package of Activities in health care centres and hospital care

Health savings: Covers healthcare services offered in peripheral healthcare centres. Solidarity (risk sharing): Covers, completely or partially, fees for evacuation to a hospital

Depends on the MHO

Student Insurance: Covers 100% of ambulance fees and hospitalizations, including medication and surgeries, for problems arising during school hours

For the MHO affiliated with the government: Covers 70% of health fees

Maternity without Risks: Covers deliveries and prenatal consultations of women in the village