UNIVERSAL HEALTH COVERAGE
The Ivorian government is firmly committed to achieving Universal Health Coverage (UHC), which is an important element of the Sustainable Development Goals (SDGs), particularly the one related to health. UHC aims for (i) equitable use of health services by populations based on their needs; (ii) the quality of health services provided; (iii) financial protection for populations; and (iv) equity in financial contributions[1].
To this end, the Ivorian government established Universal Health Coverage (UHC) through Law No. 2014-131 of March 24, 2014. UHC guarantees all individuals living in Côte d'Ivoire, whether Ivorian or not, access to quality and equitable medical care, with particular attention to low-income populations. Its management is entrusted to the Social Protection Institution known as the National Health Insurance Fund, abbreviated as IPS-CNAM, created by decree No. 2014-395 of June 25, 2014.
The operationalization of UHC required significant investments to build, rehabilitate, and modernize health infrastructure. Additionally, qualified professionals have been recruited to meet the growing needs of this innovative system.
UHC has been in effect since October 1, 2019, and includes two schemes:
- a contributory scheme, called the Basic General Scheme (RGB), financed by contributions from insured individuals. It imposes a withholding tax for private and public sector employees and is voluntary for informal sector workers;
- a non-contributory scheme, called the Medical Assistance Scheme (RAM), which targets economically disadvantaged or needy individuals. Contributions (third-party payment and co-payment) are provided by the state.
As of April 30, 2023, a total of 4,020,411 people have been enrolled in the UHC program. Additionally, the number of health facilities providing "UHC services" at all levels of the health pyramid has increased from 725 in October 2019 to 1,349 by the end of June 2023. The facilities involved are public health establishments under contract.
The UHC benefit package includes the following medical services:
- general consultations (consultations performed by general practitioners and specialists, as well as state-certified nurses and midwives);
- emergency medical-surgical consultations and care (immediate care in hospital emergency rooms for patients whose vital prognosis is at risk);
- medical and surgical hospitalizations (costs for patients whose health condition requires hospitalization).
[1] SDG 3, Target 3.8 aims to "ensure that everyone has access to universal health coverage, including financial risk protection and access to quality essential health services and safe, effective, quality, and affordable essential medicines and vaccines."