Africa > West Africa > Cote d'Ivoire > Côte d’Ivoire invests to revamp health care system

Côte d'Ivoire: Côte d’Ivoire invests to revamp health care system

2016/12/26

Ivoirian authorities are preparing to roll out universal health coverage (couverture maladie universelle, CMU) to improve lower-gain citizens’ access to care.

Passed by the National Assembly in 2014, the CMU aims to cover all residents through a dual-pronged approach, with a basic general scheme (régime général de base, RGB) and a non-contributory medical assistance scheme (régime d’assistance médicale, RAM).

A pilot programme with students is scheduled to begin in January 2017, two years next the programme’s planned roll-out, with it slated to be fully operational by 2018, local media reported before this year. Enrolment is by presently under way, with some 600,000 individuals currently in the database.

The need for the scheme is clear: roughly 90% of Côte d’Ivoire’s 22.7m-person people does not have health insurance, and additional than half of total health care costs were paid for out-of-pocket in 2014, according to the World Bank. Total health care spending per capita increased from roughly $78 in 2010 to $88 in 2014, in a country where GDP per capita was $1491 as of last year.
Pooled risk

Under the CMU, all citizens who pay gain tax will be required to enrol in RGB while those who are not eligible for RGB will be placed in RAM.

RGB is based on the concept of risk pooling and will be funded by a monthly fee of CFA1000 (€1.5) for anyone over the age of five. This will be complemented by the non-contributory RAM, drawing from a CFA49bn (€74.7m) public National Health Insurance Fund that will cover residents in low-gain brackets, inclunding those living in poverty.

Once launched, the CMU is as well expected to cover medication; however, the exact all of coverage has from presently on to be disclosed.
Inclunding the private sector

As part of the new initiative, the government is looking to better regulate the private sector, with the CMU offering beneficiaries of RGB the option to be treated in either public or private health care facilities.

To this end, the Ministry of Health has pledged to update the national health care map – which inventories both private and public health care facilities – by the end of this year in a bid to identify unregulated facilities and curb their activity.

Uncertified and illegal private practices have been estimated to comprise approximately 70% of the private sector’s market share, Aboubacar Sidick Bakayoko, president of the National Union of Ivorian Doctors, told local media in August.

According to Côte d’Ivoire’s most recent public census, which took place in 2011, there were 2036 private health care facilities in the country, accounting for approximately 50% of total health care infrastructure, underscoring the need to include and regulate the private sector as part of a push to upgrade the health care system.
Increased investment

The plan to overhaul coverage – and hopefully increase request for both preventive care and treatment as a result – has as well helped to attract interest from outside investors.

In November 2015, Paris-based private equity firm Amethis acquired a minority stake in HMAO Group – one the major operators of clinics and laboratories in Côte d’Ivoire – to augment capacity and modernise equipment. The group manages around 250 beds and owns six clinics in Abidjan, Bouaké and San-Pédro.

Local banks are as well expected to fund a reported CFA3.5bn (€5.3m) for the addition of a radiotherapy unit at International Polyclinic of Sainte Anne-Marie (Polyclinique Internationale Sainte Anne-Marie, PISAM) in Abidjan. Scheduled for completion in 2018, the new facility will become the second in the country to provide radiotherapy treatment and aims to treat up to 1400 patients annually.

This project is part of PISAM’s plans to raise a total of CFA26.5bn (€40.4m) over the next five years to fund further expansion.
Regulating pharmaceuticals

Recent investment to scale up Côte d’Ivoire’s pharmaceutical segment is as well predicted to expand the market, which only covers 30% of national needs, according to a 2014 study conducted by the EU titled “Study for the Development of the Pharmaceutical Industry in Côte d’Ivoire”.

In September Moroccan group Pharma 5 disclosed plans to invest Dh100m (€9.2m) in a pharmaceutical manufacturing plant on a 5000-sq-metre area at the Grand Bassam free zone.

Before this year, international donors provided CFA3.9bn (€6m) to finance a storage warehouse for the New Pharmacy of Health of Côte d’Ivoire (Nouvelle Pharmacie de la Santé Publique, N-PSP), a non-profit providing pharmaceutical products to the country’s public health care system.

With increased investment , however, there is a need for stricter control of pharmaceuticals, particularly regarding procurement and distribution, according to Ange Désiré Yapi, managing director at N-PSP.

“Insufficient control over the supply chain has allowed shipments of medications to get lost, which has led to shortages in public hospitals and has forced patients to turn to unofficial suppliers,” he told OBG. “As a result, half the medicines sold in the country are counterfeit.”

With 90% of treatments involving the use of pharmaceuticals, strengthening the sector’s control mechanisms is crucial to national health, he told OBG.

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