Benin has made significant progress in rolling out UHC, thanks to the establishment of the ‘assurance pour le renforcement du capital humain’ (ARCH - Insurance for Strengthening Human Capital) in 2019.
Impressive progress has been made in providing financial protection for health services, including Health Equity Fund (HEF) for the Poor, voucher systems, and social health insurance schemes for the formal sectors (NSSF). Despite this progress, government spending remains low and out-of-pocket expenditures still make up 60% of total health expenditures, which is a serious impediment to the country’s progress towards universal health coverage (UHC).
Approximately 3.7% of households were pushed into poverty due to high health spending in 2017. More specifically, women-headed households were at higher risk than male-headed households4. To this end, efforts to expand social health protection systems are underway. The government is exploring the option of extending social health protection to dependents of NSSF beneficiaries and to extend the HEF to vulnerable groups and the near poor population. The expansion of these existing schemes (NSSF and HEF) provides an adequate pathway to cover the “missing middle”.
UHC service coverage index: 39.6%
Physicians per 1,000 population: 0.16
Catastrophic expenditure: 10.9%
Completed Collective Action Initiatives
With ARCH (Assurance pour le Renforcement du Capital Humain), establish a universal health insurance scheme, including for the informal sector.
- The team met with the relevant stakeholders of ARCH and worked on a financing strategy.
- A basic care and health package was defined
- Key actors in the informal sector were identified
- A new insurance scheme was piloted in the North Zone of Benin