ROLE OF CATHOLIC CHURCH IN REVIVING MUTUELLE-APPROACH TO INCREASE ACCESS TO HEALTH CARE ON THE PATH TO UNIVERSAL HEALTH COVERAGE (UHC) IN CAMEROON

Transcription

1 ROLE OF CATHOLIC CHURCH IN REVIVING MUTUELLE-APPROACH TO INCREASE ACCESS TO HEALTH CARE ON THE PATH TO UNIVERSAL HEALTH COVERAGE (UHC) IN CAMEROON Presented by Rev Fr Nestor GHF 2016

2 MAP OF CAMEROON SOURCE: AHNLICHE BILDER 2010

3 KEY INDICATORS Total population = 23,810,475 inhabitants SW and NW Regions (2013 projections) = 3,381,980 (with a Surface Area of 42,710 KM2) Live births in 2015 = 864,236 Deaths in 2015 = 273,475 Poverty headcount ratio = $1.25 per day Total expenditure on health (2013) as % of GDP = 5.1 Private expenditure on health (2013) as % of Total expenditure = 65.3 Neonatal mortality rate (2015) per 1000 LBs = 25.7 Under-five mortality rate (2015) per 1000 LBs = 87.9 Average Life Expectancy (2015) for both male and female = 54

4 BACKGROUND The oil and financial crises of 1980s The 1987 Bamako Initiative on universal access to quality primary healthcare Participation of community members in the governance of health care centres Cameroon s 1990 Law on Association 1996 revised Constitution and 2004 framework Law on Integrated Decentralisation The 2002 HSS prioritizing RISK-POOLING February 2006 National Forum/ Strategic Plan for the promotion of MHOs Two Ministries designated to implement this plan

5 BEPHA Bamenda Ecclesiastical Province Health Assistance Initiative of the Bishops of Bamenda Church province in line with MDGs and Cameroon s HSS - To provide Access to Quality Health Care - To reduce out-of-pocket health expenditure - To promote Solidarity among community members - To promote Health Protection, curb untimely deaths, and increase productivity Thus, 4 schemes were set up in Buea, Bamenda, Kumbo, and Mamfe

6 CHALLENGES FACED Schemes Coverage Package designed arbitrarily and based on old data Problematic scheme data (paper-based reports) Undefined unit of affiliation (adverse selection) Open enrolment throughout the year Basic identification mechanism (stamped cards) Inadequate sensitization efforts Low membership involvement Dilema of being an MHO or a church-based Relationship with healthcare providers Claim processing (abuses, over prescriptions, etc) Lack of sustainable funding model Different procedures by schemes (leading to fraud, etc) Limited staff capacity and retention

7 CHALLENGES ADDRESSED Structural change in BEPHA (New Structure) with technical assistance from MIA in 2012 Sensitization workshops (with well defined Messages, Communication Channels and Tools) Structured audits from central coordination office IMIS which allows: - real time access of information, - database management, - client membership tracking, - claims scrutiny and processing of payments. - Mobile Phones planned as a pilot in one location

8 CHALLENGES ADDRESSED Local Committee (LC) structure - For greater community outreach via LC volunteers Local (LA) - For Community involvement and Member participation General (GA) N.B. - Representatives (3) from each LA - For participation of Members and other Stakeholders MIA 2014 study of LCs in Kumbo and Bamenda proves that the new BEPHA Parish Level structure works better for Community penetration and scales up Enrolment

9 NEW BEPHA STRUCTURE «CHURCH-BASED WITH MEMBER INVOLVEMENT» BAPEC Provincial Board Provincial Coordination Team Diocese Bamenda Diocese Buea Diocese Kumbo Diocese Mamfe Board of Directors Board of Directors Board of Directors Board of Directors BEPHA Bamenda Team General BEPHA Buea Team General BEPHA Kumbo Team General BEPHA Mamfe Team General Local Local Local Local

10 RE-DEFINED COVERAGE PLAN Service Buea Bamenda Kumbo Mamfe Outpatient 3 x 15,000 Fcfa 2 x 15,000 Fcfa including ANC 2 x 15,000 Fcfa 2 x 15,000 Fcfa 2 x 25,000 Fcfa Hospitalization 2 x 25,000 Fcfa 2 x 25,000 Fcfa 2 x 25,000 Fcfa Surgery 1 x 70,000 Fcfa 1 x 70,000 Fcfa 1 x 70,000 Fcfa 1 x 70,000 Fcfa Delivery 1 x 15,000 Fcfa 1 x 15,000 Fcfa 1 x 15,000 Fcfa 1 x 15,000 Fcfa Pre-Natal care or 1st ANC 1 x 10,000 Fcfa - - -

11 ENROLMENT SPLIT: JUNE 13-14

12 ENROLMENT SPLIT: JUNE 14-15

13 BEPHA: Has witnessed a steady growth in enrolment and retention due to reforms in the last few years (epecially form 2012) - E.g. BEPHA Kumbo Covered more than 64,517 Episodes for Consultation, Hospitalization, Delivery and Surgical Operations Paid over 515,160,939 FCFA for health bills within same period There is a gradual change of attitude on Solidarity in CHIs through continuous Education BEPHA continues to contribute in improving Access to Quality Health Care in Cameroon

14 IN BEPHA, WE FACE WITH COURAGE OUR CHALLENGES

15 VOTE OF THANKS THANKS FOR YOUR KIND ATTENTION