In 2005, the World Health Assembly passed a resolution urging member countries to ensure that health financing systems included pre-paid and shared risk mechanisms (1). Since then, Nations around the world have moved to implement political commitments and policy reforms to make progress towards Universal Health Coverage [UHC] goals (2). These reforms include implementing Social Health Insurance (SHI) to expand health insurance coverage for all citizens, with an aim to reduce out-of-pocket expenses and prevent impoverishment and catastrophic health costs.
The mandatory nature of SHI ensures that everyone is covered and requires compulsory enrollment. Participants must pre-pay a
specified premium or receive coverage through government contributions. Despite the use of legislation to implement mandatory health insurance in many African countries, coverage remains low and the very poor population are still exposed to financial difficulties as they seek health care (3). This brief summarizes findings from a stakeholder engagement workshop and a rapid review of the application of SHI laws through mandatory health insurance, further examines the challenges, and opportunities in three francophone West African countries; Benin, Burkina Faso, and Togo, and offers policy recommendations.