Supporting Mutual Health Insurance Schemes

Partnership objectives

  1. Contribute to the sustainable reduction of maternal mortality by promoting a partnership between health authorities and communities organized around mutual health insurance schemes.
  2. Design mechanisms for supporting pregnant women, coordinated with mutual health insurance schemes and free-of-charge schemes created by the health authorities to reduce the barriers to accessing health services and effectively allowing them to enjoy the free health care they need.

Supporting mutual health insurance schemes and involving health authorities to reduce maternal mortality in Guinea and Chad. Supporting mutual health insurance schemes and involving health authorities to reduce maternal mortality in Guinea and Chad. Copyright Sanofi

What are the health needs and challenges?

The Prefectures of Beyla, Yomou and Gouécké in Forested Guinea the Republic of Guinea, and the Pala and Gounou Gaya prefectures in the Region of Mayo Kebi in have some of the highest rates of maternal mortality in the world.

Probability that a pregnant woman dies during childbirth is Forested Guinea 4.5% and Chad 1.1%. In Forested Guinea, a woman has a one in four chance of dying during the average of six pregnancies she will have during her lifetime, and one in 14 in the Mayo Kebbi in Chad.

Less than one in every four women give birth in a health center in Mayo Kebi in Chad and in Forested Guinea.

In an attempt to reduce these devastating maternal mortality figures, the Governments of both countries have opened up free maternal healthcare services. However, the expected increase in the number of women agreeing to give birth in health centers did not materialize, due to the many barriers to access to health centers and hospitals: the lack of vehicles, high transportation costs in emergencies, the unpredictability of the amount to be paid despite the free service announced by the State, deeply-rooted cultural practices that often force women to give birth in their village, and a style of reception in health centers and hospitals that tends to demean women.

Description of partnership activities and how they address needs and challenges

To remove these barriers, communities need to be aided, and measures taken to ensure safety for women and an understanding that giving birth does not entail a risk of dying.

To achieve this, the International Center for Development and Research (CIDR) has proposed to communities of Forested Guinea organized in mutual organizations to benefit from services that enable them to reduce the risk women incur of dying during her pregnancy because she decided to give birth in the village by offering them "a "Safe Maternity" services package. This will train midwives to handle early referrals, organize prenatal visits in the villages, plan for the monitored delivery of high-risk pregnancies, call an ambulance in an emergency, and monitor effective, free-of-charge healthcare.

To benefit from these services, the villages must commit contractually to educate women and contribute to the costs. Highly significant outcomes have already been obtained with this approach, and this project plans to evaluate its impact shortly.

Summary of impact and forward looking information

This project will involve:

  • Seven new mutual schemes will be created and 17 mutual schemes will promote the "Safe Motherhood" approach.
  • The liability of 60,000 women of childbearing age living in 90 villages will be reduced.
  • And 30,000 pregnant women will be able to have their pregnancy monitored near their own village, be encouraged by their midwife to give birth in a health center, benefit from a solution for evacuating them to a hospital in case of complications and receive proper care delivered by health services.

As of now, villages that belong to the "Safe Motherhood" program have seen the recorded maternal mortality rate has been reduced 10-fold, and the birth rate has doubled. The results of the program will be monitored and reported to the health authorities so that the approach can be developed beyond the scope of this project.


Partnership information

Company(ies) Sanofi

Partner(s) BELACD, Centre International de Développement et de Recherche, Chad Liaison Office for Charitable and Development Actions, Chad Ministry of Health, European Union, Guinea Ministry of Health, Local hospitals & health centers & patient groups, Projet D'Appui Au Plan National De Developpement Sanitaire (APNDS), UNHCR, UNICEF, Union of Mutual Health Forest Guinea

Type of Partner(s) Academia / Hospitals, Government, IGOs, Multilaterals, NGOs, Other Business

Therapeutic Focus Women and Children's Health

Disease(s) Family Planning, Sexual & Reproductive Health, Obstetrics, Women's Health

Program Type(s) Availability of Treatment - Financial Support, Availability of Treatment - Product Donations, Health System Infrastructure - Outreach & Medical Services, Health System Infrastructure - Training, Prevention Programs - Awareness & Outreach

Targeted Population(s) Health professionals, Marginalised / Indigenous People, Mothers, Patients in needs of treatment, People with low income, Women

Region(s) Sub-Saharan Africa

Number of Countries 2

Country(ies) Chad, Guinea

Start Date 2013

More information Sanofi Espoir Foundation

Anticipated completion date Ongoing

« Health authorities will only be able to reduce maternal mortality (Millennium Goal 5) and sustain these outcomes beyond the projects that have helped achieve them, by cooperating closely with civil society (NGOs and communities). »

B. Galland, Project Manager