Teachers Health Mutual Fund in Burkina-Faso

Burkina Faso has 18 million inhabitants. In 2016, GDP per capita was $640[1] and 43.87% of the population lived under the poverty level with less than $1.25 per day. Agriculture accounts for 32% of the GDP and employs 80% of the active population. It is one the ten less developed countries in the world, with a human development index of 0.402 in 2015 [2].Burkina Faso is a member of the West African economic and monetary union (UEMOA).

Health profile

Life expectancy at birth is 60 years for men and 61 years for women. The epidemiological profile of the country is marked by the persistence of a high morbidity rate due to endemoepidemics including HIV infection and by the progressive increase in the burden of noncommunicable diseases. The main diseases of significance affecting public health are malaria, acute respiratory infections, malnutrition, diarrhoeal diseases, HIV, AIDS, STIs, tuberculosis, leprosy and neglected tropical diseases. Access to healthcare is difficult in this country, which suffers from a serious shortage of qualified health workers (1 doctor/35,000 people in rural areas), insufficient quantity and quality of healthcare facilities and a limited supply of health products. Health expenditure accounts for about 5 per cent of GDP. Total expenditure on health per capita as risen to $82 per year, of which 47 per cent is borne directly by households.

Health coverage

There is no national health coverage scheme and 90 per cent of the population lives without health coverage. However, several health insurance systems coexist:

  • For the formal sector: professional mutual funds and health insurance is offered by the employer
  • For the informal sector: community mutual funds
  • Free programmes for maternal and child healthcare

Burkina Faso is currently in the process of bringing into operation a Universal Health Insurance (CMU) project. This scheme aims at health coverage for the entire population. A National Health Insurance Fund (CNAMU) has been created.

The mutuality landscape in Burkina Faso

Studies count 188 functional mutual health funds with around 100,000 members and 250,000 beneficiaries[3].

  • There are professional mutual funds that bring together workers from the same institution or company. Contributions are often compulsory or automatic and deducted from your salary.
  • Community mutual funds are created at locality or municipality level. They operate on a voluntary basis.

Some well-known mutual benefit actors:

Focus on the teachers of Burkina Faso

There are around 59,000 teachers[4] of the primary education and 14,000 of the secondary education distributed all over the Burkina Faso territory. Teachers earn an average of CFA 120,000 per month [5]. They spend an average CFA 50,872 per year on healthcare. 75% of the costs paid for healthcare come from the family savings.

The most commonly treated diseases amongst teachers are:

  • Malaria
  • Typhoid fever
  • Respiratory and cardiovascular diseases

According to a study conducted on 1,000 teachers in 2013[6] by the NGO ASMADE, 93% of the polled education professionals were ready to become affiliated to a health mutual fund in order to reduce the financial expenses of healthcare. The health mutual fund project brings together 14 of the 15 education education unions of the country.

Project objectives

  1. Improve healthcare access for education professionals and their families
  2. Contribute to the health and well-being of educational staff and allow the continuity of professional activity, responsible for the quality of education

Beneficiaries

These are Ministry of Education and Literacy workers across the country (13 administrative regions, 45 provinces, 351 municipalities) plus families, representing around 356,000 people.

  • Teachers in classrooms
  • Ministry Training Schools (ENEP)
  • Agents of the central, decentralised (ministry, central directorates) administration, as well as their families

Project partners

The Education and Solidarity Network has been supporting the Syndicat National des Enseignants Africains du Burkina Faso (SNEAB) in this project to create a mutual fund for several years. Several partners have been mobilised to gather all of the necessary expertise. The project partners are:

  • 14 Education Unions: SNEA-B, SNESS, SATEB, SNEP, SYNAPAGER, SYNATRAS, SYNATENF, SPESS, SYNAVS, FESEB, STAGE, SYNAPEP, MONEP, SYNATI
  • Education and Solidarity Network (ESN - Belgium)
  • Programme d’Appui aux Stratégies Mutualistes de Santé (PASS – Ivory Coast)
  • Mutuelle Générale de l’Education Nationale (MGEN – France)
  • Centrale des Syndicats du Québec (CSQ)
  • Mutualité Socialiste – Solidaris (Belgium)
  • Association Songui Manégré/Aide au Développement Endogène (ASMADE - Burkina)
  • Mutuelle des Agents de l'Administration des Douanes du Burkina-Faso (MAADO)
  • Fédération des Mutuelles Professionnelles du Burkina-Faso (FMP/B)
  • Société Ivoirienne de Gestion d'Expertise et de Management (SIGEM)
  • Burkina Faso government (Ministry of Social Welfare, MENA, MINEFID)
  • Teachers Health (Australia)

Activities

Actuarial study

A study was conducted by ASMADE to measure the feasibility of creating a mutual fund for education professionals. This work made it possible to demonstrate the feasibility of the project and the relevance of the mutualist model to achieve the objective, taking into account the health, social, demographic and organisational conditions of the target population. A review of this study is underway.

Technical workshops

Several technical workshops were organised with partners and representatives of participating unions to build a long-term project able to best meet the expectations of teachers in the country.

Signature of an agreement with the Burkina Faso government

Project partners signed a framework agreement with the Burkina Faso government. In this agreement, the signatories recognise the importance of creating healthcare coverage scheme for education professionals in Burkina Faso.

Preparation of launch

In 2018, the project accelerated with the organisation of two workshops that brought together the 14 education unions in Burkina Faso to prepare for the launch of the education professionals’ national mutual fund. The meetings aimed to make progress on several essential elements, including defining the future mutual fund’s offer and the management of its activities. The meetings were facilitated by the Education and Solidarity Network and benefited from the participation of the Programme d’Appui aux Stratégies Mutualistes de Santé (PASS), the Ivorian firm SIGEM, the MAADO and the Fédération des mutuelles professionnelles du Burkina.

Given the progress of the work, the project partners reiterated their desire to see the mutual fund’s creation before before the end of 2019. If a pilot launch is planned in Ouagadougou, the mutual fund will aim to cover the entire territory to improve access to healthcare for all education professionals in Burkina Faso.

 [1] Burkina Faso | Data sur donnees.banquemondiale.org (visited on 3 May 2017).

[2] A propos du Burkina Faso, sur Le PNUD au Burkina Faso (visited on 3 May 2017).

[3] Les mutuelles sociales au Burkina Faso: une passerelle pour l’assurance maladie universelle, RECMA, 2013

[4] Annuaire statistique De l’enseignement primaire 2015/2016, Ministère de l’éducation nationale

[5] Rapport Etude de faisabilité Mise en place d’une mutuelle de santé au profit des professionnels de l’éducation, RES, MGEN, solidaris, CSQ, ASMADE (2013)

[6] Rapport Etude de faisabilité Mise en place d’une mutuelle de santé au profit des professionnels de l’éducation, RES, MGEN, solidaris, CSQ, ASMADE (2013)