Madagascar Advances System for Universal Health Coverage
April 20, 2017
Madagascar's government council passed a decree in April 2017 establishing a national health solidarity fund as part of its universal health coverage (UHC) efforts. The solidarity fund, called Caisse Nationale de Solidarité en Santé (CNSS) or National Solidarity Fund for Health, aims to cover the cost of preventive, curative, and rehabilitation care for its affiliates, which will be provided nationally via a third-party payment system. As a public entity with administrative and financial autonomy, CNSS will collect and manage contributions from the public, transfers, government subsidies, and other donations; contract with health structures to care for its members; and pay institutions that provide care based on the benefits offered to members and their dependents. The USAID-funded Health Policy Plus (HP+) project provided technical and financial support to the Ministry of Health's universal health coverage division to develop the decree with a broad group of public and private stakeholders. This is an important step for Madagascar following the launch of the UHC strategy, but there is still a long road ahead. HP+ Madagascar will continue to work with the government on next steps, including establishing a clear benefits package and determining the payment structure.