From the Universal Health Insurance Scheme (Ramu) to the Assurance pour le renforcement du capital humain (Arch) project currently being rolled out, access to health care and services for the most disadvantaged remains a major concern in Benin.
In public hospitals, many indigents find themselves “sequestered” for non-payment of health care fees, while others are forced to escape due to their inability to pay the bills. From the dysfunctions linked to the indigent health fund to the realities in hospitals, the situation of the indigent is a matter of concern.
While the existence of the Indigent Health Fund is a relief for beneficiaries and hospitals, certain criteria must be met to be eligible. According to Jocelyne Sevi, social worker at the Centre de promotion sociale (Cps) in Allada, indigent cases are identified by the hospital’s social services department, which triggers the process by sending a liaison letter to the Cps. Following a social survey carried out by means of visits to the patient’s locality, a survey report is drawn up and forwarded to the district chief or mayor of the commune for the issue of an indigent certificate. A file is then put together by the Cps to enable the hospital to be reimbursed from the Indigent Health Fund. The duration of the procedure, according to Jocelyne Sevi, should not exceed ten days, in line with social benefit norms and standards. However, it is not uncommon for certain procedures to take longer. Faced with the urgency of certain cases, we make the effort to keep within 5 days, sometimes a week,” she reassures us.
hen the Arch project is rolled out across all Benin’s departments, “the truly needy will have automatic access to health insurance thanks to their biometric national identity card”, assures Venant Célestin Quenum. “It’s the same for the free Caesarean section mechanism, which is now incorporated into our system,” he added.
According to him, after the generalization phase of the Arch project, the indigent health fund will simply be abolished. From January 1, 2022, poor citizens who do not fall into the “extreme poor” category will be required to take out health insurance with a state subsidy, in accordance with the new legal provisions. “So, by January, we should be able to put an end to this situation of people being held up in health centers for non-payment of their healthcare bills,” announces the Dg/Anps. The Arch project will soon cover all 77 communes in Benin. Nearly thirty conditions are covered by the project, representing 75% of the most common conditions in Benin.
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