A joint P4H scoping mission comprising WHO, France, Switzerland and the P4H Coordination Desk runs from 21 to 25 November 2011. The mission notes that among Mali’s strengths in moving towards Universal Health Coverage (UHC) are strong political backing, and an institutionalized, long term development plan for the social and health sectors. Mali also has a mandatory health insurance scheme (Assurance Maladie Obligatoire – AMO), which includes a non-contributory assistance scheme for the poor (Régime d’Assistance Médicale – RAMED), and functioning exemption mechanisms. Finally, Mali has valuable experience with decentralized, innovative approaches to the management of local public health services.
The main recommendations of the scoping mission team include: to proceed without delay in the elaboration and drafting of a national UHC strategy which should be placed at the heart of the new 2012-2022 social and health sectors’ development plan; to improve the provision of health services through strategic purchasing, including shifting from fee for service to flat payment mechanisms, contracting and performance-based financing schemes; to improve the efficiency of public health expenditures by the systematic publication of data, better drug procurement management, health services costing studies and better allocation of health staff throughout the country; to simplify the highly fragmented health financing system by merging several existing schemes; to better regulate and coordinate efforts through intersectoral collaboration and to invest significantly in UHC communication and capacity building.
