Just a quick report on the short meeting Claude, Alex and I had with Dr. Yankalbe P. Matchok Mahouri (Health and Social Affairs Advisor to the Prime Minister’s Office) and Dr. Yankalbe P. Matchok Mahouri (Health and Social Affairs Advisor to the Prime Minister’s Office). Mahamat Annour Wadak (MSP Secretary General).
We began by congratulating them on the internal and external validation of the National CSU Strategy.
To our question as to when the political validation could take place, they replied that the delays were due solely to a question of timing on the part of the Prime Minister.
They assured us that the President and PM are fully in favor of the CSU, and that political validation would take place in the coming months.
We expressed the view that this validation was essential, and that commitment at the highest political level was vital to launch the implementation process.
We also reiterated the importance of an inclusive approach from the outset, to ensure that the introduction of an insurance system for civil servants is complemented by the development of systems to cover the vast majority of the population in the informal sector.
We asked them what challenges they foresee for the scaling-up of mutual health insurance. They listed:
1. Lack of qualified staff (healthcare professionals, managers, etc.),
2. Inadequate sanitation infrastructure,
3. Other infrastructure (roads)
4. The fact that mutuals are not a national model.
In the face of these challenges, we stressed the importance of maintaining the framework for consultation that had been established with the various stakeholders when the SNCSU was defined (four ministries, civil society, private sector and donors), and encouraged them to build on the momentum created between the members of the P4H network present in Chad, and to deal with the agencies in a coordinated manner.
We raised our concern about the lack of management capacity at local level to scale up mutuals and extend the network of healthcare structures offering quality services. We also stressed the importance of the private sector’s role in certain regions, and the need to work with private structures (whether for-profit or faith-based).
They recognized that with all these challenges, there would certainly be a need for technical assistance with implementation, and expressed their wish to continue receiving it from the P4H network.
It was a very cordial discussion, which made clear the open questions that will have to be resolved when implementing this ambitious strategy.
Jacques Mader
