Scaling-up Universal Health Coverage in Benin

Achieving universal health coverage by scaling up Benin’s new health insurance program, Health Insurance for Strengthening Human Capital (Assurance Maladie de l’Assurance pour le Renforcement du Capital Humain or AM-ARCH)

The Challenge

The progressive scale-up of Benin’s new health insurance program, AM-ARCH has been marked by several ongoing challenges following its initial pilot phase. These challenges include scaling up from a small pilot program to reaching a larger proportion of the country’s population; the lack of timely and responsive reimbursement to health facilities; sub-optimal communication on AM-ARCH at the community and grassroots levels; and inadequate monitoring of implementation at the municipal level to identify issues as they arise and develop solutions.

The Opportunity

In its efforts to achieve UHC, Benin initiated an ambitious program aiming to extend access to health insurance, starting with the most vulnerable groups such as the extremely poor and progressively scaling up to reach the entire population.

After the successful closeout of the African Collaborative for Health Financing Solutions (ACS) project in March 2022, the USAID Benin Mission requested continued support from the Accelerator to consolidate and build upon ACS’s achievements to date in supporting Benin in its extension phase of AM-ARCH. The Accelerator’s strategic support areas include health financing, strengthening inclusion, improving social accountability, and increasing community awareness of the program through communication strategies.

Our Work

To support AM-ARCH implementation in Benin, the Accelerator supports the Government of Benin to effectively operationalize the scale-up of the program to new regions and additional sectors of the population; strengthening awareness of the program through improved communication strategies; improving multi-sectoral dialogue and accountability, and promoting learning and documentation of AM-ARCH scale-up efforts.

To ensure the successful scale-up of AM-ARCH to additional beneficiaries, the Accelerator is fostering ongoing collaboration between government decision-makers, the private sector, and civil society and building the capacity of civil society platforms in Benin to contribute to the political dialogue around UHC and promote government accountability to meet its commitments on extending access to national health insurance. This includes engaging civil society to manage a national beneficiary complaints system so that users can provide feedback to improve the program in real-time.

The Accelerator is also supporting an innovative peer-coaching mechanism so that health zones that have already initiated implementation of the insurance program can mentor newly implementing health zones. In remote, rural populations not reached by traditional communication means, the Accelerator is supporting the implementation of a revised health insurance communication plan to ensure that these communities know how to access the new health insurance plan.

On the ground, the Accelerator carries out supportive supervision with the national health insurance agency and the Ministry of Health to take stock of implementation successes and areas for improvement and provide rapid feedback to implementers that are used for iterative program improvements and problem-solving.

Through these efforts, including the continued facilitation of a multisectoral stakeholder consultation committee on AM-ARCH, the Accelerator is playing a key role in supporting the country’s national health insurance agency to scale-up coverage from the extremely poor to the non-extreme poor and civil service sector.

This Accelerator is also planning learning activities to contribute to the evidence base around universal health insurance scale-up in Benin and other settings, in particular achieving scale-up in an equitable and inclusive manner; the effectiveness of the Accelerator’s technical assistance approaches; and contributing to USAID’s Health Systems Strengthening Learning Agenda.