Technical assistance for the development of universal health coverage in Niger

In 2006, Niger established a free medical care policy for pregnant women and children under five. It currently reaches almost a quarter of the population. This public policy is supported at the highest level, but has still not benefited from sufficient financial resources, meaning it is sometimes only relatively effective. This is why it is now necessary to make this system fully operational.

Free care is the first stage in the establishment of universal health coverage (UHC) in Niger. It involves managing to set up a sustainable and effective third party payment system in order to reduce the advance payment of medical expenses and the out-of-pocket expenses for Niger’s population, which remain very high: 54.85% of public health expenditure, according to the ninth report of health accounts for the budget year 2016.

Through technical assistance to support the development of universal health coverage in Niger, Expertise France is helping the Government of Niger implement its roadmap towards UHC, in particular to set up third party payment for the free medical care policies. 

The main objectives of these actions are to:

• Facilitate the strategic dialogue on health financing in Niger between the ministries and technical and financial partners, with a focus on setting up and financing a purchase fund for the management of the free care and results-based financing;
• Help the Ministry of Public Health set up a purchase fund with a view to the creation of an agency for universal health coverage.

The technical assistance will support the creation of an entity dedicated to the management of free care programmes: the National Institute for Medical Assistance. The project will thereby provide additional assistance for the three following components:

1) The restructuring of the current mechanism for financing and managing free care programmes (payment exemption for beneficiaries) for health services for women and children under five;

2) The strategic management of the implementation of universal medical coverage (UMC), with a view to UHC: definition of the national UHC strategy, political support and strategic management bodies…

3) The technical management of the process at the Ministry of Public Health: assistance to the core technical group for its functioning and the development of its action plan.

This technical assistance to support the development of universal health coverage in Niger is part of the “Sahel Solidarity Health Initiative (I3S)” of Agence Française de Développement (AFD). This initiative aims to facilitate access to healthcare for children under five in Sahel countries. For this purpose, it is assisting countries that are politically committed to setting up solidarity systems for access to healthcare.

The activities implemented by this technical assistance follow the recommendations of the Providing for Health (P4H) network, which encourages the creation of a purchase fund with a third party payment management structure, while ensuring there is a separation between the decision, implementing and control functions for free care policies.