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US News: in Madagascar, Universal Health Cover Sent to see Day

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Maternité d'un centre de santé de base en brousse, dans le Vakinankaratra, à Madagascar. © RFI / Sarah Tétaud Maternity of a basic bush health center in Vakinankaratra, Madagascar.

Six years after the adoption of a national strategy to set up universal health coverage, progress is well lean but the hopes of a better, always present. This was to be retained from the morning of conferences on this theme, organized Tuesday, November 30, by the collective of citizens and citizen organizations.

with our correspondent in Antananarivo, Sarah Tétaud

only 5% to 7% of the state's general budget is allocated to health. It is a lack of consideration for the sector but also "a computing error for the future", according to Dr. Eli Ramamonjisoa, a health economist. Today at Madagascar , only one in ten people is covered by a health insurance mechanism. The rest of the Malagasy is doomed to pay when he gets sick. Or to die, in case of inability to bring together the funds to heal.

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"We always think that the health sector is a budget sector. But we do not think about the return on investment that can be obtained by financing health. If only demographically or in terms of the prevention. Disease prevention costs much cheaper than the care itself of diseases, "he says. But now, finance universal health coverage remains very expensive for a state.

"A community-level health insurance system"

HP + (Health Policy Plus), a USAID funded program, and with which Dr. Eli collaborates, has been aid for several years, the government has been developing its funding strategy for several years. health.

The program has issued several recommendations for the state to find new resources. The first is to expand the tax base, by taxing the polluting industries or agri-food companies that produce harmful drinks or foods for health. "Societies needed to have a negative impact on the health of the population pay. That it pays for health, "the economist insists.

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HP + also recommends a specific model for the Malagasy case. "The model is advocated, it is a health insurance system at Community level. It was calculated that with 9000 Ariary a year and per person for those who have the means to pay (ie 2.5 euros), the member can benefit from a basket of basic care at no level Only basic health centers, but also evacuation to district reference hospital centers. And first emergency surgical aid. For the poorest of the poor, it is the state that will pay the contributions. "

Despite the proven feasibility of this universal health coverage, the project has been in gestation since 2017. "For lack of budget," says, "for lack of will", too.

"However, recall health specialists, the pandemic could have benefited from the Malagasy health system, given the amounts of granted aid (over $ 800 million, NDLR). Unfortunately, it has not been the case. " For the moment, difficult to know where and how these funds have been spent.

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