Boidin B
CLERSÉ, Université de Lille, Lille, France.
Med Trop Sante Int. 2021 Apr 2;1(1). doi: 10.48327/mtsimagazine.n1.2021.78. eCollection 2021 Jun 30.
From the end of the 1970s, the promotion of the community and the participation of populations in the health system reinforced the idea that mutual health insurance was a potentially major player in the extension of coverage against health risks. But the history of mutuality in Africa was quickly strewn with pitfalls. The structural adjustment plans and the increase in the financial contribution of users under the impetus of the Bamako initiative put a stop to the spirit of community mutual insurances. Today, mutual insurances are once again at the heart of international and national initiatives with the promotion of the (UHC) Universal Health Coverage. But they must overcome their historical shortcomings through professionalization and compulsory membership. This movement seems to be underway, while at the same time facing the challenge of preserving the place of communities in health systems, a founding principle of the mutualist movement.
从20世纪70年代末开始，社区的推广以及民众对卫生系统的参与强化了这样一种观念，即互助医疗保险在扩大健康风险保障范围方面可能是一个主要参与者。但非洲互助的历史很快就充满了陷阱。结构调整计划以及在巴马科倡议推动下用户财政缴款的增加，终止了社区互助保险的精神。如今，随着全民健康覆盖（UHC）的推广，互助保险再次成为国际和国家倡议的核心。但它们必须通过专业化和强制参保来克服其历史缺陷。这一行动似乎正在进行，与此同时，还面临着维护社区在卫生系统中的地位这一挑战，而这是互助主义运动的一项基本原则。
