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The determinants of participation in local mutual health organisations /Study applied to the Leeré Laafi Bolem de Zabré mutual health organisation, Burkina Faso

François DUBOIS student laureate
frdub77@yahoo.fr

°1977 Belgium
Agricultural engineer, Université Catholique de Louvain-la-Neuve, Belgium, 2000

Les déterminants de participation aux mutuelles de santé/Etude appliquée à la mutuelle Leeré Laafi Bolem de Zabré/Burkina Faso

Lack of access is perhaps the most fundamental health care problem in developing countries in general, and in sub-Saharan Africa in particular. The causes are manifold. One of them is problematic financial accessibility.
The development of mutual financing systems based on insurance and solidarity is one of the most prominent strategies that have been developed in recent years to deal with this. Today, small mutual health organisations are sprouting like mushrooms, in West Africa at any rate. However, this trend keeps on being confronted with a number of significant problems. It is indeed a fact that the coverage of such innovative payment systems remains, for the time being, relatively limited. Research into the reasons why some people join these systems while others choose not to is therefore particularly relevant.
This is precisely what François Dubois has done in his research. He compares the members and non-members of the Leeré Laafi Bolem mutual health organisation in Burkina Faso with reference to a number of demographic, social and economic characteristics. He does this in a rigorous and scientifically based manner, employing both qualitative and quantitative methods. This dissertation is, to my knowledge, one of the few existing studies which attempt to establish the factors determining the membership or non-membership of African households in mutual health organisations.
Moreover, the conclusions of this study are of particular interest. One is that it is clearly demonstrated that in the case of Leeré Laafi Bolem, it is not the poorest members of the population that make use of the mutual health organisation. The study confirms the argument that mutual systems do not necessarily offer a solution to the problems of financial accessibility for the very poorest people in African society.

report by Dr. B. Criel, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium