@article{fdi:010087599,
  title = {{I}nnovations in mutuality : challenges and learnings for the {U}niversal {H}ealth {I}nsurance {P}lan in {M}ali},
  author = {{T}oure, {L}. and {B}oivin, {P}. and {D}iarra, {Y}. and {D}iabate, {S}. and {R}idde, {V}al{\'e}ry},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {M}any {S}ahel countries in {A}frica are looking for solutions for universal health coverage ({UHC}). {M}ali is in the process of adopting the {U}niversal {H}ealth {I}nsurance {P}lan, which allows for the mutualisation of existing schemes. {I}ts operationalisation requires numerous adjustments to the current mutualist proposal and innovations in the system. {T}he study focuses on innovations experienced in mutuality and their conditions of scale for {UHC} in {M}ali.{M}ethods {T}his is qualitative research by multiple case studies. {I}t is based on the collection of data by interviews (n=136), at a national and local level, on the analysis of documents (n=42) and a long field observation (7 months). {T}he analytical framework concerns the dissemination and maintenance of health innovations ({G}reenhalgh et al, 2004).{R}esult {T}he analysis of this innovation shows an interest in the technical and institutional viability that determines its performance and scale-up. {T}he procrastination and scepticism displayed at the highest level of the state and the international level, the reluctance, both financial and ideological, to renew the old mutualist proposal, penalise this {M}alian experiment.{C}onclusion {T}his innovation is a decisive step in ensuring the health coverage of {M}ali's agricultural and informal sectors. {T}he reform will need to be amplified and supported in the future to expect the scale-up of a cheaper, technically and institutionally more efficient system. {W}ithout a political intention to mobilise national resources and accept a fundamental paradigm shift in health financing, the search for the financial viability of mutuality may, again, be at the expense of the performance.},
  keywords = {health insurance ; health systems ; {MALI}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {7},
  numero = {{S}uppl. 9},
  pages = {e011055 [10 p.]},
  ISSN = {2059-7908},
  year = {2023},
  DOI = {10.1136/bmjgh-2022-011055},
  URL = {https://www.documentation.ird.fr/hor/fdi:010087599},
}