Evaluation of the viability of 4 mutual health insurance companies in urban Africa: the case of Goma in eastern DR Congo
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Abstract
Introduction: In Africa, health mutuals, although relatively recent, are experiencing rapid growth but remain fragile. This study, conducted in April 2024 in Goma, aims to assess the viability of four health mutuals to guide their management based on evidence.
Materials and Methods: This is a cross-sectional, descriptive, and evaluative study based on exhaustive sampling. Data were analyzed using SPSS software. Quantitative variables were summarized using means, frequencies, and proportions. Proportion comparisons were performed using Pearson’s chi-square test.
Results: The study reveals numerous shortcomings. Institutionally, overall viability stands at 68.5%, below the 90% threshold, with only one mutual reaching 94.2%. Affiliation with a mutuals' association is very low (0.25), and the administrative component scores only 56.57%, with one structure deemed viable (81.2%). Risk portfolio monitoring is limited, with an average score of 0.37. Technical viability is 56.57%, with gaps in tracking and analyzing service costs. Functional viability reaches 66.65%, despite a zero penetration rate. Financial viability is the lowest, with an average of 41.62%, mainly due to high operating costs.
Conclusion: The mutuals studied exhibit major weaknesses that threaten their viability and effectiveness. An urgent strengthening of their management is necessary.
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