Implementation Decree Establishes Universal Health Insurance Management in Togo

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The question of Universal Health Insurance (AMU) was once again the main subject that covered Wednesday’s Council of Ministers chaired by the Head of State, Faure Gnassingbé. Thus, under the terms of a decree, the INAM and the CNSS form the Universal Health Insurance Management Organization. Six other decrees concern the different contours of the AMU.

The decree of the Council of Ministers entrusts the management of universal health insurance to the National Health Insurance Institute (INAM) and the National Social Security Fund (CNSS).

Indeed, the law establishing universal health insurance in the Togolese Republic provides for the establishment of a universal health insurance management body in Togo. Management entrusted to INAM by a previous decree.

“The acceleration of the process of operationalization of universal health insurance and the expansion of the scope of insured persons require that a new architecture be adopted, with an implementation plan making it possible to take advantage not only of experience of the INAM, but also that of the CNSS in the management of social protection,” explains the government.

Basically nothing changes. INAM retains its current missions as a management body for universal health insurance for public and similar employees and holders of civil and military pensions. Added to this is the management of universal health insurance for the benefit of vulnerable individuals and households.

The only new thing is that the CNSS will manage the AMU for employees and pension holders in the private sector, self-employed workers in the informal and agricultural sectors as well as ministers of religion.

“The adoption of this decree allows the two AMU management bodies to align their work with the set operationalization timetable,” specifies the government.

Health insurance and its contours

And 2^e decree adopted by the Council of Ministers establishes the conditions and modalities of subjection, affiliation and registration to the medical assistance regime. A decree which concretizes Faure Gnassingbé’s desire to guarantee access to essential health care for all segments of the Togolese population, taking into account vulnerable people.

And 3^e adopted decree sets the conditions and modalities of affiliation and registration to the compulsory health insurance scheme.

THE control methods universal health insurance are for their part set by a 4^e decree.

And 5^e decree establishes the terms and procedures for concluding, suspending and terminating agreements between managing organizations and providers of care and health services.

Likewise, the 6^e decree determines the attributions, the organization and the functioning of the free appeals commission of the managing bodies. Finally, the 7^e adopted decree defines the values ​​and nomenclatures of pharmaceutical procedures and products covered by the AMU regime.

Enshrined by Law No. 2021-022 of October 18, 2021 establishing AMU in the Togolese Republic, universal health coverage aims to achieve equal access to essential or primary health care for all. It also aims to improve the quality of healthcare provision, on the basis of national solidarity.