Management of a Mutual Health Organization on the Accessibility of Members to Medical Care

Abstract

Introduction: The management of a mutual health insurance company presents many challenges. The implementation of effective strategies is essential for its proper functioning. The Bishop Grison Centre and the Saliboko Primary School were the subject of this investigation, which aimed to identify the major management problems of mutual health insurance that prevent it from functioning properly, to determine the consequences of the dysfunction of mutual health insurance on members' access to care and to identify strategies to be put in place for good medical care thanks to the mutual health insurance. Methodology: We opted for a descriptive method with a cross-sectional focus; a study carried out at the Bishop Grison Centre and the Saliboko Primary School, which involved 50 members of the two mutual health organisations of the two mutual health organisations studied, selected according to the LYNCH formula, and two key informants. The interview is the technique that enabled us to collect the data. Results: With regard to the problems related to the management of the Mutual Health Organisations, 46% of the respondents made a judgement on the low income, 38% of the subjects mentioned the poverty that characterises the leaders of the Mutual Health Organisation and 58% of the subjects stated that the management is done within the institutions. In addition, 54% of respondents said that bills are paid by the head of the Mutual Health Organisation, characterised by mistrust (48%), refusal to contribute is linked to the poor access to medical care of members (64%) and 44% over-billing by the health care provider is the main reason for the dysfunction of the Mutual Health Organisation in terms of access to care. As strategies to be put in place for better management of the Mutual Health Organisation, 64% of respondents proposed a re-explanation of the rationale for the Mutual Health Organisation and 22% wanted recourse to donors. Conclusion: The chaotic and non-transparent management of Mutual Health Organisations does not favour accessibility to health care for their members. This situation deserves to be treated with great consideration in order to promote the accessibility of the population to health care. Thus, the unfailing support of the government is indispensable.