In 2010, the government of Mali introduced a compulsory health insurance scheme with third-party payment for civil servants and workers to guarantee affordable health care.
In 2011, the National Sickness Insurance Fund (Caisse nationale d'assurance maladie (CNAM)) concluded agreements with all public agencies, in particular with hospitals, referral health centres and community health centres.
In the context of the introduction of mandatory health insurance in Gabon, the government was concerned about social coverage for its economically disadvantaged citizens. It was not politically or socially acceptable to establish health coverage that would exclude a large segment of the population. This raised the issue of the financing of their benefits. An innovative form of financing was thus found - specifically, an indirect earmarked tax referred to as the "mandatory health insurance fee".
Although the National Pension and Occupational Risks Office for Civil Servants, Magistrates and Judicial Personnel (Office national des pensions et risques professionnels des fonctionnaires, des magistrats et des agents de l'ordre judiciaire (ONPR)) is a relatively young institution created in 2010, a system for improving services was established in January 2011 for members and beneficiaries in the following areas.
