Departmental Strategy Meeting Departmental Strategy Meeting Social Security Department Social Security Department Social protection dynamic of extension in Senegal extension in Senegal Geneva 15-16 december 2005
Reminder: Some data Population: 11 millions Population: 11 millions GDP / capita: 385 000 FCFA = 700 US $ GDP / capita: 385 000 FCFA = 700 US $ Life expectancy: 54 years Life expectancy: 54 years HDI: 160th / 175 HDI: 160th / 175 HDI: 160th / 175 HDI: 160th / 175 Child infant mortality: 150 / 1000 Child infant mortality: 150 / 1000 Maternal mortality: 510 / 100 000 Maternal mortality: 510 / 100 000 48,5% of population is poor 48,5% of population is poor Poverty in worse in rural areas (57,5%) Poverty in worse in rural areas (57,5%)
Stage 0: Social protection in Senegal 10 years ago Formal sector Covered employees 17% OTHER MECANISMS Private insurance Private insurance SOCIAL SECURITY CSS / IPM / IPRES / FNR CSS / IPM / IPRES / FNR Rural and informal sector sector Excluded 70 à 80% Traditional solidarity networks SOCIAL ASSISTANCE Indigents 10 à 20%
Stage 1: Development of MI (bottom-up) : 1995-2005 Micro-insurance Complementary health managed by a MFI insurance MECIB, Pamecas Entreprise based mutuals Entreprise based mutuals Trade union based mutuals Trade union based mutuals Civil servants mutual Civil servants mutual MFI Federation Mutuelle des volontaires de Mutuelle des volontaires de l’éducation l’éducation Insurance managed by a federative structure UNCAS Health Micro-Insurance UMSK, Wer Werlé, Bok Schemes (« mutuelles ») Faj, And Faju, Aprofes…
Stage 2: Development of linkages : since 2003 Linkages formal / informal Social Protection schemes Contracting with HC Unions des Mutuelles de providers Santé de Dakar, UMSD « mutualized » agreements Partnership with local government MFI Federation Process of agreement between Dakar local government and UMSD Linkages of MI schemes Union des mutuelles de Koungheul « Sponsorship », solidarity and equity funds Wer Werlé Thies
Stage 3: New animals under construction (2005 …) Linkages with formal Social security schemes: COSRISS ?? Coverage of some risks Linkages with Global MFI fund, IPIC fund, PRSP Federation (subsidies) Linkages with central & Nation wide Nation wide local government local government SP schemes (MoH: health system; MoF: subsidies / redistribution) Trade-unions Projects 2006: Socio-occupational groups Agriculture workers 5 million people Transport operators 400 000 people
How did this dynamic work? Stage 0 BIT/STEP Stage 1 networking, advocacy, technical 1998 Platform of Abidjan Mutuals support, tools … CAMICS / CAFSP networking, advocacy, Development of HMIS : knowledge development, community based, socio- occupational based, trade unions … technical support, tools … Stage 2 Stage 2 advocacy > legal recognition + technical support 2003 Linkages Law (décrets) via UEMOA / MS project 2004 Campaign took part in its organization Social dialogue advocacy, technical support > social / CNDS protection included in CNDS’s priorities LOASP (Loi d’orientation agro-sylvo pastorale)
How did this dynamic work? BIT/STEP Stage 3 New took part in formulation of the Strategy + 2005 SNPS / GR animals steering committee SNPS included in advocacy > inclusion of Social PRSP + PRSC protection in PRSP + PRSC’s action plan and financing; a powerful tool for poverty alleviation Contracting policy ongoing advocacy, training, with HC system with HC system technical support technical support organized : « réunion des organisations Social dialogue de travailleurs africains s/ protection sociale dans l’économie informelle » fund raising : 30 million dollars from the World Fund raising Bank for PRSC / SNPS action plan Agriculture workers & technical support, feasibility study, transport operators strategic and political orientations
How did this dynamic work? Ingredients of an ASAP (Adapted Social Security Action Plans) Gaps identification (who, what) State’s implication Very progressive & iterative process => towards quality insurance Coverage (governance, equity, efficiency) Stage 0 Stage 0 1 1 2 2 3 3 Built on past experiences & Built on past experiences & social capital social capital State Bottom up dynamic + Bottom up dynamic + political commitment => political commitment => priorities + fiscal decisions priorities + fiscal decisions SPS Sustainable financing & Sustainable financing & Resource mobilization Resource mobilization Social dialogue, trust and consensus building consensus building
How did this dynamic work? Types of linkages Mechanisms Actors MI schemes Subsidies / internal, external (local, national, international) Civil society organizations Contracting with HC providers State & local governments Sub-contracting technical Sub-contracting technical Social security institutions functions Private insurers Risk transfers (reinsurance, guarantee funds, …) Global social trust, global fund, donors Distribution of public goods HC providers (immunization, social assistance) Bargaining Service providers: TPAs … Regulation, control Private sector
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