Chad Government is engaged in an ambitious reform to make the Universal Health Coverage (UHC) legislation operational with its three pillars defined as follows: a) contribution-based scheme for the formal sector, b) contribution-based scheme for the self-employed (informal sector) and c) non-contributory, tax-funded scheme for the identified poor so-called AMED (Assistance médicale pour les personnes reconnues économiquement démunies).
To contribute to this strategy, a mandate is given to a dedicated unit, the CIC (Inter-ministerial Committee) – CSU (UHC), to work on the functional needs of AMED. The first results of CIC-CSU work are the existing official documents about the main orientations towards UHC. Another achievement of the CIC-CSU is the choice made for openIMIS as the management software, if its test is conclusive.
AMED is the first step of the UHC progressive implementation process.
The overall objective of this study is to propose an institutional and organizational configuration as well as to define in general the key operational processes of the AMED scheme that Chadian Government intends to test as part of its UHC three components.
This includes 5 expected outputs:
(i) An initial assessment of what is already planned on the institutional side, including stock taking of existing structures’ added value and taking into account that AMED’s setup has to contribute to the overall goals of the UHC system.
(ii) A review of AMED’s functional needs according to official documentation and ongoing discussions at the level of the CIC-CSU;
(iii) An AMED institutional building chart, including structures at central and decentralized levels and their general responsibilities considering the evolution towards the National Health Insurance and Solidarity Fund (NHIF); including its oversight mechanisms, stakeholders’ participation and clear accountability and reporting lines,
(iv) A description of the key procedures for starting AMED: simplified business process description (title, subtitle, objective) for the implementation of all required functions to be mapped against the functions and organizational structure of the scheme;
(v) A list and estimated quantity of human resources required for all required system functions.
The strategy to be implemented will be based on two elements: the analysis of the proposals made by the studies already carried out and in progress concerning the topics to be addressed, but also taking into account the realities of the country.
Exchanges with the CIC-CSU, the funder (GIZ) and also with the people who will be met during the data collection will contribute to achieving this objective. It is also planned to exchange from the start of the study with the consultants in charge of the ongoing studies related to AMED, which should be completed by the end of January 2021: (i) the targeting and enrolment of beneficiaries, (ii) the trust fund and (iii) the nomenclature of benefits.