Case Study 13: L’UNION TECHNIQUE DE LA MUTUALITE MALIENNE

As of 2011, the mutuelles covered only 4% of the population, with a goal of reaching 40% by 2023. Membership in the mutuelles is voluntary and primarily consists of low-income populations residing in rural areas. A major challenge facing the mutuelles is the collection and management of membership contributions, which are CFA 6,000 (approximately 12.70 USD) per year. The Government of Mali subsidizes 50% of the membership contribution for many members, but even the subsidized premium is expensive for Mali's poorest residents. Traveling to a mutuelle facility to pay membership fees can be burdensome and create additional costs for members, particularly those living in remote rural areas. For the mutuelles, collecting membership contributions in-person is administratively complicated and costly, especially in hard-to-reach rural areas. In response to these challenges, UTM managers attended a workshop in Kenya in 2011, where they learned about the Kenya National Hospital Insurance Fund's (NHIF) use of M-Pesa, a mobile payment platform, to collect health insurance premiums from informal sector populations. Inspired by this experience, UTM managers began exploratory conversations with Orange Telecommunications, the mobile network provider in Mali with the most extensive coverage across the country. Over the next two years, UTM managers worked in partnership with Orange-Cash to design a mobile money payment system for collecting mutuelle membership contributions. The mobile money application, launched in September 2013, features a customized IT platform developed jointly by Orange and UTM to enable secure file transfer between the two institutions. This platform allows UTM administrators to register mutuelle members with Orange mobile accounts to the Orange-Cash program directly from the UTM office. As of June 2014, 300+ mutuelle members from across the country had paid premiums via mobile money, resulting in 500+ mobile money transactions. This number continues to grow. Key lessons learned from the implementation of the mobile money payment system include the importance of establishing an agreement with a network service provider, adapting a mobile money application to meet program needs, and educating program users about mobile money. UTM also faced challenges, such as resistance among users to pay transaction fees and providing customer-service to mutuelle members. To address these challenges, UTM staff worked with the telecom provider to ensure transparency about transaction fees and provided support to mutuelle members when needed. Looking forward, UTM and Mali's mutuelles aim to increasingly use mobile money to collect and manage premium payments, particularly as the mobile money ecosystem continues to develop in Mali and membership in mutuelles expands. UTM is also exploring a mobile-based payment mechanism to send claims payments to health providers.