Fabienne Richard, Matthieu Antony, Sophie Witter, Allison Kelley, Isidore Sieleunou, Yamba Kafando, and Bruno Meessen

Photo Courtesy of The Gates Foundation via Flickr
Several countries have recently introduced maternal health care fee exemptions as a quick win approach to reach MDG 5 goals. It has also been argued that these policies were relevant first steps towards universal health coverage (UHC). The scope and contents of the benefits package covered by these policies vary widely. First evaluations raised questions about efficiency and equity. This article offers a more comprehensive view of these maternal health fee exemptions in Africa. We document the contents and the financing of 11 of these policies. Our analysis highlights (1) the importance of balancing different risks when a service is the target of the policy – C- sections address some of the main catastrophic costs, but do not necessarily address the main health risks to women, and (2) the necessity of embedding such exemptions in a national framework to avoid further health financing fragmentation and to reach UHC.
I thank you for this these importants documents full of lessons towards UHC. I hope that our African governments will be aware of them and take them into account in the implementation of the policies related to free cares.