The Council of Ministers met this Wednesday, October 4, 2023 under the chairmanship of His Excellency Mr. Faure Essozimna GNASSINGBE, President of the Republic. The council examined four (04) draft decrees and listened to three (03) communications. The work mainly focused on universal health insurance. At the opening of the proceedings, the Council of Ministers listened to a first communication relating to universal health insurance, in particular to the technical parameters of implementation, presented by the Minister of the public service, labor and social dialogue. This communication aimed to report to the Council of Ministers on practical proposals intended to enable the acceleration of the process of implementing universal health insurance. The Head of State, in accordance with his policy of social cohesion and harmony, promotion and development of human capital, instructed the Government to strengthen and extend social protection to all segments of the population. Thus included among the priority projects of the 2020-2025 Roadmap, universal health coverage was enshrined by Law No. 2021-022 of October 18, 2021 establishing universal health insurance in the Togolese Republic. The communication presented today to the Council of Ministers reaffirms the emphasis placed on equal access to essential or primary health care, on the quality of care and on solidarity. It formulates proposals based on the basket of care, contribution rates, the architecture of universal health insurance, and the provisional timetable for the integration of different categories of the population into universal health insurance. It should be remembered that the timetable for integrating the different layers and categories of members of universal health insurance begins on January 1, 2024. Ultimately, the success of accelerating the AMU process in our country requires collaboration. and the involvement of all: social actors, public authorities, citizens and technical and financial partners of Togo. The President of the Republic instructed the government to continue the inclusive approach and permanent consultation in the implementation of the process of deploying universal health insurance.
Under the draft decrees,
The council examined and adopted a first decree setting the benchmark care basket for universal health insurance for public sector employees and workers in the formal private sector. This text determines the detailed care basket of guaranteed benefits, taking into account the need to ensure basic health care and maintain the technical and financial balance of the system. It defines three groups or categories of people subject to universal health insurance:
– public and similar employees as well as holders of civil and military pensions;
– workers in the private sector, holders of private sector retirement pensions, ministers of religion, self-employed workers as well as people in the informal and agricultural sectors;
– vulnerable people.
It is specified that the different categories of taxable persons have the possibility of subscribing to complementary care baskets. The adoption of this decree ensures equitable access to essential health care for different segments of the population through universal health insurance. The council examined and adopted a second decree establishing the contractual framework between the management bodies and the delegated management bodies of universal health insurance. Law No. 2021-022 of October 18, 2021 establishing universal health insurance in the Togolese Republic provided for the possibility of delegation of certain skills and functions of the universal health insurance management body to delegated management bodies. This is to increase the efficiency of services, bring services closer to users and enable better communication between stakeholders. This decree therefore offers the possibility for organizations managing universal health insurance to rely on proven skills in this area and to strengthen proximity with the populations. It will make it possible to strengthen the efficiency, speed and good administration of universal health insurance. The council examined and adopted a third decree establishing the terms of access to health care services covered by universal health insurance. This decree regulates the conditions for granting rights of access to health care services, the different types of existing health facilities and defines the coordinated care pathway that the insured must follow. It makes it possible to regulate access to services guaranteed by universal health insurance. The council examined and adopted a fourth decree setting the rates, amounts and methods of recovery of social security contributions and other contributions due under the universal health insurance scheme. This decree defines the basis and rates of social contributions for those subject to the basic compulsory health insurance scheme, and specifies the methods of payment and recovery, defined and adapted according to the particularities of each category or group of subject persons, taking into account in particular the nature of their income. For people falling into the category of vulnerable taxable persons, a flat-rate monthly contribution is proposed, the amount of which will be set later. The adoption of this decree allows the AMU management body (INAM and CNSS) to have the legal instruments necessary to effectively begin the implementation of universal health insurance. It also makes it possible to establish equitable financing which takes into account the contributory capacities of each person.
In terms of communications,
The council listened to a second communication relating to the rural electrification project for 317 localities, presented by the Minister Delegate to the President of the Republic, in charge of energy and mines. Initiated in 2019, the rural electrification project for 317 localities using mini-solar networks consists of the construction of a mini solar power plant for each locality concerned and the deployment of low-voltage electrical networks for connecting households. In view of the general and localized developments making it necessary to update and recalibrate the scope of execution of this project, a new selection of localities for which electrification by mini-networks remains relevant is carried out on the basis of criteria relating in particular to distance, population density, concentration of habitat and consumption potential.