Table 2

The key events that made the process of RAMU policy

DateKey events
2004–2006Discussions on the ideas and draft statuses and internal rules of a health insurance scheme for public workers by the representative of Ministry of labour and Civil service and Ministry of Health with the support of the International Labour Organization.
2007Organisation of the ‘Etat généraux de la santé’ by the government where healthcare financing issues were discussed by the health system actors. The workshop recommended to the Government to set up health insurance scheme for the population.
Public Health Insurance coverage remains an option for healthcare financing.
2008Universal Health insurance coverage has been put into political agenda by the government (29 May 2008).
Setting up of the ‘omité Technique Interministériel’ (interministerial committee) under the leadership of the Ministry of Health.
Visiting studies to learn from the experiences of countries that are in advance on the issue.
2009–2010Adoption of the concept of RAMU (July 2009).
Technical support from international organisations (French Agency for the Development, WHO, World Bank, Belgian Technical Cooperation).
Organisation of several workshops with the participation of many institutions including the trade unions, representative of the providers, Mutual health organisations, civil society organisations, Private insurance compagnies.
2011Appointment by the government the Director General and the Deputy Director General of The National Health Insurance Agency (August 24, 2011).
Official launching ceremony of RAMU development by the President of the Republic (19 December 2011).
2012Joint experts’ mission from the World Bank, WHO, Belgian Technical Cooperation, USAID to operationalise the RAMU implementation strategy (February 2012).
Creation of the National Health Insurance Agency (9 May 2012).
Launch of first operational phase and symbolic delivery of the first insurance cards by the Minister of Health to mutual members of the Municipality of Nikki (28 May 2012).
2013Signature of agreement with health facilities (18 March 2013)
Launch of multiple awareness, information and social dialogue campaigns around the concept (4 October 2013)
Decrees relating to the identification of health facilities and diagnostic centres to be agreed under the RAMU (9 July 2013). Establishment of a healthcare benefits package under the RAMU and establishment of an indicative list of reimbursable drugs under the RAMU.
TWG-NHI to lead discussions for the harmonious implementation of universal health coverage was established
Workshop on health financing in Benin (June 2013).
Adoption in the Council of Ministers of the unique method of identifying the poorest.
First Launch of pilot implementation phase one in six health districts: Cotonou 6, Nikki-Kalalé-Péréré, Cové-Ouinhi-Zangnannado Porto novo-Sémé-Aguégué, Bassila and Comé-Bopa-Houéhouogbé.
The RAMU bill was submitted to the Parliament (Decree no 2013-507, 24 December 2013).
2014Creation of the RAMU National Steering Committee by decree no 2014-361 of 16 June 2014).
RAMU implementation conditions workshop (February 2014).
2015Vote by the Parliament of the law on universal health insurance in Benin.
2016Promulgation of the law on RAMU by the President of the Republic (7 March 2016)
Second launch of the pilot implementation phase with support from the World Bank. The target concerns the extreme poor and covered eight health districts: Lokossa-Athiémé, Ouidah-Kpomassè-Tori, Porto-Novo-Aguégué-Sèmè, Adjohoun-Bonou-Dangbo, Zogbodomey-Bohicon-Zakpota, Covè-Ouinhi- Zandjannado, Banikoara and Kérou-Kouandé-Péhunco in August 2016.
Discussions about the abolition of RAMU policy during the formulation of the Government Action programme 2016–2021 (April 2016).
2017Abolition of the RAMU policy and adoption of a new Health insurance project Called Projet d’Assurance pour le Renforcement du Capital Humain by the new elected government Agenda.
  • NHI, National Health Insurance; RAMU, Régime d’Assurance Maladie Universelle.