Social and Solidarity Economy as Main Actor of the Extension of Social Protection in Health in Africa? (Draft)

From the 1990s, many mutual health organizations have been set up to provide social protection mechanisms to populations not covered by their national social protection systems. In various African countries, these organizations are expected to play a major role in the upcoming policies related to social protection. Mutual health organizations are expected to cover de facto about 80 per cent of the population. The inclusion of such organizations in public policies can be interpreted as recognition, in terms of capacity, of the Social and Solidarity Economy in providing service, governance and representation of the interests of the members. But the low number of mutual health organizations and their weak capacity to scale-up raise questions about the feasibility of such policies. This paper proposes an analysis of this paradoxical situation from both the perspective of public policies and the perspective of the social and solidarity economy.