In sub-Saharan Africa, a health problem can still plunge an entire family into poverty. Without adequate social protection, households finance their own healthcare, often at the cost of heavy sacrifices. Faced with this reality, community health mutuals are an essential lever for ensuring sustainable and equitable access to healthcare. However, they must be given the means to play their role fully.

Today, less than 20% of the African population has access to health-related social protection. And in sub-Saharan Africa, 94% of the poorest and 97% of those living in extreme poverty are not covered or are inadequately covered (World Bank, 2025). A very large proportion of healthcare financing is therefore borne directly by households, exposing them to a significant risk of poverty.

Behind these figures are human beings and everyday realities that are unimaginable to Westerners: a father who hastily sells part of his harvest to pay for medicine to cure his son, knowing full well that there will not be enough food for the rest of the family. Or an expectant mother in labour praying that her family will raise the money needed for the caesarean section that will save her and her child.

A goal not yet achieved

So what about African social protection systems? Today, the overall goal is to achieve universal health coverage (UHC), meaning that everyone has access to health services without facing financial hardship. UHC is one of the targets that countries around the world set themselves when they adopted the United Nations Sustainable Development Goals (SDGs) for 2030 in 2015.

However, it must be acknowledged that there is still a long way to go. For more than 20 years, Louvain Coopération has been fighting for access to healthcare in Benin, Togo and Burundi. It does so through the development and structuring of mutual health organisations at municipal and regional levels, but also through political advocacy, aimed at convincing governments to invest in this fundamental issue.

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