The Mutual Health Organisation scheme, aptly described by the Lord Mayor of Santa, Wanki Clement as the “poor man’s health insurance scheme” was created because the greater majority of the population (over 60%) could not have access to quality health care and 98% of health care financing came from individual’s pockets.
But since 2004 when the first MHO was created in Kumbo, most people, especially those for whom it was created are not still making use of it because perhaps, they fail to understand its importance
Therefore, following an Open Day on Mutual Health Organisations in Santa, Mezam Division recently, TFV chose to bring you some excerpts from papers presented at the occasion to give clarifications to some important issues.

Role of Councils in the promotion of MHOs
- Considering that among the basic services Councils have a duty to provide to their populations, health care occupies a prominent position;
- Considering that an unhealthy population cannot contribute to development;
One can safely say that, for the creation and promotion of MHOs, Councils are indispensable partners
Firstly Councils are most well-placed to play the role of information, education and sensitization of the population on the objectives, importance and functioning of MHOs.
Secondly, at the initial stages and from time to time in the life of the MHOs, Councils may be called upon to give logistical support to these community-based institutions. For example, providing accommodation, venue for meetings and other organizational support

Thirdly, to ensure sustainability, Councils should participate in the putting in place of structures necessary for the management of MHOs e.g. election of the BOD and the recruitment of personnel.
Fourthly, if MHOs function normally, they will certainly bring about an upsurge in the number of persons soliciting health care leading to an increase in the use of medical facilities.

Fifthly, since Mayors are chairpersons of the Management Committees of District hospitals, they are in a good position to liaise with the local administration to guarantee legal protection to MHOs through fighting parallel practices that may lure patients away from the advantages provided by MHOs or members that may not play by the rules of the MHOs.

Sixthly, as the MHOs function, the Council should keep an eye on or follow up their activities to ensure that the rights of members are not being abused in one way or another.
Generally speaking, dear mutualists, ladies and gentlemen, Councils have to play an advisory role to all the actors involved in the management of MHOs. They are, as said at the beginning, indispensable partners in this endeavour.
(Excerpts from a paper presented by the Lord Mayor of Santa during the Open Day on Mutual Health Organisations).

Role of promoters in the development of MHOs
Promoters are people or institutions who try to make a community support an idea, those who spearhead the creation or implementation of the schemes.

Their role:
1.) Contribute to the formulation of policies, implementation of policies adopted by actors involved in the concept. (The national strategic plan, the mutuality code etc)
2.) Ensure that communities/populations are mobilized; participate actively in the promotion and development of the concept of mutuality.
3.) Implant, follow-up and control schemes in communities which have expressed a vested need.
4.) Collaborate with other actors (municipal authorities, administrative authorities, traditional authorities, the clergy, healthcare providers etc) to ensure that the schemes succeed by offering the services to members as prescribed in the texts.

5.) Organize joint reflection sessions in order to diagnose the problems, difficulties and constraints faced in the running of the schemes, and also organize forums which will permit other actors to share experiences, ideas and best practices so that others should learn from it in order to improve on the functioning of their schemes.
6.) Assist in designing communication and marketing strategies so as to increase outreach and involvement of other community members into the schemes. This might involve organizing and/or supporting sensitization, information and education campaigns in target areas.

7.) Provide technical and some times financial assistance to the schemes prior to take-off, start-up funds and putting at their disposal an advisory medical doctor.
8.) Train and empower elected management organs to assume their functions fully and also provide suggestions and recommendations after a follow-up mission and make sure that these are translated into concrete action.
(Excerpts from a paper presented by Stephen Ngenchi during the Open Day on Mutual health Organisations)

Role of MHO in improving population’s access to quality health care
A member of an MHO who makes his or her contributions regularly would benefit from the following services.
- Out patient consultations
- Admissions
- Delivery
-Surgeries
He is expected to pay only a small percentage of the total cost of care given.

Results obtained so far in the NWR
- Increased access of the population to health care (17, 000 eople benefited in the NW enrolled in 15MHOs
- Signing of contracts between MHOs and most peripheral health units (Integrated Health Centres)
- Careful treatment/handling of MHO members by some service providers
- Less waiting time in some health care units as a result of consciousness/presence of health care providers
- Proper reception of MHO members by service providers
- Provision of health care to vulnerable and informal sector workers - 167 paupers registered into Bamenda MHO by the Bamenda II and III Councils and now have access to health care with a very low moderating ticket

What is quality health care?
- Health care provided according to norms and standards
- Health care for which the user is satisfied
- Healthcare that is cost effective
- Through the services of a medical adviser who ensures that medical practice respects set norm and standards through verification of bills and feed back
He/she ensures that:
- Treatment guidelines are respected
- The health Unit does not issue very high bills to patients
- There is no exaggerated prescription of lab tests and drugs
- Mutualist don’t abuse the use of the schemes

The way forward
- Massive public education and awareness creation campaigns
- Involvement of all stakeholders (policy makers, administrators, NGOs etc)
- Authentication of micro health insurance through legislation
- Inclusion of modules on micro health insurance in curricula of medical schools
Conclusion
MHOs in Cameroon have proven to be a better option of financing healthcare by the population as it improves quality and access.
(Excerpts of paper presented by Dr Che Kingsley, Focal Point, MHO activities in the Delegation of Public Health, NWR)