Photo Credit Dominic Chavez

Momentous amendments to the Affordable Care Act were announced last week mandating all health insurance plans to provide women’s preventive services at no additional cost, including FDA approved contraceptive methods.

“The Affordable Care Act helps stop health problems before they start,” said US Department of Health and Human Services Secretary Kathleen Sebelius.  “These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need.”

These new regulations are considered groundbreaking in the United States, however similar regulations have been enacted in the developing world, creating an opportunity for the US to learn from the global South. 

In Mali, a community based health insurance scheme, known as mutuelles de santé, aimed at providing financial access to healthcare services to the 80% of the population without health coverage was adopted by the government earlier this year. The National Strategy for Expansion of Health Coverage through mutuelles and five year operational plan includes preventive services, among them, family planning.

This approach strives not only to expand affordable access to family planning as part of a sustainable health financing framework providing basic universal health coverage, but also, more simply to improve the health of all citizens. The benefits of family planning are well documented, including the spacing of pregnancies and preventing unintended pregnancies, thereby reducing maternal mortality and morbidity.  Including it as a covered benefit in a national insurance program could dramatically increase access to this preventive service, reduce the national macro health costs related to maternal health complications, and reduce the micro health costs to individual women and their families.  

The newly adopted national strategy will be piloted from 2011 to 2013 in three regions of Mali, something the US should pay close attention to in efforts to learn from the successes and challenges of including family planning as a covered benefit through health insurance.

Lord Nigel Crisp, in his book, ‘Turning the World Upside Down: the search for global health in the 21^st century’, writes that wealthy, developed countries stand to gain considerable knowledge in innovative ways to provide health services from poorer countries and thus ultimately contributing to an overall improvements in global health.

 “There is a great deal of technology, knowledge, and basic resources that need to be transferred from the rich world to the poor if the health of the poorest is to be improved. However, at the same time…pioneers and leaders in poor countries are developing new ideas and new approaches to health that may have real relevance and application in rich countries,” states Crisp.  

The idea of adding family planning services as a covered benefit to health insurance in the US is not a new one. It has been initiated and trialed in other parts of the world; and as Crisp writes, “We can all learn from each other.” North-South learning can serve as a pertinent process as the globe strives to improve maternal health, promote gender equality and address critical areas for action which include reproductive health outreach and education and provision of high-quality, accessible and affordable family planning services.