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Paper short abstract:

This paper focuses on mobile-based projects to improve financial accessibility of healthcare. It compares two programs deployed by Telcos in Africa in the past years to finance access to healthcare through mobile money services ; services that represent brand new forms of social protection.

Paper long abstract:

Many health actors as well as Telcos have promoted the potential benefits of "mHealth" in Africa. In developing countries where banking enrolment is low, mHealth is matched with mobile banking services that allow individuals to pay health expenses via mobile money. These services represent brand new forms of social protection that need to be analyzed. Based on qualitative research done in Ghana and Kenya, this paper compares Airtel insurance - a free micro health insurance offered by Airtel in 8 African countries - and M-TIBA, Safaricom's mobile wallet dedicated to health expenses launched in Kenya.

In one of the most "uninsured" part of the world, these programs constitute a commercial response to a burning international public health issue : universal health coverage. Shedding light on the lack of a welfare state, these services promise their first health coverage to Africans that fall into debt to cover medical costs. Because mobile markets in Africa are dominated by prepaid users - 90% of customers buy credit as they go and repeatedly switch operators - mobile based health insurances are strongly related to the construction of sustainable and profitable mobile markets in a competitive and unstable African context. Indeed, health coverage comes here as a "stickiness" program ; a bonus for loyal customers and a way to keep them. This paper analyzes strategies, and resistances that characterize these programs and highlights the market implications that make them rise and shine or collapse in a day.