Digital Pathways to Expanding Private Health Insurance in Cameroon

By Dr. Solange Dabou, Dr. Constantine Asahngwa and Dr. Ronald Gobina

Introduction

In sub-Saharan Africa, 27% (320 million people) of the population have access to mobile internet and 44% (527 million unique subscribers) now use mobile phone technology, with 51% of SIM connections done through smartphones according to the 2024 GSMA Intelligence report. This uptake of digital technologies has found applications in almost every aspect of human life in professional settings and otherwise. In the healthcare space, this spike in use of digital technologies is transforming health service delivery globally, opening avenues for achieving health equity and universal health coverage in low-resource settings.

In Cameroon however, financial barriers are among the most common obstacles to health equity and well-being for all, with majority of the population paying out-of-pocket for health services at the point of care. This exposes Cameroonians to catastrophic health expenditures and deepens poverty and social inequalities, especially among the most vulnerable populations. There is evidence that private prepayment mechanisms can improve access to healthcare and offer financial security, even to people with very limited resources. These mechanisms include private commercial health insurance plans and community-based, non-profit schemes offered by healthcare providers, NGOs, or local associations. Private Health Insurance (PHI) in this brief will refer to schemes offered by private commercial entities.

While (PHI) has shown potential to reduce health financial burden alongside other health protection mechanisms, its penetration rate in Cameroon remains extremely low. Less than 4% of Cameroonians  are currently covered by a PHI scheme, leaving households vulnerable to financial hardship in case of illness. The main barriers to PHI adoption in Cameroon are reported to be unaffordability (high cost of premiums), complexity of enrollment and claim management procedures, lack of trust in existing schemes and limited awareness. Digital innovations offer practical solutions to address these gaps; mobile enrollment platforms, electronic claims management, and data-driven product design among others can contribute to increased accessibility and affordability of PHI schemes, improved service delivery and insurance literacy. This paper examines how digital technologies can strengthen private health insurance delivery in Cameroon and provides insights to guide policymakers, insurers, and partners in leveraging technology for expanded coverage.

The potential of digital technologies in improving private health insurance services

Digital technology is reshaping insurance service provision globally, providing innovative, simple, efficient and affordable solutions to existing challenges in cost and enrollment procedures, claim management, design of benefit packages, funds pooling and redistribution, and access to healthcare.

Increasing access and affordability

The proportion of mobile connectivity via smartphones has skyrocketed in Cameroon over the last decade, rising from less than 1% (2010) to more than 40% (2020) of all mobile connectivity, offering a ready platform for mobile applications-based PHI innovations. Indeed, enrollment to PHI schemes through mobile applications can simplify enrollment processes and insurance membership status updates, thus efficiently addressing the current lengthy and bureaucratic nature of PHI operations in Cameroon and increasing accessibility. The development of mobile applications’ user-friendly interfaces involves emerging technologies such as data analytics, automated algorithms, machine learning and AI tools.

Automated algorithms can also be used to generate fair and affordable premiums, thus reducing inequalities. Several digital innovations are designed specifically to reach underserved populations such as informal sector workers and low-income individuals. A case study from Nigeria reveals that digital insurance management systems have the potential to boost insurance enrollment, particularly among poor households. For these subgroups of the population, registration through mobile phone, and mobile money payment options channel affordable and accessible solutions. In addition, digital technology can improve health insurance literacy, thus increasing willingness to pay and enroll.

Improving efficiency of operations and customer satisfaction

With the development of Machine learning, insurance providers in other regions of the world are now able to offer fast, accurate and efficient coverage to subscribers. Although they remain under-utilized Cameroon’s insurance sector, technologies such as blockchain and smart contracts enhance interactions between individuals and insurance providers, offering secure, fast and reliable communication  and data sharing  platforms. In Kenya for example, ACRE Africa an insurance intermediary company tested the use of smart contracts in climate insurance to improve experiences for climate-impacted smallholder farmers. Preliminary results showed an average reduction of payout times by 64%, improved efficiencies, reduced administrative costs and 27% increase in coverage for farmers.

Blockchain and AI tools can also be used for health insurance fraud detection and prevention, thus increasing providers’ trust and commitment to quality service delivery. An innovation known as Connected health insurance, based on the Internet of Things (IoT) and integrating wearable devices and mobile applications enables the efficient connection of all stakeholders (insurers, health service providers, consumers) for data sharing and data informed decisions and programs. This model enhances customer experience, improves risk prediction and management, optimizes costs and contributes to the customer’s overall wellbeing through health promotion programs. However, creating a conducive environment for the emergence of PHI innovations based on these technologies while preventing their pitfalls require strong governance and interoperability frameworks, which are still nascent in Cameroon.

Improving access to quality healthcare services

The benefits of digital health technologies are widely recognized today to the extent of being considered as a new determinant of health. Mobile health and telemedicine increase access to quality care and specialized services, especially for rural and remote communities.  Adoption of digital technologies leads to enhanced awareness and accessibility of health information for communities and healthcare professionals, as well as advances in the safety and quality of healthcare services and goods. This improved healthcare access increases demand for services, raises awareness of health insurance, and enables insurers to offer affordable, data-driven products.

Challenges of integrating digital solutions in private health insurance delivery in Cameroon.

While the potential of digital technologies in improving health insurance service delivery and coverage in Cameroon is undeniable, there is a risk of deepening social inequalities, with digital solutions benefiting mostly wealthier households who can afford stable power supply, electronic devices and permanent internet connections. Indeed,  only 17% of households in rural Cameroon have access to reliable internet, compared to 68% in urban centers. High costs of internet connectivity, frequent power cuts, weak network coverage combined with low trust in digital systems, reduce the willingness of individuals and providers to adopt digital solutions even when they are available. According to a survey conducted across the country, 48% of Cameroonians express dissatisfaction with the cost of their internet connection, and 55% with the reliability of their electrical and power supply. Poor infrastructure limits the consistent functioning of digital innovations and the digital divide could exacerbate existing inequalities in healthcare access and financial protection.

Another barrier to a widespread adoption of PHI digital solutions is the low level of digital literacy among both health workers and the public. Several health facilities lack trained personnel to keep digital systems running smoothly, limiting operationalization of PHI digital tools at the point of care.

On the governance side, gaps in data protection policies and unclear rules for sharing health information create privacy concerns and make insurers cautious about using digital platforms. These issues slow down the spread of digital tools that could make private health insurance more transparent, efficient, and widely accessible.

Conclusion

Without deliberate investment, private health insurance coverage will stay below 4% in Cameroon, leaving households financially vulnerable when confronted with health problems. Digital technologies offer an opportunity to address this issue by transforming PHI through improved enrollment, claims processing, and overall access to quality care. However, without addressing infrastructure gaps, building digital skills, and strengthening governance and trust, this potential will remain underutilized. A coordinated effort between government, insurers, health providers, and technology stakeholders is needed to create an enabling ecosystem that makes digital health insurance solutions reliable, inclusive, affordable, and user-friendly.

Policy Recommendations

The study of effective models for integrating digital health insurance management systems reveals that a favorable policy environment, public-private-partnerships, and sustained stakeholder engagement and training are the main drivers. To satisfy these conditions in Cameroon, localized interventions with expansion potential need to be implemented, to build strong foundations for systemic reforms. These include:

1. Building Digital Literacy and Capacity

The government, civil society organizations and tech companies should develop and implement digital skill building programs for health workers, insurers, and end-users to improve adoption and proper use of digital platforms.

2. Strengthening Digital Infrastructure

In addition to more investments in reliable internet connectivity, electricity supply, and network coverage, it is important to design accountability mechanisms to ensure the maximum quality of service from public and private mobile companies.

3. Enhancing Data Governance

A clear policy framework is necessary to prevent possible downsides of digital technologies’ adoption. It is necessary to enforce data protection mechanisms/policy, improve digital systems interoperability, and establish independent oversight to build trust in digital health data use. In addition, adoption of sandboxes, as illustrated by Datasphere Initiative could help to regulate and control the development of digital health insurance solutions.

4. Promoting Inclusive and Affordable Solutions

The government and civil society organizations should work together to identify, assess and support scalable models of low-cost, mobile-friendly insurance products targeting particularly low-income and rural populations.