National community health insurance at village level: the case from Guinea Bissau

The experience in Guinea Bissau of a voluntary levy scheme at village level, called 'Abota', makes one point very clear. Collective health insurance schemes at village level may be feasible and manageable in rural parts of Africa if the village population is allowed to decide on the amount of money and method of collection and if the government supports the scheme by guaranteeing sufficient drugs, low prices, effective control measures and a village health worker who is officiallly part of the national referral system.