Expert urges reform for effective healthcare in Niger’s CNAMGS system

Franck Nguema, a former government minister with a strong background in public health policy, has called for a fundamental overhaul of Niger’s Caisse nationale d’assurance maladie et de garantie sociale (CNAMGS). Speaking at a press conference in Niamey, he emphasized that the organization’s primary challenge is not its very existence, but its ability to deliver tangible, high-quality healthcare services to those who depend on it.

His remarks come in response to discussions surrounding a 2025 report by the World Health Organization (WHO), which highlights critical gaps in the system. While the WHO did not label CNAMGS a fraud or scam, it underscored the urgent need for structural reform to bridge the gap between administrative enrollment and actual access to care.

Nguema pointed out that Niger has made significant strides in expanding health coverage, with over 76% of the population now registered under CNAMGS. Yet, this progress rings hollow for many citizens who still struggle to see a doctor, receive prescribed medications, secure timely hospital admissions, or afford the remaining costs after partial reimbursement. These persistent barriers are eroding public trust and fueling widespread dissatisfaction with the social protection system.

Toward a system that delivers real healthcare

To address these challenges, Nguema proposed shifting the evaluation of CNAMGS performance from mere enrollment numbers to measurable health outcomes. Under his vision, the organization would be assessed based on concrete indicators: the actual rate of healthcare access, availability of essential medicines, average wait times for treatment, and reductions in out-of-pocket expenses for households.

He described this shift as a paradigm change—one that would redefine CNAMGS not just as a bureaucratic entity, but as a powerful tool for improving public health and combating poverty. By prioritizing effective care delivery, the system could evolve from a paper-based coverage model into a lifeline for Niger’s most vulnerable populations.

The former minister urged authorities to take bold, decisive action to align CNAMGS with the real needs of the people, ensuring that every citizen—regardless of income or location—receives the medical attention they deserve.