Strengthening Role of Cooperatives and Mutual Societies in Healthcare and Social Protection

The conference aimed to advocate for their better integration into international, regional, and national systems to enhance universal health coverage and social protection.

The International Mutualist Conference, held in Bujumbura, Burundi, and online on February 3-4, 2025, brought together experts, policymakers, and representatives from the International Labour Organization (ILO) to discuss the critical role of mutual societies in providing healthcare and social protection services worldwide. Despite their significant contributions, mutual societies remain under-recognized in national policy frameworks. The conference aimed to advocate for their better integration into international, regional, and national systems to enhance universal health coverage and social protection.

Mutual Societies and the Social and Solidarity Economy (SSE)

The event focused on the broader theme of the social and solidarity economy (SSE) and its role in promoting decent work, social justice, and sustainable development. The discussions were aligned with the ILO resolution concerning decent work and SSE, as well as the United Nations General Assembly resolutions (2023, 2024) emphasizing the importance of SSE in achieving the 2030 Agenda for Sustainable Development. These resolutions present a key opportunity for mutual societies to highlight their contributions to Sustainable Development Goals (SDGs) such as:

• SDG 3: Good health and well-being
• SDG 8: Decent work and economic growth
• SDG 11: Sustainable cities and communities

Furthermore, both the European Union and African Union have recognized SSE entities, including mutual societies, as crucial in advancing decent work and social protection.

ILO's Emphasis on Mutual Societies' Governance and Contributions

During the high-level panel, Simel Esim, Head of the ILO Cooperative, Social and Solidarity Economy (COOP/SSE) Unit and Chair of the UN Inter-Agency Task Force on the Social and Solidarity Economy (UNTFSSE), highlighted the democratic and participatory governance structures of mutual societies. She stressed that these organizations prioritize social impact over financial gain and have been instrumental in advancing universal health coverage, particularly for informal workers and marginalized populations.

Esim called for lifting legal and administrative barriers to enable mutual societies to scale up their operations. She also underscored that the UNTFSSE provides an avenue for mutual societies to strengthen their presence in global policy discussions, expand partnerships, and influence national and international strategies. She further encouraged engagement with multilateral initiatives such as the Global Coalition for Social Justice and the Global Accelerator on Jobs and Social Protection for Just Transitions.

Models of Mutual Society Participation in Social Health Protection Systems

A key thematic workshop at the conference explored the role of mutual societies in national social health protection systems, based on insights from an ILO working paper. Mathilde Mailfert, Technical Officer at the ILO, outlined five models of mutual participation in these systems:

1. Management Delegation: National agencies delegate key management functions for basic social protection coverage to mutual societies, which operate with limited autonomy.
2. Decentralization: Public insurance schemes are implemented by autonomous mutual entities targeting specific groups.
3. De-concentration: Public or semi-public participatory entities manage local or proximity functions, operating with only modest autonomy.
4. Absorption: National social protection systems incorporate pre-existing mutual societies and community health insurance schemes, benefiting from their expertise.
5. Non-involvement: In contexts lacking a national scheme, mutuals step in to offer supplementary or even basic coverage independently.

Mailfert emphasized that there is no universal model for integrating mutual societies into social health protection systems; rather, context-specific solutions are necessary to ensure effectiveness and sustainability.

Call for Strengthened Partnerships and Policy Support

The discussions at the conference reinforced the necessity of integrating mutual societies into national and global SSE platforms. Participants called for:

• Greater engagement of mutual associations in policymaking processes.
• Stronger partnerships between mutual societies, international institutions, and national governments.
• Development of legal and institutional frameworks that support the growth and recognition of mutual societies.

The conference concluded with a collective commitment to amplifying the role of mutual societies in achieving universal health coverage and enhancing social protection systems worldwide. Moving forward, efforts will focus on strengthening collaboration, advocating for policy inclusion, and ensuring that mutual societies receive the necessary support to continue serving millions globally.