1. Second African Decent Work Symposium Yaoundé 6th - 8th October Panel Discussion 3 The Social Security Extension Challenge in Africa: Income security and health benefits 1

2. The Context Deprivation, poverty and vulnerability
Insufficiency of income
Numbers in poverty
Depth of poverty
Insufficiency of access to health care
Insufficiency of employment opportunity
Income maintenance, especially in old age

3. Health Care Influence on poverty
Catastrophic costs of health care
Prevalence of Out-of-pocket payments
Provision for formal and informal economy participants
Maintaining productivity of workers and enterprise
Infrastructural issues
Human resources, facilities, supplies

4. Income and livelihoods
Formal economy and enterprise
“traditional” social security schemes
Convention 102
Informal economy and enterprise
Basic package of social protection
Life-cycle approach
Particular vulnerable groups
Women
Migrant workers
......

5. Towards a Coherent Approach
Two dimensions
Horizontal - framework of Social Protection Floor
Vertical - formal schemes
Basis of rights
In constitution or law
Affordability
Adequacy
Fiscal space
Technical capacities
Administration, statistical, accounting, actuarial,...

6. Some Subjects for Debate
How can a realistic national strategy
to bridge the coverage gap between the formal and informal economies, and
build the social protection floor, including achieving universal coverage and access to health care
be defined?
How can fiscal space be preserved, freed and/or extended to ensure the financing of adequate benefit levels?
What is the role of social dialogue in addressing issues linked to financing, defining priorities and benefit packages of social security?
What activities supporting the reinforcement of capacities
for policy-makers, administrators, social partners
are needed the most?

7. Asking the questions…