Introduction: Managing a mutual health insurance scheme presents many challenges. The Centre Mgr Grison and the Saliboko Primary School, which conducted this survey with the aim of identifying the major problems in the management of mutual health insurance schemes that prevent them from functioning properly, determining the consequences of the malfunctioning of mutual health insurance schemes on members' access to care, and identifying the strategies to be put in place to ensure good medical care for members.

Methodology: We opted for a descriptive, cross-sectional approach based on the interview technique, which involved 50 members of the two mutual health organisations studied, selected according to the LYNCH formula, and two key informants.

Results: Regarding to the problems linked to the management of mutual health insurance, we noted low incomes (46%) and poverty among the managers of mutual health insurance (38%). In addition, bills are paid by the manager of the mutual health insurance scheme (54%), which is characterised by mistrust (48%), refusal to contribute is linked to poor access to medical care for members (64%) and over-billing by the health care provider is the main reason for the malfunctioning of the mutual health insurance scheme in terms of access to care (44%).As for strategies, 64% of respondents suggested re-explaining the raison d'être of the mutual health insurance scheme and 22% wanted recourse to donors.

Conclusion: The chaotic and non-transparent management of mutual health insurance schemes does not encourage members to have access to healthcare. This situation deserves to be treated with great consideration in order to promote access to healthcare. Unwavering support from the government is therefore essential.

Keywords: Management, Mutual health insurance, Accessibility, Medical care