The Healthcare System in Cabo Verde: Public, Private, Access to Care and Health Risks

Cape Verdean healthcare relies on public health centres and hospitals spread across the islands, supplemented by a private sector. In its useful links, the Ministry of Health cites the Dr Agostinho Neto Hospital, in Praia, and the Baptista de Sousa Hospital, in Mindelo; the ministry’s contact details are +238 261 01 16 and minsaude@gov.cv. According to the World Bank, the country spends about USD 290 per capita on health, or about 6% of its GDP, has fewer than one doctor per 1,000 inhabitants and shows life expectancy of about 76 years. Households directly finance 25.7% of health expenditure.

France Diplomatie nevertheless indicates that local medical capacity is weak and that access to medicines may be limited. It names no facility and describes no medical evacuation procedure: this goes through the assistance provider of the contract taken out.

According to CLEISS (the French liaison centre for social security abroad), the INPS pays most of the benefits of the Cape Verdean social security scheme. Care is covered for insured people and their dependants, with a patient contribution that varies from 15 to 50% for workers and from 5 to 45% for retirees; care is free for pensions below 2.5 times the monthly minimum wage. Sickness daily allowances reach 70% of the average salary of the last four months from the fourth day for employees, and maternity, paternity and adoption allowances 90%. Employees contribute 4% for sickness-maternity, the employer 4% as well.

A foreign employee declared by their employer comes under this scheme, France being linked to Cabo Verde by a social security agreement in force since 1 April 1983: employees come under the legislation of the country where they work, except in cases of secondment. The conditions of access for a non-employed resident should be confirmed with the INPS (avenida Amílcar Cabral, Praia, +238 260 91 00). The page on healthcare reimbursement in Cabo Verde details each situation.

The official pages consulted do not describe a family-doctor system comparable to that of France: a resident chooses a doctor or a facility according to their cover, checking with their insurer or the INPS which facilities are concerned. France Diplomatie notes the absence of a helicopter for mountain evacuations, notably on Fogo, and the absence of a decompression chamber for diving.

The France Diplomatie page publishes no medical emergency number for Cabo Verde. Useful points of reference are the French embassy in Praia (+238 260 45 35 during office hours, +238 991 21 29 outside office hours in cases of absolute necessity) and the contract’s assistance provider. At sea, there is no rescue service and swimming is not supervised.

France Diplomatie points out that access to medicines may be limited: regular treatment is prepared by taking the quantity needed for the stay, with a prescription and if possible a prescription using the international nonproprietary name. It is useful to check with your doctor or the embassy the availability of the prescribed product before settling in.

For a chronic illness, a recent medical report, the insurer’s prior agreement on coverage of treatments and an evacuation plan make any care easier. Passing travellers can enter their contract number in the Ariane system.

The French vaccination schedule must be up to date (diphtheria, tetanus, polio, whooping cough, measles). Depending on the stay, France Diplomatie mentions yellow fever (mandatory for travellers coming from endemic areas), hepatitis A and B, typhoid, tuberculosis for children under 15 on frequent or long stays, rabies, chikungunya and dengue depending on the epidemic or the length of stay.

Malaria gives only rare sporadic cases, limited to the island of Santiago (Praia). Dengue has no curative treatment and anti-inflammatory drugs should be avoided. Zika, which calls for particular vigilance for pregnant women, is reported sporadically, mainly on the Leeward Islands (Brava, Fogo, Santiago, Maio) during the rainy season, from August to October. Typhoid, hepatitis A, rabies and tuberculosis are prevented by hygiene, vaccination and caution around animals.

Before departure, a check-up with the family doctor and the dentist avoids having to look for scheduled care on the spot. The vaccination record is up to date, usual treatments are taken in sufficient quantity, and the insurance contract is checked on three points: cover for air evacuation, handling of pre-existing conditions and conditions of direct payment on the island of residence.

On the spot, it is useful to save the embassy number and that of the assistance provider, to identify the facility closest to home and to register with the Ariane system. For outdoor activities, France Diplomatie reminds travellers that currents and waves are often strong, that swimming is not supervised and that mountain or dune excursions are done with a Cape Verdean guide. Travellers by sea notify their arrival and departure to the port authorities.

France Diplomatie asks for an assistance contract or insurance covering medical costs, surgery, hospitalisation and medical repatriation; without this cover, access to care may be refused, even in a life-threatening emergency, and the embassy does not pay these costs. It also invites travellers to check their insurance for air medical repatriation. The contract is compared on the annual ceiling, evacuation, the handling of pre-existing conditions and direct payment.

The notions of medical evacuation and medical repatriation help to read the offers; the page on expat health insurance presents the solutions, and Expavy helps to compare them against your situation. For settling in, see living in Cabo Verde.