ILO Global Flagship Programme on Building Social Protection Floors for All

Overview

Duration: December 13, 2021 - September 30, 2026

Development partners: Ministry of Foreign Affairs, Foreign Trade and Development Cooperation, Belgium and Ministry of Foreign and European Affairs, Defence, Development Cooperation and Foreign Trade, Luxembourg

Reference: GLO/21/34/MUL

Implemented with the support of the Governments of Belgium and Luxembourg, the Multi-donor Programme in support of the second phase of the ILO Global Flagship Programme on Building Social Protection Floors for All has supported six countries—Burkina Faso, Burundi, the Democratic Republic of the Congo (DRC), Rwanda, Senegal and Lao PDR—as well as regional initiatives in Southeast Asia, West and Central Africa to strengthen and build inclusive, sustainable and rights-based social protection systems.

With a strong focus in supporting ILO constituents in country, the programme combined technical assistance, policy dialogue, institutional capacity development, knowledge generation and South–South cooperation to address one of the key challenges facing social protection systems worldwide— how to effectively reach workers in the informal economy. The expansion of social protection coverage to workers in the informal economy and their families has also supported the transition to the formal economy, in line with the Social Protection Floors Recommendation, 2012 (No. 202) and the Transition from the Informal to the Formal Economy Recommendation, 2015 (No. 204).

By bringing donors together around shared priorities, the multi-donor programme enabled more strategic and efficient use of resources while strengthening coherence across the ILO’s work. It increased the reach, impact and visibility of the Belgium and Luxembourg’s contributions, while creating opportunities to leverage complementary funding, expertise and partnerships..

Programme objectives

The project supported countries in building stronger, more inclusive and sustainable social protection systems, with particular attention to extending protection to workers in the informal economy and others who remain uncovered. Alongside country-level support, the project fostered regional cooperation, knowledge exchange and learning across countries.

Country-level and regional objectives were as follows:

Burkina Faso — Support the implementation and expansion of universal health insurance (RAMU), including the progressive extension of health protection to workers in the informal economy and their families.
Burundi — Strengthen the social protection system and develop practical pathways for extending social security to informal economy workers and other groups that remain inadequately protected.
Democratic Republic of the Congo — Support the development and implementation of Universal Health Coverage by strengthening its legal, institutional and financing foundations.
Lao People’s Democratic Republic — Strengthen the effectiveness, sustainability and inclusiveness of the National Health Insurance system and support the further extension of social health protection.
Rwanda — Develop practical solutions to extend effective social security coverage to workers in the informal economy, while strengthening the institutions and mechanisms needed to reach them.
Senegal — Support the extension of social protection to workers in the informal economy through the Simplified Social Security Scheme for Small Taxpayers (RSPC), including new approaches to facilitate enrolment and contributions.
West Africa — Strengthen regional institutions and cooperation, particularly through UEMOA and CIPRES, so that countries can learn from one another and accelerate the extension of social protection, especially to workers in the informal economy.
Asia and the Pacific — Strengthen regional cooperation on social health protection through CONNECT, bringing institutions together to develop knowledge, build capacities, provide technical support and promote South-South learning.

Key achievements

Overall, the project contributed to the achievement of 24 institutional changes and improved social protection coverage for over 9 million people across six countries.

The programme primarily supported the legal, technical and institutional foundations of Burkina Faso’s Universal Health Insurance (RAMU), helping to operationalize the scheme and extend social health protection to workers in the informal and rural economy and their families.

Key achievements

Over 400,000 members registered with the RAMU providing them and their family members gradually with subsidized access to health services.

11 decrees and three ministerial orders supporting RAMU’s operationalization were in place by end-2025, including provisions on the benefit package, contribution rates and contracting with healthcare providers.

3,102 healthcare providers were contracted under the RAMU by 2026, while more than 200 providers in the South-East and Centre-East regions were trained with ILO support on RAMU tools and procedures.

An extension strategy and automatic-enrolment mechanisms were developed to expand RAMU to informal-economy workers in 2025 and are under final approval.

Learn more about the programme’s work in Burkina Faso.
In Burundi, the multi-donor programme supported the finalization, dissemination and operationalization of the National Social Protection Policy with a focus on the needs and priorities of workers in the informal economy and other vulnerable groups.

Key achievements

The National Social Protection Policy and its implementation strategy were adopted in 2024, establishing a ten-year framework for the development of Burundi’s social protection system.

A feasibility study on extending social security to the informal economy informed a roadmap covering five priority groups: fishers, informal transport workers, domestic workers, independent workers and agri-food cooperative members and as a first step towards implementation the revision of the modalities for employers’ affiliation, workers’ registration, and the collection of social security contributions to facilitate the enrolment of salaried workers in the informal sector into the social security schemes managed by the National Social Security Institute.

The Social Security Inquiry (SSI) was adopted as Burundi’s national reporting tool, strengthening the availability of social protection coverage data and providing an evidence base for policy development and monitoring. A multisectoral technical committee on social protection data collection was established and trained to strengthen coordination of social protection interventions across sectoral ministries and support the regular monitoring and evaluation of national efforts to expand social protection coverage.

Harmonized guidelines for Employment-Intensive Investment Programmes were developed to improve coordination across public works programmes and strengthen their links with the social protection system, supporting more coherent and effective implementation.

A feasibility study for establishing a social insurance maternity benefit scheme was conducted, with technical guidance provided on its institutional design, sustainable financing mechanisms, and coordination arrangements, etc.

Learn more about the programme’s work in Burundi.
In DRC, the multi-donor programme supported the extension of social protection coverage, particularly through social health protection.

Key achievements

ILO support contributed to the legal and institutional framework for Universal Health Coverage, including the 2023 revision of the Public Health Law and the development of seven implementing legal texts covering compulsory health insurance affiliation, contributions, benefits, registration and medical control.

A financial feasibility study and simulation tool were developed to assess financing options for public health insurance over its first five years, including different contribution scenarios. A complementary study was launched to categorize informal-economy workers according to their socio-economic characteristics and contributory capacity, providing a basis for adapting insurance arrangements to different groups.

The operationalization of the Health Solidarity Fund supported the launch of free maternity and newborn care in Kinshasa: 52,305 deliveries were financed between September and December 2023, representing more than US$6.7 million in healthcare expenditure. Since 2024, coverage has been progressively expanded to the provinces of Kongo-Central and Kasai-Oriental. As a result, the programme financed 243,111 deliveries across the three provinces between January and December 2024, increasing to 487,271 deliveries in 2025.

The first Social Protection Statistical Bulletin for 2023 was developed and published in 2024 in collaboration with the Ministry of Public Health, Hygiene and Social Welfare (MSPHPS), strengthening the evidence base for monitoring social protection coverage and informing policy development. A second bulletin is currently being prepared and will be published in collaboration with the MSPHPS, further supporting data-informed policymaking and implementation of Universal Health Coverage.

Learn more about the programme’s work in Democratic Republic of the Congo.
In Rwanda, the multi-donor programme supported social protection as a key lever for formalization while advocating for more comprehensive and adequate social protection aligned with international labour standards.

Key achievements

A study on extending social protection to informal-economy workers informed an implementation plan developed by the Ministry of Public Service and Labour and the Rwanda Social Security Board. It includes an aggregator approach, builds on lessons from two sectoral prototypes, and has informed efforts to extend social security to dependent contractors and self-employed workers. The Rwanda Social Security Board operationalized new delivery mechanisms, enabling automatic enrolment and contribution payments for informal economy workers and improving the efficiency of registration and collection systems.

A costing study for unemployment insurance developed three design options aligned with ILO Conventions Nos. 102 and 168, providing a pathway towards more comprehensive social security coverage and stronger links with employment services.

The Government of Rwanda confirmed its commitment to promote social protection and decent jobs by becoming a pathfinder country under the Global Accelerator on Jobs and Social Protection for Just Transitions.

Learn more about the programme’s work in Rwanda.
In Senegal, the multi-donor programme supported the implementation and expansion of Senegal’s Simplified Regime for Small Contributors (RSPC), strengthening access to and comprehensiveness of social protection for artisans and other workers in the informal economy.

Key achievements

Over 60,000 members of the National Social Mutual Fund for Artisans (MSNASA) and their family members have access to health care services.

14 regional units of the MSNASA were established – exceeding the initial target of four – creating a nationwide structure for reaching and supporting informal-economy workers.

More than 530 leaders of socio-professional organizations were trained to support outreach and enrolment and support to contracting health care providers led to the MSNAS signing agreements with 893 healthcare providers nationwide by 2025.

A national strategy and roadmap for the systematic enrolment of informal-economy workers in health insurance was developed and validated in 2025, following a participatory process involving more than 80 stakeholders per workshop across four national workshops.

Two management-delegation agreements between MSNASA, the Senegal Pension Fund (IPRES) and the Social Security Fund were developed and signed, laying the foundation for informal-economy workers to access old-age, invalidity, survivors’, family, employment injury and occupational disease benefits.

Learn more about the programme’s work in Senegal.
In Lao People’s Democratic Republic, the multi-donor programme supported a more effective and financially sustainable National Health Insurance (NHI) system, while strengthening social security administration, compliance and access to entitlements.

Key achievements

The NHI Claim and Verification Guidelines were revised and 230 provincial and district health insurance officers trained in their application. New NHI reporting tools were also introduced nationwide to monitor coverage, service use, costs, payments, co-payments and out-of-pocket expenditure.

A comprehensive actuarial analysis and costing exercise covering five central hospitals provided evidence for NHI and Lao Social Security Organisation (LSSO) financing reforms, including Decree MOH/824 on reimbursement rates and co-payments, and the provider payment rates applied under the LSSO, while extensive consultations supported the preparation of revised Laws on Health Insurance and Social Security.

A dedicated social security inspection function was established within the LSSO, including Inspection Guidelines, Standard Operating Procedures and a seven-module training curriculum. 30 inspectors were trained, with inspections commencing in Vientiane Capital in December 2025.

Learn more about the programme’s work in Lao People’s Democratic Republic.
The multi-donor programme contributed to support West African countries in extending social protection, particularly to workers in the informal economy, through stronger regional guidance, capacity building, evidence and on-demand technical assistance.

Key achievements

ILO support to the West African Economic and Monetary Union (WAEMU) contributed to the development of its regional social protection strategy and a WAEMU Commission recommendation on universal health coverage architecture, providing member States with guidance on the respective roles and articulation of social mutual organizations and national health insurance institutions.

Cooperation with the Inter-African Conference on Social Protection (CIPRES), representing 18 member countries, was formalized through an ILO–CIPRES Memorandum of Understanding and joint work plan. Sustained capacity building supported CIPRES in advancing its guidelines for extending social protection to informal-economy workers and initiating the development of health insurance guidelines and a stocktaking of national extension strategies.

Regional capacities and evidence were strengthened through training of 43 tripartite constituents on social protection and public finance management and social protection data-collection processes in six countries, supporting more evidence-based social protection policy development.

On-demand regional expertise supported reforms in four countries – Senegal, Burkina Faso, Togo and Guinea. This contributed, among other results, to Togo’s first National Social Protection Policy and Guinea’s first public health insurance scheme, extending coverage to more than 300,000 beneficiaries.

Thematic areas

The programme provided country support as well as support at regional level to promote the achievement of universal health coverage.

Key achievements

The CONNECT network expanded to include 18 member institutions, exceeding its target of 15, and its institutional sustainability was strengthened through a formal partnership between the ILO and Mahidol University and the transfer of Secretariat functions to the ASEAN Institute for Health Development.

More than 170 officials and practitioners strengthened their social health protection expertise through regional fellowships and training: 22 students received support for the Master’s Degree in Primary Health Care Management and Social Health Protection at Mahidol University, while more than 150 participants benefited from short-term training. The Master’s programme also obtained ASEAN University Network Quality Assurance accreditation for 2025–2030.

CONNECT members produced three major regional research products on social health protection for persons with disabilities, labour rights and social protection for domestic workers, and maternity benefits in ASEAN – exceeding the original target of one – providing comparative evidence to inform more inclusive social health protection policies across the region.

Support at country level to strengthen social health protection was provided in Burkina Faso, Burundi, Democratic Republic of Congo, Senegal, Lao PDR, Cambodia, Mongolia and Viet Nam. Please see country components for more information.

Learn more about the ILO’s work on social health protection.
The programme supported the improved availability of social protection data in the African region, strengthening the capacities and the tools available to collect, analyse and disseminate information on social protection coverage.

Key achievements

25 focal points representing 12 francophone African countries have been trained on the collection and analysis of social protection coverage data contributing to up to date coverage data that fed into the World Social Protection Report.

The Democratic Republic of Congo published two statistical bulletins on social protection coverage providing the basis for developing evidence-based policies to promote coverage extension.

The Social Security Inquiry (SSI) was adopted as Burundi’s national reporting tool, strengthening the availability of social protection coverage data and providing an evidence base for policy development and monitoring.

Learn more about the ILO’s work on social protection statistics, monitoring and evaluation.
The programme provided support for improved social dialogue on financing social protection in Africa, and more specifically in Burundi, DRC and Rwanda through capacity building and knowledge sharing.

Key achievements

A regional training on Financing Decent Work and Social Protection strengthened the capacities of 42 tripartite representatives from East African Community (EAC) Partner States, including government, workers’ and employers’ representatives. Participants strengthened their capacity to analyse employment-related budgets and developed country roadmaps identifying reforms to better align public expenditure with employment and social protection policies.

Support was provided at country level in Burkina Faso, Democratic Republic of Congo, Rwanda and Lao PDR to identify financing sources for social protection, conduct actuarial valuations of existing schemes or do the cost estimates for new schemes to be launched. Please see country components for more information.

Learn more about the ILO’s work on social protection financing.