A. General

I. Structure

The Congolese social protection system guarantees :

• disability, old-age and survivors' insurance benefits,
• occupational injury benefits,
• family benefits and daily maternity allowances,
• healthcare following the creation of the Compulsory Universal Health Insurance Scheme (RAMU) instituted by Law no. 37- 2014 of June 27, 2014,
• social assistance for the most disadvantaged.

The employer is responsible for maintaining wages during work stoppage.

II. Organization

Law No. 10-2014 of June 13, 2014 on the reform of the social security system acts to dissolve the Caisse Nationale de Sécurité Sociale (CNSS) and create two new funds:

• Caisse des Risques Professionnels et des Pensions des Travailleurs du Secteur Privé (CR2PTSP);
• Caisse de la Famille et de l'Enfance en Difficulté (CAFED).

This same law transfers management :

• family benefits to the Caisse de la Famille et de l'Enfance en Difficulté (CAFED);
• des risques professionnels et des pensions des travailleurs privés (RR2P) to the Caisse des Risques Professionnels et des Pensions des Travailleurs du Secteur Privé (CR2PTSP).

Pending the operation of these funds and the implementation of the new schemes, the Caisse Nationale de Sécurité Sociale (CNSS ), which is a public social institution with legal personality under the supervision of the Ministère de la Fonction Publique, du Travail et de la Sécurité Sociale, continues to :

• manage the scheme for salaried employees, covering the risks of old-age pensions, disability, survivors' benefits and industrial accidents and occupational illnesses,
• to provide family benefits,
• to collect all contributions.

It has regional and departmental offices.

In charge of vocational training, employment monitoring and matching job offers and applications, the Congolese EmploymentAgency (ACPE) and the National Fund for Employability and Apprenticeship Support (FONEA) have replaced theNational Office for Employment and Labor (ONEMO ) since July 2019.

Created in 2015, the Caisse d'Assurance Maladie Universelle (CAMU), a financially autonomous public establishment under the supervision of the Ministry in charge of Social Security, is responsible for managing the Régime d'Assurance Maladie Universelle (RAMU) and the healthcare provided to affiliates.

The scheme is financed by contributions from employers and employees in the private sector, the self-employed, the state as employer and state employees, pensioners...

As of the start-up date of RAMU, public or private organizations that provide medical coverage to all employees through insurance companies or mutual insurers may continue to provide this coverage for 6 months.

In addition, the management of state employee pensions has been entrusted to a new body, the Caisse des Pensions des Agents de l'Etat (CPAE ), replacing the Caisse de Retraite des Fonctionnaires (CRF).

III. Contributions

1. Salaried workers

2. Self-employed workers

B. Health care

I. Health care system

In the Congo, the healthcare system is spread across 12 health care and service departments: Kouilou, Niari, Lékoumou, Bouenza, Pool, Plateaux, Cuvette, Cuvette Ouest, Sangha, Likouala, Brazzaville and Pointe-Noire. Each department is subdivided into 52 health districts, enabling us to be as close as possible to the population.

The public healthcare network comprises 8 general hospitals, 27 district hospitals, 127 integrated health centers and 451 dispensaries. It is organized into 3 levels:

• The primary care network (dispensaries and health centers) provides 2 types of coverage, a Standard Minimum Package of Activities (PMAS) which includes curative consultation, prenatal consultation, preschool consultation, promotional activities and family planning, and an Expanded Minimum Package of Activities (PMAE) which, in addition to laboratory tests, offers delivery and surgical services;
• The second level is made up of district hospitals, which offer a Complementary Activity Package (CAP ) that includes care for patients referred by health centers, basic medical and surgical emergencies, and basic neonatal, obstetric and gynecological emergencies, hospitalization in the four basic specialties (medicine, surgery, pediatrics and gyneco-obstetrics), management of basic stomatological, otorhinolaryngological and maxillofacial emergencies, basic biological and radiological explorations, and storage and dispensing of essential drugs and health products;
• Third-level care is provided by general hospitals: medical-surgical emergency services, obstetrics and gynecology, pediatrics, stomatology, conventional and digital radiology, ultrasound and dental panoramic.

The private healthcare network comprises 810 health facilities, including 54 clinics, 71 medical-social centers, 167 doctors' surgeries, 19 dental surgeries, 499 nursing surgeries and 203 pharmacies.

The cost of a medical consultation ranges from 6,000 FCFA for a general practitioner to 15,000 FCFA for a specialist.

Pending the full implementation of RAMU, article 142 of the Labor Code instituted by Law 45-75 of March 15, 1975, stipulates that "every company or establishment must provide a medical or health service for its workers and members of their families recognized by the CNSS. Companies unable to provide adequate health facilities must join forces to set up inter-company health facilities".

The CNSS will cover the costs of childbirth and pregnancy-related medical care.

II. Universal Health Insurance Scheme (RAMU)

Adopted in June 2014 and pending its full implementation, the RAMU will ensure that insured persons and their dependents have access to healthcare services in the public and private sectors, with the exception of risks linked to work-related accidents and occupational illnesses.

This scheme aims to cover the entire Congolese population. Health coverage is based on the principle of national solidarity.

Several categories of people can join:

• employees of the State, local authorities, public establishments and legal entities under public law,
• people in the private sector,
• self-employed professionals,
• beneficiaries of public and private sector retirement pensions,
• the spouse, as a beneficiary of the insured person, who is not covered by compulsory health insurance,
• people targeted as vulnerable,
• students,
• self-employed workers,
• of people held in prisons, regardless of nationality,
• dependent descendants of the insured.

Affiliation and registration with the plan's management body will take effect 90 days after the registration date.

Entitlement to benefits is subject to prior payment of contributions or membership fees.

This solidarity-based scheme will entitle members and their dependants to curative and preventive health care inherent in :

• illness, accident, maternity,
• functional physical rehabilitation.

The lists of specialties, medical and paramedical procedures, drugs, appliances and medical transport costs that will be covered, and their reference rates where applicable, will be set by joint order of the ministers responsible for social security and health. The same decree will also set the list of benefits requiring prior agreement from the scheme's management body.

Benefits covered under the UHIP scheme will only be reimbursed if they are provided in France.

The care basket should comprise two levels: the base and the complementary.

The basic basket should be covered at 100% by the health insurance fund if the care pathway is respected (consultation in the 1st level then 2nd or 3rd level with prescription or in case of emergency). Medical transport will also be covered in the case of a justified prescription.

The base basket includes :

• comprehensive care for mothers and children up to the age of 5, as well as related nutritional diseases,
• the management of certain transmissible and neglected tropical diseases (malaria, HIV, tuberculosis, etc.),
• the management of certain non-communicable diseases within the healthcare pathway. (Hypertension, diabetes, etc.).

The complementary basket will benefit from a co-payment to be determined at a later date. It comprises :

• coverage of other communicable diseases not included in the basic basket, as well as road accidents,
• management of other non-communicable diseases.

The insured will have a free choice of practitioner, health establishment, pharmacist, etc., provided that these are under agreement with the organization in charge of managing the UHIP.

UHIP will not cover medical evacuations.

For a period of 6 months, the beneficiaries of a deceased insured will be entitled to the benefits of the scheme to which the deceased insured belonged at the time of death.

The insured may take out supplementary insurance to cover the cost of benefits not covered by the plan.

C. Family benefits

The family and children in difficulty scheme set up in 2012 and managed by the CNSS, will after its effective dissolution be the responsibility of the Caisse de la Famille et de l'Enfance en Difficulté (CAFED).

Self-employed workers are excluded from the scope of family benefits. They will be subject to them as soon as the family and special needs scheme and the fund in charge of these benefits are fully implemented,

This plan includes the following branches:

• maternity: prenatal allowance, birth grant and daily maternity allowance;
• family benefits: family support allowance, back-to-school allowance, family allowances ;
• social integration of vulnerable minors.

I. Maternity

1. Prenatal allowances

All pregnant women resident in the Congo are entitled to antenatal allowances from the 90th day of pregnancy, once the pregnancy has been declared to the family benefits office. Entitlement may not exceed 6 months.

When a pregnancy is declared, the health insurance fund issues a pregnancy and maternity booklet for the fulfilment of compulsory medical prescriptions.

To qualify for prenatal benefits, pregnant women must undergo 3 medical examinations:

• the 1st before the end of the 3rd month of pregnancy,
• the 2nd around the 6th month of pregnancy,
• the 3rd around the 8th month of pregnancy.

Paid in 3 instalments, they amount to :

• FCFA 2,200 after the 1st and 2nd exams,
• 2,750 FCFA after the 3rd exam.

     2. Birth bonus

A birth bonus is paid on the birth of the first 3 viable children, subject to the provision of a medical birth certificate and registration of the child.

It amounts to 1,200 FCFA per birth.

     3. Daily maternity benefits Maternity leave

To receive daily maternity benefits, the employee must :

• have paid contributions for 6 consecutive months,
• have worked 20 days or 133 hours each month.

All pregnant employees are entitled to 15 weeks' maternity leave, including 6 weeks before and 9 weeks after childbirth, even if the child is not born viable.

The indemnity paid by the Caisse is equal to 50% of the salary received at the end of the month preceding the period of leave. If the employer has maintained all or part of the employee's salary for the duration of the maternity leave, the indemnity is paid back to the employer.

Payment of this benefit may be extended by 3 weeks in the event of pregnancy or the aftermath of pathological childbirth.

      4. Breastfeeding

Article 115 of the French Labor Code stipulates that, from the birth of her child and for a period of 15 months, a female employee is entitled to one hour's breastfeeding rest per working day. This hour can be split into 2 half-hours at the mother's request.

II. Family benefits

1.    Family support allowance

This allowance is paid to the parent (mother or father) who :

• single parent of one or more children under the age of 19,
• is destitute or has a low income,
• is of Congolese nationality.

This allowance cannot be combined with a school or university grant. The amount and conditions of allocation are set by regulation (not published).

     2. Back-to-school allowance

This allowance is paid each school year to parents with little or no income and one or more dependent school-age children.

The amount and terms of award are set by regulation (not published).

     3. Family allowance

Family allowances are paid to insured persons for each of their dependent children (legitimate, illegitimate, adulterous or adopted) from birth until the age of 18, subject to presentation of annual supporting documents (certificate of living and maintenance for beneficiary children not attending school, school attendance certificate or training certificate for school-age children).

To be entitled to family allowance payments, you must :

• be registered and have the status of a beneficiary,
• have been in paid employment for at least 6 consecutive months,
• provide proof of a minimum of 20 days' paid work per month or 133 hours,
• to reside with his children in the Congo.

The amount of the family allowance depends on household income.

Amount levels are set by regulation (not published).

At present, they amount to 2,000 FCFA per month per child, and are paid quarterly.

    4. Social integration

The social integration branch deals with the integration of minors in vulnerable situations.

Integration initiatives include

• accommodation in social centers,
• integration or reintegration into schools,      
• vocational training in state-approved training centers,
• coverage of healthcare costs in the event of illness.

D. Occupational injuries and illnesses

This insurance covers salaried employees and voluntary members.

The insurance covers :

• workplace accidents,
• commuting accidents between the insured's home and place of work,
• listed occupational diseases.

Benefits are not subject to any prior activity requirement.

First-aid treatment and salary on the day of the accident are fully covered by the employer.

Treatment provided to the victim is fully paid for by the CNSS (direct payment of treatment costs by the CNSS to medical establishments under contract with the fund).

Services include :

• general and specialized care,
• pharmaceutical costs,
• hospitalization,      
• surgery,
• vocational rehabilitation,     
• prostheses,
• travel requirements.

I. Temporary disability

The daily allowance is equal to :

• 100% of the average daily wage for the last 30 days from the 1st to the 29th day of sick leave,
• 2/3 of the average salary from the 30th day to the 90th day of stoppage,33.3% of the average salary from the 91st day of stoppage.

The daily salary used to calculate this allowance may not exceed 1% of the maximum annual remuneration used to calculate social security contributions (600,000 FCFA per month).

After the 91st day of work stoppage, the insured must return to work or request that his temporary disability be recognized as permanent disability.

II. Permanent disability

In the event of permanent disability duly confirmed by the doctor appointed or approved by the CNSS, the victim is entitled to a monthly pension equal to the last monthly salary multiplied by the degree of disability previously reduced by half for the part of this degree which does not exceed 50% and increased by half for the part which exceeds 50%:

• 0.5 for each degree of disability between 1% and 50%,
• 1.5 for each degree above 50%.

If the employer is responsible for the accident, the benefit payable by the employer is increased by 25%.

The amount of the annuity can never be less than the minimum wage, nor can it exceed the insured's average earnings.

Depending on the assessed degree of disability, the pension is paid :

• monthly if the degree of disability is between 75% and 100%,
• quarterly if the degree of disability is between 50 and 74%,
• annually if the degree of disability is between 49% and 10%.

When the degree of disability is less than 10%, the victim receives an annuity in the form of a lump-sum payment.

If the permanent disability is total and obliges the victim to rely on the assistance of a third party to carry out the ordinary acts of life, the amount of the annuity is increased by 30%.

III. Deaths (survivors)

If the victim dies as a result of an accident at work or an occupational disease, an annuity is paid to his or her heirs, who are :

• the surviving spouse (neither divorced nor legally separated, provided the marriage was contracted prior to the accident): the pension is equal to 15% of the annual salary used to calculate the victim's pension;
• dependent children (as defined for family benefits): 35% of the annual salary used to calculate the victim's pension. This amount is to be shared equally between the children. The minimum amount is 2,000 FCFA per eligible child.

If the surviving spouse remarries, pension payments cease.

The total amount of survivors' pensions may not exceed 50% of the deceased insured's pension.

In the event of death, funeral expenses are covered up to the maximum amount set by ministerial decree.

E. Disability, old age, death (survivors)

Pensions are paid quarterly.

I. Old age

1.    Conditions

To qualify for an old-age pension under the Congolese scheme, you must :

• between 57 and 65 years of age, depending on socio-professional category,
• have been registered with the CNSS for at least 20 years;
• have completed 240 months of insurance or at least 60 months of insurance in the 10 years preceding the date of pension entitlement,
• have permanently ceased all salaried activity.

The age of entitlement and the number of months of contributions vary according to socio-professional category:

• 57 years of age and at least 22 years of contributions for labourers, manual workers and other assimilated workers;
• 60 years of age and at least 25 years of contributions for supervisors and managers ;
• 65 years of age and at least 30 years of contributions for non-category executives ;
• Insured persons suffering from premature physical or mental deterioration rendering them unfit for salaried employment and who meet the conditions below may apply for an early retirement pension:
• 52 years for labourers and other similar workers ;
• 55 years for supervisors and managers ;          
• 60 years for non-category managers.

An insured person who does not meet the conditions for entitlement to an old-age pension or early retirement pension may receive an old-age allowance in the form of a lump-sum payment, if he or she :

• has completed more than 12 months and less than 60 months of insurance,     
• has reached pensionable age,
• ceases all salaried activity.

Lastly, a proportional pension may be granted under the same conditions as a normal old-age pension, provided that the amount is not less than 60% of the minimum wage.

       2. Amount

The amount of the pension is based on the average monthly remuneration of the best 36 or 60 months of remuneration subject to contributions during the 10 years prior to the date of pension entitlement.

The monthly pension is equal to :

• 44% of the average wage for labourers and other similar workers ;
• 50% of average salary for supervisors and managers ;
• 60% of average salary for non-category executives ;

The percentage is increased by 2% for each 12-month period of insurance or equivalent in excess of the minimum contribution period for each socio-professional category.

The monthly amount of the old-age pension may not be less than 60% of the minimum wage, nor more than 80% of the insured person's average earnings over the best 36 months of earnings over the last 10 years.

Insureds with less than 60 months' contributions receive an old-age allowance equal to one month's average monthly salary for the 3 or 5 highest-paid years in the last 10 years, for each 12-month period.

II. Disability

1. Conditions

An insured person who becomes disabled as a result of a non-work-related illness or accident before reaching the age of 60 is entitled to a disability pension if he or she meets the following conditions:

• have been registered with the caisse for at least 5 years,
• have completed 6 months of insurance during the last 12 calendar months prior to the onset of the incapacity leading to disability,
• have suffered a permanent, medically-recognized reduction in their physical or mental capacities, rendering them incapable of earning more than 1/3 of their normal salary.

If the disability is due to an accident, the insured is entitled to a disability pension with no minimum qualifying period, provided he or she has :

• occupied a job subject to insurance on the date of the accident,
• registered with the caisse before that date.

      2. Amount

The amount of the pension is calculated in the same way as the old-age pension.

The insured is credited with 6 months of coverage for each year from the start of the disability until the normal old-age pension age.

A supplement of 30% of the pension may be granted for the assistance of a third party if the pensioner needs constant help to carry out the acts of daily life.

The monthly amount of the disability pension may not be less than 60% of the minimum wage, nor more than 80% of the insured's average earnings over the best 36 months of earnings over the last 10 years.

At retirement age (which differs according to socio-professional category), the disability pension is replaced by an old-age pension of the same amount.

III. Deaths (survivors)

1. Conditions

The death of an insured person entitles him/her to a survivor's pension:

• holder of an old-age pension,       
• holder of a disability pension,
• holder of an early retirement pension,
• who, at the date of death, was eligible for an old-age or disability pension,
• with at least 264 months of insurance (300 or 360 depending on socio-professional category).

The following are entitled to the pension:

• the surviving married spouse (provided that the marriage was
• contracted at least one year prior to death), or a widow who is self-employed or employed and disabled, or a widower who is disabled,
• the insured's dependent children, as defined for the purposes of family allowances.

      2. Amount

Survivor's pensions are calculated as a percentage of the pension to which the insured was or would have been entitled at the date of death at the rate of :

• 15% of the pension for the surviving spouse,
• 35% of the pension for dependent children. This amount is divided equally between the children.

The total amount of survivors' pensions may not exceed 50% of the deceased insured's pension.

Pension entitlement lapses:

• for the surviving spouse in the event of remarriage,    
• for children :
  • at age 16 for children no longer attending school,
  • to age 17 for apprentices,
  • to age 20 for disabled children or those in education.

If the insured was not entitled to a pension and had less than 240 months' insurance at the date of death, his survivors are entitled to a one-off survivor's allowance equal to the monthly pension to which the insured would have been entitled (30% to the surviving spouse and 70% to the orphans).

In the event of death, a lump sum representing 3 months' pension is paid to cover funeral expenses.

F. Social assistance

The Congo has a National Social Action Policy (PNAS ) steered by the Ministry of Social Affairs and Humanitarian Action, one of whose 3 priorities is to set up a system of social safety nets.

The LISUNGI project is the fruit of collaboration betweenAgence Française du Développement (AFD), the World Bank and the Congolese government. It is a pilot fund designed to provide financial support to 100,000 households in 7 localities in the departments of Pool (Brazzaville), Kouliou (Pointe-Noire) and Cuvette.

This project has 3 components:

• setting up the administrative pillars needed to run a national social safety net program, with the creation of a single social register equipped with an information and management system;
• a pilot program of non-contributory cash transfers to the most vulnerable households. These cash transfers are subject to certain conditions, such as school enrolment and immunization of children from beneficiary households, or prenatal medical check-ups for pregnant women;
• project monitoring and evaluation.

An emergency food allowance of 50,000 FCFA per household is paid to households that meet the following criteria:

• be of Congolese nationality or live legally in Congo,
• have a household identification code from the unique social register and have been declared eligible following social surveys,
• work in the informal sector, notably transport, catering and construction, and have lost their main source of income,
• the household must be made up of people living with a disability or children under 18, or pensioners who have not received their pension for at least 3 years.

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Article source: https://www.cleiss.fr/docs/regimes/regime_congo.html