Private health insurance markets also exist in Africa with South Africa, Namibia and Zimbabwe funding a significant percentage of their health care costs through private insurance. Botswana, Cote d’Ivoire, Kenya, Madagascar and Mali, have large markets as well. Community health insurance schemes are also fairly extensive in some countries, such as the mutuelles in Senegal. (17,18) Other forms of voluntary coverage have emerged as the result of market forces and laissez faire government policies towards the private sector. As a result, regulation of insurers tends to be weak and private insurance may lead to greater inequity and cost-escalation if it expands significantly.