This document informs on the knowledge learned during the implementation of the mutual health insurance extension project in the Boucle du Mouhoun region of Burkina Faso. Community-based mutual health insurance is a reliable alternative in our countries with limited resources to help break the financial barrier to health care. This experience, which was capitalized on in this health region, clearly shows the feasibility and effectiveness of implementing community-based mutual health insurance in our country. Above all, this experience presents the levers for sustaining the achievements and the mechanisms for scaling up. The development of community-based mutual health insurance by the NGO ASMADE according to the approach of "one commune, one mutual," "one region, one union," effectively constitutes a gateway for developing and stimulating other approaches to access to health care for the population towards universal health coverage. It is now time for health policies aimed at fee-for-service exemptions to be supported and linked intelligently with this community model.