UNISSAHEL in Senegal

Contexte

In Senegal, in 2006, the strategic document for the fight against poverty DSRPII (2006-2010) was associated with a National Social Protection Strategy 2005-2015. A Strategy for the Extension of Health Risk Coverage was drawn up from 2008. The national health development plan (PNDS 2009-2018) recommended the acceleration of its implementation.

In a context of advocacy by technical and financial partners for the establishment of health insurance systems in the countries of the South, the President of the Republic of Senegal has granted significant funding for the establishment of Universal Health Coverage (UHC) which constitutes a major axis of the Emerging Senegal Plan. Until 2012, nearly 80% of the Senegalese population did not have access to a health coverage system. In 2013, the Universal Health Coverage Insurance Unit (CACMU) was set up. The "CMU agency" (http://agencecmu.sn/ ) is one of the pillars of this strategy.

A Strategic Plan for the Development of Health Coverage (PSD-CMU) 2013-2017 which aimed at 75% of population coverage by 2017 was developed around the following axes:

  • Development of basic UHC through mutual health insurance;

  • Reform of compulsory health insurance and organization and functioning of the Health Provident Institutions (IPM);

  • Strengthening of existing health fees exemption policies (sesame plan, caesarean section, dialysis, etc.);

  • Initiative free care for children 0- 5 years

Mutuals

The CACMU provided for the registration of each citizen in a mutual health insurance to benefit from low cost support and / or to participate in the financing of the care of other citizens. Two types of subsidies have been set up:

  • A partial subsidy for which the beneficiary adheres to CFAF 1,000 and contributes to CFAF 3,500 and the State subsidizes CFAF 3,500, for a total amount of CFAF 7,000 per year.

  • A targeted subsidy for specific categories (disabled, indigent) for which the State pays membership at 1000 FCFA, photos at 250 FCFA per person, the annual membership fee at 7000 FCFA and the user fee at 2000 FCFA.

At the level of huts, posts and health centers, members of mutual insurance companies benefit from an 80% subsidy except for specialized services subsidized at 50%. At the hospital level, members benefit from a 50% subsidy except for medical interventions and hospitalizations for 7 days are covered at 100%.

Health fees exemption policies

All the free initiatives have been grouped under the term medical assistance, and concern the areas below:

  • Free care for children under 5: the care package offered, according to the health pyramid, concerns: At the post and health center level: consultation tickets, generic drugs, vaccination tickets and subsistence costs in the event of hospitalization; In hospitals: emergency consultation tickets and consultation tickets for referred cases. However, additional examinations (analyzes, x-rays) are excluded.

  • Caesarean sections for a flat rate of 85,000 FCFA, which includes : biological examinations, the pre-anesthetic visit, related medications and hospitalization for a period of five days.

  • Free renal dialysis since 2013; free hemodialysis sessions in public hospitals and partial subsidy for private dialysis.

  • Support for people aged 60 and over on Sesame Plan. The care package concerns consultations, para-clinical examinations, essential drugs, and hospitalizations in the 3rd category.

  • Medical care for disabled people with the equal opportunity card and beneficiaries of the “National Family Security Scholarships” enrolled in mutual health insurance with a 100% subsidy of the contribution and the co-payment.