Implications for Senegal’s UHC Program Sample Clauses

Implications for Senegal’s UHC Program. Launched in 2013, Senegal has an ambitious UHC Program given limited government and financial resources, a large informal sector and a high unemployment rate. Although complete population coverage will undoubtedly take time, significant progress can be made towards UHC given a few key considerations. For one, it is essential to identify the reasons for the low uptake of health insurance at a population level. Since formal sector workers are automatically covered, the focus is mostly on the informal sector and the unemployed for whom mutuelles are the most viable source of health coverage. But low enrollment into mutuelles results in small pools that have limited risk sharing and cross-subsidization and ultimately threaten the financial viability of these schemes. Thus it might be time to question the current voluntary enrollment option and consider a policy that would make enrollment in a health insurance plan compulsory. This policy would have important implications for the way in which mutuelles are managed and operate. In a 2009 household survey in Senegal, investigators explored determinants of dropout and active community participation in community-based health insurance (CBHI) in three regions of the country (Xxxxxxxxx, 2014). Levels of active participation, analyzed using logistic regression, were assessed on 387 members and ex- members of 3 CBHI schemes: Soppante (region of Xxxxx), Ndondol (region of Diourbel) and Wer ak Xxxxx (region of Dakar). The results show that “the more active the mode of participation in the CBHI scheme, the stronger the statistically significant positive correlation with remaining enrolled” (Xxxxxxxxx, 2014). While financial factors did not seem to determine dropout, the study found that “members were wealthier and had higher expenditure levels than ex-members” (Xxxxxxxxx, 2014), although that was not statistically significant. Still, only 38.68% of those surveyed were satisfied with the accessibility of premium price (odds ratio not significant), suggesting that the premium was too high for most. Adverse selection was also found to be an issue as members were “twice as likely to have had an illness, accident or injury, and nearly twice as likely to have a disability than ex-members” (Xxxxxxxxx, 2014). The study found that the following factors were most associated with either participation or dropout: training, followed by voting, participating in general assembly, awareness raising and information dissemination, as well ...