Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop

1. FINANCIAL PROTECTION AND IMPROVED ACCESS TO HEALTH CARE:
PEER-TO-PEER LEARNING WORKSHOP
FINDING SOLUTIONS TO COMMON CHALLENGES
FEBRUARY 15-19, 2016
ACCRA, GHANA

2. Republic of Senegal
One People - One Goal - One Faith
Ministry of Health and
Social Action
Universal Health Coverage (UHC) in Senegal:
Implementation Status and Outlook
February 2016

3. Context
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Financial access to health services is a major concern
for most people in Senegal.
Before 2012, more than 80% of the people in Senegal
had no health coverage.

4. Coverage Plans in Senegal
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R1
• Non-contributory plan for government employees (budget
allocations)
• Mandatory plan for private sector employees (IPM)
R2
• Voluntary plan through mutual health insurance companies
• Voluntary plan through private insurance
R3
• Medical care plan through no-cost initiatives for the indigent and
persons at risk

5. Political commitment at the highest level
2/18/2016
“Beyond a new resolve to improve
health facilities, I intend to launch
a program of universal health
coverage and a serious debate on
the government’s health policy, in
concert with the actors
concerned.”
(excerpt from the speech to the nation on
April 3, 2012)

6. Goal of the UHC Program
To improve financial
accessibility to quality health
care for the people of Senegal,
particularly those in the
informal sector and rural
areas
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7. Goal of the UHC Program
To extend basic health coverage to 75% of
the population by 2017.
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8. Strategic Planning Areas
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Expansion of basic
universal health coverage
through mutual health
insurance companies
Strengthening of existing
no-cost initiatives
Implementation of new no-
cost care initiative for
children under 5 years of
age.
Reform of Health Coverage
Institutions by implementing
decree 2012 - 832 of August
7, 2012

9. Priority area:
Promotion and expansion of
mutual health insurance
companies

10. Approach and major innovations in
the promotion of mutual health insurance
companies
 Approach: “In each municipality, at least one mutual health
insurance company.”
 Major innovations:
 Contribution of 7,000 Francs per person per year, 50% subsidized
for persons who are able to contribute, i.e. a contribution of 3,500
Francs per person per year;
 Free care for indigent persons through a 100% subsidy of the
contribution and the copayment.
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11. Package of care offered (health center
and unit)
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Paquets de Bénéfices de Base Type (Postes et Centres de Santé)
Prestations prises en charge par la mutuelle de santé
Taux de prise en
charge
par la mutuelle de
santé
Soins ambulatoires
• Consultation curative générale 80%
• Consultation dentaire 80%
• Pansement, piqûres, transfusions 80%
• Vaccinations 100%
• Petite chirurgie ambulatoire 80%
• Soins dentaires 80%
• Echographie 80%
• Analyses médicales/Laboratoire 80%
• Médicaments de spécialité ou de marque 50%
• Médicaments génériques 80%
Transport
• Ambulance 80%
Hospitalisation
• Forfait de séjour 80%
• Analyses médicales/Laboratoire 80%
• Médicaments de spécialité ou de marque 50%
• Médicaments génériques 80%
• Consommables médicaux 80%
Maternité
• Consultation prénatale 80%
• Consultation post-natale 80%
• Planning familial 80%
• Accouchement simple 80%
• Hospitalisation 80%
• Echographie 80%
• Analyses médicales/Laboratoire 80%
• Médicaments de spécialité ou de marque 50%
• Médicaments génériques 80%

12. Package of care offered (hospital)
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Paquet de Bénéfices Complémentaire (Hôpitaux)
Référence Obligatoire pour Bénéficier de la Couverture
Prestations prises en charge par la mutuelle de
santé
Taux de prise en charge
par la mutuelle de santé
Soins ambulatoires
• Consultation curative générale 80%
• Consultation dentaire 80%
• Consultation ophtalmologie 80%
• Consultation autres spécialités 80%
• Pansement, piqûres, transfusions 80%
• Petite chirurgie ambulatoire 80%
• Soins dentaires 80%
• Radiographie/Scanner/Echographie 80%
• Analyses médicales/Laboratoire 80%
• Médicaments de spécialité ou de marque 50%
• Médicaments génériques 80%
Transport
• Ambulance 80%
Hospitalisation
• Forfait de séjour 80%
• Radiographie/Scanner/Echographie 80%
• Analyses médicales/Laboratoire 80%
• Médicaments de spécialité ou de marque 50%
• Médicaments génériques 80%
• Consommables médicaux 80%
• Chirurgie 80%
Maternité
• Consultation gynécologie 80%
• Accouchement avec complications 80%
• Césarienne 100%
• Hospitalisation 80%
• Radiographie/Echographie 80%
• Analyses médicales/Laboratoire 80%
• Médicaments de spécialité ou de marque 50%
• Médicaments génériques 80%

13. The UHC in Senegal.
Where do we stand?

14. Strategic Achievements
Creating the UHC Agency
Setting up the National Interministerial
UHC Steering Committee
Preparing a plan for information and
communication about the UHC
Preparing a strategic plan for 2013-2017
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15. Missions and powers of the UHC
Agency
18/02/2016
Develop communication
strategies to better promote
the universal health coverage
program.
Promote the financing of the
Universal Health Coverage
policy in cooperation with the
actors concerned.
Participate in defining and
implementing the policies for
expanding health coverage for
indigent persons and groups
at risk.
Promote mutual health
insurance companies and
other social mutual companies
as part of expanding health
coverage to the informal
sector and rural areas.

16. Achievements before creation of the Agency
Strategic
Areas
Results
Promotion of
community-
based health
insurance
(mutual health
insurance
companies and
district health
insurance units)
 Pilot regions
106 new mutual health insurance companies were set up in
one year in the 14 districts;
about twenty mutual health insurance companies are in the
process of restructuring;
28,293 new members;
 In total: 369 functional mutual health insurance
companies.
 Large-scale health insurance model
Koungheul Regional Health Insurance Unit: 4,704
beneficiaries
Foundiougne (Sokone) Regional Health Insurance Unit:
5,335 beneficiaries
 Enrolment of beneficiaries of the Family Security
Grant Program
97,883 beneficiaries already enrolled in mutual insurance
companies
18/02/2016

17. Strategic Areas Results
The initiative of
free care for
children under
five (05) years of
age
More than 2 million cases were covered under the initiative
in 2015.
Free caesareans
and other no-cost
initiatives
12,066 women received free caesareans from January to
December 2014.
More than 215,000 elderly received free care
Dialysis is free at all public health facilities, and sessions at
private facilities are subsidized.
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18. Change in National Coverage
Rate
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18
Indicator 2013 2014
% of population
that had a coverage
system
Less than 20% 32%
(estimate)

19. Outlook for the UHC Agency
18/02/2016
19
 Advance from the pilot phase of development of mutual health insurance
companies in the 14 districts to the phase of coverage of the country’s 45
districts;
 Set up regional offices of the UHC Agency;
 Exhaustive inventory of health coverage in Senegal;
 Expand the package of care offered under the initiative of free care for
children under 5 years of age;
 Free coverage of the 2,400,000 beneficiaries of the 2016 Program of Family
Security Grants through mutual health insurance companies.

20. Major Challenges
 Availability of quality care offerings;
 Sustainable financing of the UHC;
 Identifying and targeting beneficiaries;
 Strengthening the legal and regulatory framework;
 Improving communication about the UHC.
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21. 18/02/2016
THANK YOU FOR YOUR
KIND ATTENTION