SP&PFM is providing technical assistance to the Agency for Universal Health Coverage to improve the effectiveness of Senegal’s universal health coverage programme through reforms. The programme is structured in two schemes: (i) a contributory scheme managed through community mutual insurance companies and subsidized at 50 per cent for traditional beneficiaries (contributors) and at 100 per cent for vulnerable people; and (ii) a medical assistance scheme that includes free care for children younger than 5 years, people aged 60 and older, pregnant women who need a caesarean section and people undergoing dialysis.

Video of the capacity buidling session for executives of Senegal’s Agency for Universal Health Coverage.

After some seven years of the programme, significant progress has been observed. The International Labour Organization, in the framework of the SP&PFM Programme, participated in the technical follow-up of the various evaluations of the universal health coverage schemes, which revealed several shortcomings:

  • the financial sustainability of free health care initiatives and the coverage of beneficiaries of the National Family Security Grant Programme and holders of the Equal Opportunities Card;
  • the weakness of the intrinsic contribution of mutual health insurance in the coverage of populations not benefiting from free or 100 per cent coverage against the risk of illness, with low community membership, a low rate of renewal of contributions and a low level of functionality and risk pooling;
  • the lack of targeting of beneficiaries; and
  • the effectiveness of beneficiaries’ access to certain health care services.

Following the evaluations, reforms to make the universal health coverage programme more effective and which the SP&PFM Programme is supporting were initiated, beginning with the repositioning of the Agency in its role as the main insurer. The Agency will now more directly implement certain technical functions related to health insurance and delegate other functions to management bodies, in particular mutual departments. Another important change is the increase in risk pooling, from the community level to the departmental level.

To help execute the reforms, the SP&PFM Programme organized a training session (January 2023) to strengthen the capacities of 45 Agency executives from the 14 regions of Senegal and other actors and stakeholders operating in the technical areas of social health protection.

Previous training for the Agency covered health actuarial science, and soon the SP&PFM Programme will support an actuarial study to inform the reforms for the financial sustainability of the universal health coverage model.

Watch the video on the training session here.

Learn more about SP&PFM in Senegal here.