Facteurs d’adhésion et utilisation des Mutuelles de Santé (MS) : région Ziguinchor au Sénégal

Sow, Papa Gallo; Bop, Martial Coly; Akoetey, Kossivi; Diop, Cheikh Tacko; Kâ, Ousseynou

doi:10.3917/spub.205.0563

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…Regarding household size, some empirical work presents results that state the greater difficulty of large households to participate in a health risk pooling system. Although these families are not considered among the poorest in the community, they are generally unable to bear the contributions for all the members of the household [14,22,23,26,28,39,41,42].…”

Section: Household Sizementioning

confidence: 99%

“…The existence of informal risk-sharing associations appears to facilitate the establishment of a community health insurance scheme; the involvement of community leaders positively influences membership. One study shows that 41% of CBHI members say they signed up on the advice of an influential person and research in Burkina Faso indicates that members of a community health insurance system have a more negative perception of traditional healthcare than non-members, often judging it to be poor or ineffective [19,20,30,32,42].…”

Section: Association History Target Group Cohesion Therapeutic Use An...mentioning

confidence: 99%

“…The target populations frequently adopt a cautious attitude at the launch of a CBHI scheme, preferring to observe before participating [15-17, 23, 28, 34, 35, 43, 45-48]. Other studies indicate that doubts about the honesty of the CBHI leaders or previous experiences with embezzlement may have a negative impact on membership [19,35,42,43,[45][46][47][48].…”

Section: Trust In the Cbhi Schemementioning

confidence: 99%

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Factors determining membership in community-based health insurance in West Africa: a scoping review

Condé

Camara

Jallal

et al. 2022

glob health res policy

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Background In many low-income countries, households bear most of the health care costs. Community-based health insurance (CBHI) schemes have multiplied since the 1990s in West Africa. They have significantly improved their members’ access to health care. However, a large proportion of users are reluctant to subscribe to a local CBHI. Identifying the major factors affecting membership will be useful for improving CBHI coverage. The objective of this research is to obtain a general overview of existing evidence on the determinants of CBHI membership in West Africa. Methods A review of studies reporting on the factors determining membership in CBHI schemes in West Africa was conducted using guidelines developed by the Joanna Briggs Institute. Several databases were searched (PubMed, ScienceDirect, Global Health database, Embase, EconLit, Cairn.info, BDPS, Cochrane database and Google Scholar) for relevant articles available by August 15, 2022, with no methodological or linguistic restrictions in electronic databases and grey literature. Results The initial literature search resulted in 1611 studies, and 10 studies were identified by other sources. After eliminating duplicates, we reviewed the titles of the remaining 1275 studies and excluded 1080 irrelevant studies based on title and 124 studies based on abstracts. Of the 71 full texts assessed for eligibility, 32 additional papers were excluded (not relevant, outside West Africa, poorly described results) and finally 39 studies were included in the synthesis. Factors that negatively affect CBHI membership include advanced age, low education, low household income, poor quality of care, lack of trust in providers and remoteness, rules considered too strict or inappropriate, low trust in administrators and inadequate information campaign. Conclusions This study shows many lessons to be learned from a variety of countries and initiatives that could make CBHI an effective tool for increasing access to quality health care in order to achieve universal health coverage. Coverage through CBHI schemes could be improved through communication, improved education and targeted financial support.

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Section: Household Sizementioning

confidence: 99%

Section: Association History Target Group Cohesion Therapeutic Use An...mentioning

confidence: 99%

Section: Trust In the Cbhi Schemementioning

confidence: 99%

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Factors determining membership in community-based health insurance in West Africa: a scoping review

Condé

Camara

Jallal

et al. 2022

glob health res policy

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Assessment of the Viability of Community-Based Health Insurance Schemes in the Ziguinchor Department from 2016 to 2018 in the Context of Universal Health Coverage (Senegal)

Tacko,

Mouhamed,

Mareme

et al. 2024

HEP

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Introduction: This study examines the viability of community-based health insurance schemes in the Ziguinchor department of Senegal from 2016 to 2018, within the context of universal health coverage. Health insurance schemes have emerged as a promising solution to extend social health protection to informal sector workers and rural populations. However, despite political support, these structures face persistent challenges in terms of enrollment, member retention, and management. The study aims to assess the viability of these schemes, as well as the perceptions of various stakeholders on mutual health insurance. Methodology: The study adopted a mixed approach, combining quantitative and qualitative methods, based on the theoretical framework developed with the support of the International Labor Office (ILO). This framework evaluates the viability of health insurance schemes according to four dimensions: institutional, technical, functional, and financial/economic. A questionnaire with 87 questions was used to collect quantitative data on these aspects from the seven health insurance schemes in the Ziguinchor department. For the qualitative component, focus groups and individual interviews were conducted with various actors, including beneficiaries, non-beneficiaries, community leaders, scheme managers, and healthcare providers. Results: The study's findings reveal a complex situation for the health insurance schemes in the Ziguinchor department. Institutionally, the schemes have a solid foundation with legal status, internal regulations, and affiliation to a departmental union. Technically, membership is voluntary and family-based, with control mechanisms in place, although their effectiveness is limited. Functional viability shows positive signs with a membership growth rate of 20.18%, but the overall penetration rate remains low at 16.99%, and the premium collection rate is very low, averaging 26.78%. The financial situation is particularly of concern: no scheme can meet its short or long-term debts, and the average claims ratio is excessively high at 282%. As for stakeholder perceptions, they are mixed: while the schemes are generally considered beneficial, significant practical difficulties are identified, including lack of information, funding problems, and procedural complexity. Conclusion: The study highlights the complexity of the role of health insurance schemes in the quest for universal health coverage. Despite undeniable strengths, the schemes face considerable challenges in terms of functional and financial viability. Corrective measures are necessary, including strengthening management capacities, innovating premium collection methods, and improving communication. An evolution of the model is also suggested, potentially towards greater integration into a national social protection system or the development of innovative public-private partnerships.

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Facteurs d’adhésion et utilisation des Mutuelles de Santé (MS) : région Ziguinchor au Sénégal

Cited by 2 publications

References 4 publications

Factors determining membership in community-based health insurance in West Africa: a scoping review

Factors determining membership in community-based health insurance in West Africa: a scoping review

Assessment of the Viability of Community-Based Health Insurance Schemes in the Ziguinchor Department from 2016 to 2018 in the Context of Universal Health Coverage (Senegal)

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