This week, FOHSEN is celebrating the launch of its Health Insurance Initiative in Senegal’s Kaffrine region. The initiative ensures that enrolled beneficiaries from 100 households, or 300 individuals, are entitled to receive a broad package of services which will remove point of care fees for treatment of 95% of the most diseases in the region. While many challenges remain for achieving Universal Health Coverage (UHC), this building block will support the Mutuelle de Santé of Nganda and the Kaffrine Regional Medical team in continuing to financially support rural families with handling the impact of out-of-pocket health care expenditures.
“One problem is that we see patients every single day that cannot pay $2 for a consultation because of the poverty that exists in our communities,” noted Mrs. Ndeye Aida Sall, Head Nurse at the Nganda Health Post.
“At the moment we’re just waiting for the government to send the money. Everyone must wait for the subsidy,” mentioned a member of the Mutuelle team.
The launch involved working with Community Health Workers to identify the families with the highest need for health insurance. Criteria for being considered a family with high need was based on family income level and occupation. Following this, the team worked with local insurance officers to create ID cards with biometric registration details such as fingerprints and pictures to allow for members to be correctly identified at health facilities which will aid in preventing fraud and abuse.
Senegal introduced its version of UHC, Couverture Maladie Universelle (CMU), in 2013 with three core pillars: the development of community-based health insurance; the promotion of health insurance for private sector employees; and free-of-charge public health initiatives for children under five, cesareans, dialysis, and people aged 60 and over. While there have been impressive results since the UHC program was launched, with over three million beneficiaries, the coverage rate is still less than 50%.
As the initiative evolves into the future, a widely acknowledged challenge is how to accelerate the enrollment of the rest of the population, particularly those living in rural areas, so that UHC is realized in a manner that ensures the financial sustainability of the initiative. While the initiative will certainly help increase health care coverage, the long term sustainability of the scheme will perhaps require a broader discussion on the content of the benefits package, measures to promote the rational use of drugs, and possible complementary funding sources. While challenges remain to be addressed, this is a great first step that wouldn’t have been possible without the collaboration of FOHSEN, local & regional government, and community members.