title: [Analysis of free health care for the elderly in the context of the "Plan Sésame" in Senegal].
abstract: BACKGROUND
  Access to health care remains a major problem in Senegal, particularly among vulnerable groups such as the elderly. In 2006, the Senegalese government introduced a national plan for the provision of free health care known as "Plan Sésame" to improve access to care. The purpose of this study was to examine the current state of the "Plan Sésame" in national hospitals four years after its implementation (2006-2009).
  
  
  METHODS
  A qualitative study using individual interviews was conducted between 15 March and 14 May 2010 among five target populations: hospital directors, health care providers, managers of the "Plan Sésame" in hospital admission services, management accountants, and beneficiaries. Content analysis was used.
  
  
  RESULTS
  Between 2006 and 2008, hospital attendance rates increased every year. However, attendance rates began to decrease in 2009, except in the main hospital. The state has been left with a growing debt because of issues surrounding the reimbursement of expenses related to the "Plan Sésame'. As a result, national hospitals have been forced to restrict certain services included in the "Plan Sésame" and even to withdraw free health care for the elderly. These difficulties are likely to undermine the sustainability of the "Plan Sésame"
  
  
  CONCLUSIONS
  The health authorities need to audit the "Plan Sésame:, to comply with standard procedures through regular monitoring and to redefine conditions of access.
authors.affiliation: Service de Médecine Préventive et Santé Publique, Université Cheikh Anta Diop (UCAD), BP 16390, Dakar, Sénégal. mamadou.Ieye@yahoo.fr
authors.forename: Mamadou Makhtar Mbacké
authors.initials: MM
authors.lastname: Leye
authors.forename: Mayassine
authors.initials: M
authors.lastname: Diongue
authors.forename: Adama
authors.initials: A
authors.lastname: Faye
authors.forename: Mamadou
authors.initials: M
authors.lastname: Coumé
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Faye
authors.forename: Alioune Badara
authors.initials: AB
authors.lastname: Tall
authors.forename: Khadim
authors.initials: K
authors.lastname: Niang
authors.forename: Issa
authors.initials: I
authors.lastname: Wone
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Seck
authors.forename: Papa
authors.initials: P
authors.lastname: Ndiaye
authors.forename: Anta
authors.initials: A
authors.lastname: Tal-Dia
mesh_terms: D000368:Aged; D006299:Health Services for the Aged; D006801:Humans; D012675:Senegal; D017664:Uncompensated Care