title: [Sesame Health Programme at Senegal: Limitations of this free healthcare model].
abstract: BACKGROUND
  Up until now, elderly people have experienced medical management difficulties despite the free care provided by the Sesame Health Programme. The objective of this study was to determine the costs borne by beneficiaries and/or their families and to evaluate these costs in relation to overall management. This comprehensive, cross-sectional, quantitative study was conducted from 21 February to 21 March 2011 in the Ouakam gerontology centre.
  
  
  METHODS
  Epi Info Version 6 software was used for data analysis. The study population was composed of 203 patients with a mean age of 68 years, with 59% of women and 63% of retired subjects. The most common diseases were hypertension (52%), cataract (16%), and osteoarthritis (12%).
  
  
  RESULTS
  The beneficiaries healthcare costs were covered by the Sesame Health Programme, apart from most of the drugs used to treat chronic diseases, which remained at the charge of patients and/or their families. The overall mean cost of monthly management of the diseases detected in elderly people was estimated to be CFA 37,700, a large share of which (65%) was supported by the patient and/or the family corresponding to the purchase of these drugs. Other dysfunctions were also observed, particularly the difficulty of targeting beneficiaries, generic stock shortages, absence of generics for the treatment of chronic diseases.
  
  
  CONCLUSIONS
  Recommendations are formulated to improve implementation of the Sesame Health Programme.
authors.forename: Ousseynou
authors.initials: O
authors.lastname: Kâ
authors.forename: El Hadji
authors.initials: el H
authors.lastname: Mbaye
authors.forename: Mamadou Makhtar
authors.initials: MM
authors.lastname: Mbacké Leye
authors.forename: Atoumane
authors.initials: A
authors.lastname: Faye
authors.forename: Alioune Badara
authors.initials: AB
authors.lastname: Tall
authors.forename: Awa
authors.initials: A
authors.lastname: Gaye
authors.forename: Abdoul Aziz
authors.initials: AA
authors.lastname: Ndiaye
authors.forename: Papa Gallo
authors.initials: PG
authors.lastname: Sow
authors.forename: Papa Moustapha Awa
authors.initials: PM
authors.lastname: Touré
authors.forename: Anta Tal
authors.initials: AT
authors.lastname: Dia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016527:Drug Costs; D005260:Female; D006297:Health Services Accessibility; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D012675:Senegal