title: [Study of the Consumers' preference on the universal health coverage development strategy through health mutual in Ziguinchor Region, Southwest of Senegal].
abstract: In Senegal, the informal and rural sector that accounts for over 80% of the population is covered only up to 7% by a health insurance system. That is why, for the implementation of development strategy of the universal health coverage (UHC) through mutual health insurance providers, the Government of Senegal has focused on this sector. The objective of this study was to assess the consumer's preference on the UHC development strategies through mutual health insurance providers. This was a qualitative and exploratory study based on a literature review, and indepth interview with the heads of households. It was also based on focus groups of people with and without health mutual membership, and the Expert Committee meetings. The results showed that the most critical attributes in the decision-making of consumers to join the health mutual in Ziguinchor were the membership units; the content of the benefit package, the payment modalities of the premium, the premium amount, the availability of transportation, the co-payment level, convention arrangement with health facilities, and health mutual governance. For a successful implementation of the UHC development strategy through health mutual organizations, policymakers should explore the possibility of introducing the modality of payment in kind, the revision of the co-payment amount, and the promotion of equity through the introduction of a differentiated premium contribution by income. They should also establish a crossborder strategy with The Gambia and Guinea-Bissau to improve health care access to people living in the borders. The promotion of innovative funding and risk equalization between health insurance schemes is also recommended. In areas where the microfinance institutions are well organized and structured their substitution to health mutuals should be an option the decision-makers have to explore.
authors.affiliation: Institut santé et développement, université Cheikh-Anta-Diop, Dakar, Sénégal. oumsagna2003@yahoo.fr.|United State Agency for International Development (USAID), C/O American Embassy, route des Almadies, BP 49, Dakar, Sénégal. oumsagna2003@yahoo.fr.
authors.forename: O
authors.initials: O
authors.lastname: Sagna
authors.affiliation: Institut santé et développement, université Cheikh-Anta-Diop, Dakar, Sénégal.
authors.forename: I
authors.initials: I
authors.lastname: Seck
authors.affiliation: Institut santé et développement, université Cheikh-Anta-Diop, Dakar, Sénégal.
authors.forename: A T
authors.initials: AT
authors.lastname: Dia
authors.affiliation: Organisation mondiale de la santé, bureau Dakar, BP 4039, Dakar, Sénégal.
authors.forename: F L
authors.initials: FL
authors.lastname: Sall
authors.affiliation: Agence couverture maladie universelle, Dakar, Sénégal.
authors.forename: S
authors.initials: S
authors.lastname: Diouf
authors.affiliation: Ministère de la Santé et de l'Action sociale, Fann Résidence, rue Aimé-Césaire, Dakar, Sénégal.
authors.forename: J
authors.initials: J
authors.lastname: Mendy
authors.affiliation: Ministère de la Santé et de l'Action sociale, Fann Résidence, rue Aimé-Césaire, Dakar, Sénégal.
authors.forename: O
authors.initials: O
authors.lastname: Ka
authors.affiliation: Union régionale des mutuelles de santé de la région de Ziguinchor, Dakar, Sénégal.
authors.forename: B
authors.initials: B
authors.lastname: Kassoka
mesh_terms: D003258:Consumer Behavior / Q000191:economics* / Q000706:statistics & numerical data*; D017144:Focus Groups; D006078:Government Programs / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D012675:Senegal / Q000453:epidemiology; D019472:Universal Health Insurance / Q000191:economics / Q000706:statistics & numerical data*
keywords: Consumers’ preference; Gambia; Guinea-Bissau; Health mutual; Payment in kind; Senegal; Sub-Saharan Africa; Universal health coverage; Ziguinchor region