Reconciling the Senegalese Population with Their Healthcare System: Strategies to Mitigate healthcare Renunciation

In Senegal, the effectiveness of efforts to develop universal health cover is hampered by the fact that a significant proportion of the population refuses to exercise their rights. A distinction is made between barrier-denial, linked to the economic costs of care, and refusal-denial, reflecting people's preferences for other ways of dealing with their health problems. Survey data shows that these two forms of renunciation coexist, even among people with serious illnesses who benefit from free healthcare programmes. Suggestions are put forward for reducing the scale of renunciation and gaining a better understanding of the underlying decision-making processes.