Impact and quality of universal health coverage in Senegal

Senegal aims to transform into an emerging market economy by 2035 with the help of its ambitious development policy, the Plan Sénégal Emergent (PSE). The PSE highlights the crucial role of health in achieving this goal and emphasizes the need for "an efficient health system that provides quality services accessible to the population". This objective is one of the three expected outcomes of the National Health and Social Development Plan (PNDSS) for 2019-2028. To this end, the country has made significant investments to improve access to healthcare. The State now has a programme to provide free health care services to women, children under-five, and the elderly (Plan SESAME). Additionally, caesarean sections are free and the country launched the Universal Health Coverage (UHC) program in 2013. The country is also expanding health care services in remote areas (Kaffrine, Touba, Kédougou and Sédhiou) and is undertaking efforts to improve the quality of health care service (PNDSS 2019-2028). As a result, current health expenditure per capita have increased by 20% between 2013 (120 $ ppp) and 2019 (145 $ ppp)(World Bank 2023). However, several health indicators in the country have considerable room for improvement. For example, life expectancy at birth is only 68 years, the child mortality rate is 39 ?, maternal mortality ratio is 315 per 100,000 live births, 25% of births are unattended by skilled health staff (World Bank 2023) and only 50% of the population have access to essential health care services . Diseases such as neonatal disorders, diarrheal diseases, respiratory infections, and malaria, all of which are in principle readily preventable or treatable, continue to be the leading causes of death in the country. . In addition, recent data suggests that 41 % of people forgo healthcare (Sall, 2023) despite needing it, thereby highlighting potential demand or access issues. . The project has three main objectives: (i) to measure the contribution of universal health coverage to the increase in demand for health care and the improvement of health indicators in Senegal; (ii) to produce an epidemiological map of Senegal, calculate the costs of treating the most important and common diseases and measure the out-of-pocket expenditure of people covered by the CMU; and (iii) to analyse the impact of the merging ('departmentalisation') of mutual health insurance on health indicators.