Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study

In response to the failure of community-based health insurance (CBHI) at the municipal level, some African countries are implementing district or departmental CBHIs to improve universal health coverage. After creating two CBHIs at the departmental level in 2014, Senegal launched a campaign to dissem...

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Main Authors: Valéry Ridde, Mouhamadou Faly Ba, Babacar Kane, Anouk Chouaïd, Adama Faye
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Health Systems & Reform
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Online Access:https://www.tandfonline.com/doi/10.1080/23288604.2024.2402084
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author Valéry Ridde
Mouhamadou Faly Ba
Babacar Kane
Anouk Chouaïd
Adama Faye
author_facet Valéry Ridde
Mouhamadou Faly Ba
Babacar Kane
Anouk Chouaïd
Adama Faye
author_sort Valéry Ridde
collection DOAJ
description In response to the failure of community-based health insurance (CBHI) at the municipal level, some African countries are implementing district or departmental CBHIs to improve universal health coverage. After creating two CBHIs at the departmental level in 2014, Senegal launched a campaign to disseminate the model in 2022. This article presents the stakeholders’ perspectives on the factors and challenges of scaling up CBHI departmentalization in Senegal. The study uses a mixed-methods approach, utilizing concept mapping and a focus group to examine scaling up departmentalization. The sample size consists of 22 individuals involved in the process. The quantitative analysis includes hierarchical cluster analysis, multidimensional scaling analysis, and the Pearson coefficient test. The qualitative analysis involves content analysis to triangulate the findings. Participants identified 125 factors to consider for the departmentalization of CBHI. They were categorized into nine clusters according to their degree of importance (I) and ease to organize (F): service package (I: 4.07; F: 2,26), communication (I: 4.05; F: 2.96), governance (I: 3.96; F: 2,94), human and logistical resources (I: 3.94; F: 2,82), financing (I: 3.90; F: 2,31), involvement of the authorities (I: 3.82; F: 2.75), community involvement (I: 3.81; F: 2.76), membership (I: 3.70; F: 2.24, strategic planning and implementation (I: 3.57; F: 2,62). The main challenges faced were a process perceived as precipitous and vertical and needing more negotiation and consultation. The conditions for accompaniment and public funding availability need to be sufficiently considered. The study proposes avenues for action to promote the scaling up of CBHI departmentalization in Senegal.
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spelling doaj-art-c026989bb5644b4bb89e0bc8578499a62025-08-20T02:49:39ZengTaylor & Francis GroupHealth Systems & Reform2328-86042328-86202024-12-0110110.1080/23288604.2024.2402084Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method StudyValéry Ridde0Mouhamadou Faly Ba1Babacar Kane2Anouk Chouaïd3Adama Faye4IRD, INSERM, Ceped, Université Paris Cité, Paris, FranceInstitute of Health and Development (ISED), Cheikh Anta Diop University, Fann-Dakar, SenegalInstitute of Health and Development (ISED), Cheikh Anta Diop University, Fann-Dakar, SenegalIRD, INSERM, Ceped, Université Paris Cité, Paris, FranceInstitute of Health and Development (ISED), Cheikh Anta Diop University, Fann-Dakar, SenegalIn response to the failure of community-based health insurance (CBHI) at the municipal level, some African countries are implementing district or departmental CBHIs to improve universal health coverage. After creating two CBHIs at the departmental level in 2014, Senegal launched a campaign to disseminate the model in 2022. This article presents the stakeholders’ perspectives on the factors and challenges of scaling up CBHI departmentalization in Senegal. The study uses a mixed-methods approach, utilizing concept mapping and a focus group to examine scaling up departmentalization. The sample size consists of 22 individuals involved in the process. The quantitative analysis includes hierarchical cluster analysis, multidimensional scaling analysis, and the Pearson coefficient test. The qualitative analysis involves content analysis to triangulate the findings. Participants identified 125 factors to consider for the departmentalization of CBHI. They were categorized into nine clusters according to their degree of importance (I) and ease to organize (F): service package (I: 4.07; F: 2,26), communication (I: 4.05; F: 2.96), governance (I: 3.96; F: 2,94), human and logistical resources (I: 3.94; F: 2,82), financing (I: 3.90; F: 2,31), involvement of the authorities (I: 3.82; F: 2.75), community involvement (I: 3.81; F: 2.76), membership (I: 3.70; F: 2.24, strategic planning and implementation (I: 3.57; F: 2,62). The main challenges faced were a process perceived as precipitous and vertical and needing more negotiation and consultation. The conditions for accompaniment and public funding availability need to be sufficiently considered. The study proposes avenues for action to promote the scaling up of CBHI departmentalization in Senegal.https://www.tandfonline.com/doi/10.1080/23288604.2024.2402084Community-based health insurancescalabilitySenegaluniversal health coverage
spellingShingle Valéry Ridde
Mouhamadou Faly Ba
Babacar Kane
Anouk Chouaïd
Adama Faye
Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study
Health Systems & Reform
Community-based health insurance
scalability
Senegal
universal health coverage
title Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study
title_full Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study
title_fullStr Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study
title_full_unstemmed Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study
title_short Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study
title_sort scaling up departmental health insurance units in senegal a mixed method study
topic Community-based health insurance
scalability
Senegal
universal health coverage
url https://www.tandfonline.com/doi/10.1080/23288604.2024.2402084
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