The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal

Ridde, Valéry; Kane, Baïdy Sy; Mbow, Ndeye Bineta; Senghor, Ibrahima; Faye, Adama

doi:10.1136/bmjgh-2022-010062

Cited by 8 publications

(9 citation statements)

References 52 publications

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“…It also demonstrates the benefits of a systemic approach because, in parallel with the organisation of demand, the programme has intervened to reform supply 42. Several studies have presented the sustainability and resilience of these UDAMs43 and confirmed the fundamental role of professionalisation for the performance of CBHI in Senegal 14. In September 2022, the National Agency of the CMU of Senegal decided to transform all communal community CBHI into 46 departmental CBHI.…”

Section: Discussionmentioning

confidence: 89%

Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali

Touré

Boivin²,

Diarra³

et al. 2023

BMJ Glob Health

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BackgroundMany Sahel countries in Africa are looking for solutions for universal health coverage (UHC). Mali is in the process of adopting the Universal Health Insurance Plan, which allows for the mutualisation of existing schemes. Its operationalisation requires numerous adjustments to the current mutualist proposal and innovations in the system. The study focuses on innovations experienced in mutuality and their conditions of scale for UHC in Mali.MethodsThis is qualitative research by multiple case studies. It is based on the collection of data by interviews (n=136), at a national and local level, on the analysis of documents (n=42) and a long field observation (7 months). The analytical framework concerns the dissemination and maintenance of health innovations (Greenhalghet al,2004).ResultThe analysis of this innovation shows an interest in the technical and institutional viability that determines its performance and scale-up. The procrastination and scepticism displayed at the highest level of the state and the international level, the reluctance, both financial and ideological, to renew the old mutualist proposal, penalise this Malian experiment.ConclusionThis innovation is a decisive step in ensuring the health coverage of Mali’s agricultural and informal sectors. The reform will need to be amplified and supported in the future to expect the scale-up of a cheaper, technically and institutionally more efficient system. Without a political intention to mobilise national resources and accept a fundamental paradigm shift in health financing, the search for the financial viability of mutuality may, again, be at the expense of the performance.

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Section: Discussionmentioning

confidence: 89%

Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali

Touré

Boivin²,

Diarra³

et al. 2023

BMJ Glob Health

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“…For example, Williamson, Colley, and Foley (2022) report that superiors experienced an “epiphany” once realizing that, differently from their expectations, employees were as or more productive working from home than in the office. Also at the macro level, from a measure of resilience both in developed (Rivera‐Macias & Casselden, 2022) and in developing economies (Singh et al, 2021), telework became an established routine, making its undoing more complex (Ridde et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Telework in public organizations: A systematic review and research agenda

Mele,

Belardinelli,

Bellé

2023

Public Administration Review

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After a relatively slow policy and scholarly take‐up, recent developments created the urgency for massive efforts to implement and regulate telework in public organizations. We contribute to this debate through a systematic review of 120 studies across disciplines. Findings from our analysis reveal a few established antecedents of telework, including individual characteristics like family responsibilities and expected productivity, but also organizational aspects like supportive leadership, and contextual features like natural disasters. Self‐reported productivity and work‐life balance stand out as telework's most widely studied outcomes, although evidence is often conflicting when coming to the effects of telework. We present our results by distinguishing pre‐ and post‐pandemic findings. Complementing our systematic review, we engage in a generative exercise by identifying emerging debates on telework in public bureaucracies. We conclude by indicating future research directions.This article is protected by copyright. All rights reserved.

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“…Since 2014, Senegal has experimented a different model of CBHI, consisting in departmental mutual health insurance managed by professionals, whose coverage rate demonstrate its relevance (14).…”

Section: Introductionmentioning

confidence: 99%

Mandatory membership of community-based mutual health insurance in Senegal: A national survey

Ridde

Gaye

Ventelou

et al. 2023

Preprint

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With the low adhesion to voluntary mutual health insurance, Senegal’s policymakers have sought to understand the feasibility of compulsory health insurance membership. This study aims to measure the acceptability of mandatory membership in community-based mutual health insurance (CBHI) and to understand its possible administrative modalities. The study consists of a national survey among a representative population sample selected by marginal quotas. The survey was conducted in 2022 over the phone, with the random composition method among 914 people. The questionnaire measured the socio-economic characteristics of households, their level of acceptability concerning voluntary and compulsory membership, and their level of confidence in CBHIs and the health system. Respondents preferred voluntary (86%) over mandatory (70%) membership of a CBHI. The gap between voluntary and compulsory membership scores was smaller among women (p=0.040), people under 35 (p=0.033) and people with no health coverage (p=0.011). Voluntary or compulsory membership was correlated (p=0.000) to trust in current CBHIs and health systems. No particular preference emerged as for the preferred administrative channel (e.g. death certificate, identity card, etc.) which could enable to enforce the mandatory character. The results confirmed the well-known challenges of building universal health coverage on the basis of CBHIs, a model which is poorly appreciated and whose low performance reduces the acceptability of populations to adhere to it, be it on a voluntary or mandatory basis. Suppose Senegal persists in its health insurance approach. In that case, it will be essential to strengthen the performance and funding of CBHIs, and to gain population trust to enable a mandatory or more systemic membership.

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The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal

Cited by 8 publications

References 52 publications

Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali

Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali

Telework in public organizations: A systematic review and research agenda

Mandatory membership of community-based mutual health insurance in Senegal: A national survey

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