Making Health Care Affordable in Senegal, One Village at a Time

Fifty thousand. That’s the number of people (approximately) who now have affordable health care through the Health System Strengthening (HSS) Plus project. The Abt-led HSS Plus is USAID’s flagship universal health coverage (UHC) project in Senegal.

Through HSS Plus’ predecessor (HSS, also led by Abt), we helped to create over 100 mutuelles (community health insurance schemes), educate community members on these schemes and secure government subsidies for vulnerable families who could not pay the mutuelles premiums. Abt and our partners are now building on this work and have helped nearly 50,000 people to enroll in mutuelles. We’re making significant advances by working at the:

• National level (e.g., with Senegal’s Ministry of Health and UHC Agency) on policy-related issues.
• Community level to implement UHC reforms on the ground through various community organizations.

One community organization is the “Watch and Alert Committee” (comite de veille et d'alerte, or CVA). These local committees are comprised of community members who regularly follow up with pregnant women and new mothers to:

• Ensure they attend antenatal and postnatal appointments at their local health facility.
• Direct them to the health care they need.

For HSS Plus, the CVA is a natural partner to educate citizens about mutuelles and the benefit of enrolling. As a pilot, Abt trained the CVA members in the Keur Mor Ndiaye village--explaining what UHC is and what it means for them--and visited over 300 households with the CVA members to explain mutuelles and to organize “community chats.” In a one-month period, nearly 90 women enrolled in the mutuelles. One new member commented: “I was impressed by the information I was given; that’s why I did not even hesitate to come and enroll my family and myself.”

HSS Plus continues to work with the CVA to increase members’ knowledge of mutuelles so they can continue encouraging community members to enroll. Abt also is training the local mutuelles and providing tools for better planning, budgeting, accounting and client communication. Finally, at the national level, we’re still working to provide the UHC Agency with more accurate costing information so it can better plan for the resources it needs to support the community health insurance schemes and other UHC reforms.