Effectiveness of the Universal Health Coverage Scheme in Senegal

The aim of this study is to assess the impact of the universal health coverage (UHC) scheme in Senegal on the use of medical care and employee productivity, and to carry out a cost-effectiveness analysis of the scheme. The data used come from the Harmonized Survey of Household Living Conditions (Enquete Harmonisee sur les Conditions de Vie des Menages, EHCVM) in Senegal conducted in 2018 by the National Statistics and Demography Bureau (Agence nationale de la statistique et de la demographie, ANSD). The study used the Endogenous Switching Regression (ESR) model to take account of the self-selection bias. Its findings show that the beneficiaries of the scheme had greater access to medical care and lost fewer days of work due to illness than the non-beneficiaries. They also show that if the non-beneficiaries were covered by the UHC scheme, they would have increased their access to medical care and would have lost fewer days of work. These results are consistent since easy access to medical care enables its beneficiaries to receive treatment quickly when they fall ill. But the study also found that although the UHC scheme improved its beneficiaries access to medical care and productivity at work, it also increased their medical care costs. Indeed, the cost-effectiveness analysis carried out showed that the scheme was unequivocally ineffective in the case of the 15-60 age group, one which essentially constitutes the working population. In other words, the beneficiaries of the UHC scheme in Senegal incurred more medical care costs and obtained fewer benefits from it than its non-beneficiaries. The study recommends that advocating an extension of the schemes coverage, while emphasizing its positive effects on its beneficiaries health and productivity at work would lead to enhanced mobilization on the part of the government. In addition, better knowledge of the medical care package offered as part of the scheme and of its effectiveness would enable its beneficiaries to make better use of the benefits its offers. Keywords: Healthcare, Insurance uptake, Socio-economic factors, NHIS, NHIA