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An assessment of the core capacities of the Senegalese health system to deliver Universal Health Coverage

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  • Elisabeth Paul
  • Youssoupha Ndiaye
  • Farba Lamine Sall
  • Fabienne Fecher
  • Denis Porignon

Abstract

Senegal is firmly committed to the objective of universal health coverage (UHC). Various initiatives have been launched over the past decade to protect the Senegalese population against health hazards, but these initiatives are so far fragmented. UHC cannot be achieved without health system strengthening (HSS). Here we assess the core capacities of the Senegalese health systems to deliver UHC, and identify requirements for HSS in order to implement and facilitate progress towards UHC. Based on a critical review of existing data and documents, complemented by the authors’ experience in supporting UHC policy making and implementation, we evaluate the main foundational and institutional bottlenecks relative to the six health system building blocks, together with an analysis of the demand-side of the health system, which facilitate or hamper progress towards UHC. Despite the fact that many institutions are now in place to deliver UHC, important weaknesses limit progress along the two dimensions of UHC. Substantial disparities characterize resource allocation in the health sector, and health risk protection schemes are highly fragmented. This spreads down to the rest of the health system including service delivery and consequently, impacts on health outcomes. These constraints are acknowledged by the authorities, solutions have been proposed, but these necessitate strong political will. Moreover, progress towards UHC is constrained by the difficulty to act on social determinants of health and a lack of fiscal space.

Suggested Citation

  • Elisabeth Paul & Youssoupha Ndiaye & Farba Lamine Sall & Fabienne Fecher & Denis Porignon, 2020. "An assessment of the core capacities of the Senegalese health system to deliver Universal Health Coverage," ULB Institutional Repository 2013/312244, ULB -- Universite Libre de Bruxelles.
    • Handle: RePEc:ulb:ulbeco:2013/312244
    Note: SCOPUS: ar.j
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    References listed on IDEAS

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    1. Elisabeth Paul & Céline Deville & Oriane Bodson & N'koué Emmanuel Sambiéni & Ibrahima Thiam & Marc Bourgeois & Valéry Ridde & Fabienne Fecher, 2019. "How is equity approached in universal health coverage? An analysis of global and country policy documents in Benin and Senegal," ULB Institutional Repository 2013/298047, ULB -- Universite Libre de Bruxelles.
    2. Cheryl Cashin, 2016. "Health Financing Policy," World Bank Publications - Books, The World Bank Group, number 23734.
    3. Daniel Cotlear & Somil Nagpal & Owen Smith & Ajay Tandon & Rafael Cortez, 2015. "Going Universal," World Bank Publications - Books, The World Bank Group, number 22011.
    4. Mcintyre, Di & Meheus, Filip & Røttingen, John-Arne, 2017. "What level of domestic government health expenditure should we aspire to for universal health coverage?," Health Economics, Policy and Law, Cambridge University Press, vol. 12(2), pages 125-137, April.
    5. International Monetary Fund, 2019. "Senegal: Fiscal Transparency Evaluation," IMF Staff Country Reports 2019/034, International Monetary Fund.
    6. World Bank, 2013. "World Development Indicators 2013," World Bank Publications - Books, The World Bank Group, number 13191.
    7. Tania Dmytraczenko & Gisele Almeida, 2015. "Toward Universal Health Coverage and Equity in Latin America and the Caribbean," World Bank Publications - Books, The World Bank Group, number 22026.
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    Cited by:

    1. Wood, Anna, 2023. "Patronage, partnership, voluntarism: Community-based health insurance and the improvisation of universal health coverage in Senegal," Social Science & Medicine, Elsevier, vol. 319(C).
    2. Valéry Ridde & Ibrahima Gaye & Bruno Ventelou & Elisabeth Paul & Adama Faye, 2023. "Mandatory membership of community-based mutual health insurance in Senegal: A national survey," ULB Institutional Repository 2013/363350, ULB -- Universite Libre de Bruxelles.
    3. Abayomi Samuel Oyekale, 2023. "Utilization of Proximate Healthcare Facilities and Children’s Wait Times in Senegal: An IV-Tobit Analysis," IJERPH, MDPI, vol. 20(21), pages 1-18, November.
    4. Abdel-Basset, Mohamed & Chang, Victor & Nabeeh, Nada A., 2021. "An intelligent framework using disruptive technologies for COVID-19 analysis," Technological Forecasting and Social Change, Elsevier, vol. 163(C).
    5. Valéry Ridde & Ibrahima Gaye & Bruno Ventelou & Elisabeth Paul & Adama Faye, 2023. "Mandatory membership of community-based mutual health insurance in Senegal: A national survey," Post-Print hal-04222420, HAL.
    6. Bonoua Faye & Jeanne Colette Diéne & Guoming Du & Chang’an Liang & Yao Dinard Kouadio & Edmée Mbaye & Yuheng Li, 2024. "Decentralization Policies and Rural Socio-Economic Growth in Senegal: An Exploration of Their Contributions to Development and Transformation," World, MDPI, vol. 5(4), pages 1-23, November.
    7. Roosa Lambin & Milla Nyyssölä, 2022. "Two decades of Tanzanian health policy: Examining policy developments and opportunities through a gender lens," WIDER Working Paper Series wp-2022-30, World Institute for Development Economic Research (UNU-WIDER).

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