Evaluation of the viability of 05 community health mutuals in the health district of Oussouye in 2018

Abstract

Introduction: In Senegal, mutuality has benefited from considerable political support from the country's authorities, who have defined Universal Health Coverage (UHC) as a priority. The general objective of our study was to assess the viability of community health mutuals in the Oussouye health district in 2018. Methodology: In this descriptive cross-sectional study with an evaluative aim, the mixed method was used. Sustainability had been assessed in its institutional, technical, functional and financial dimensions. For the perception of the populations, an individual interview was carried out with the presidents or representatives of mutual health insurance, the beneficiaries or not and a focus with the community leaders. Results: All of the mutuals were institutionally viable. Technically, there was control over the risks of adverse selection, over prescription and overconsumption. Functionally, the results were able to show a positive gross growth rate for 80% of mutual health organizations ranging from 5% to 33%, the average penetration rate was 74% and the recovery rate at 49.33%. From a financial standpoint The expense coverage ratio, which measures financial autonomy, was less than 1 for 80% of mutuals. Conclusion: The Oussouye and Mlomp mutuals, i.e. 40%, were viable taking all dimensions into account. Sixty percent (60%) of mutuals dependent on state subsidy, corrective actions were necessary for the sustainability of health financing.