2018年5月30日（水）に加藤（山内）珠比 HIAS Health 研究員（一橋大学社会科学高等研究院　特任助教）を報告者として定例研究会を開催しました。
 
一橋大学は国際協力機構（JICA）およびセネガル医療保障庁（UHC Agency）と共同で、セネガルにおけるJICA技術協力プロジェクト『コミュニティ健康保険制度及び無料医療制度能力強化プロジェクト』のインパクト評価を行っています。セネガルの三つの州における保健共済組合の運営能力の現状を把握する目的で、2017年11月から12月にかけて、州内の全組合を対象に実施した調査を行いました。今回の定例研究会では、その調査結果の中間報告が行われました。
 
戸辺誠 HIAS Health 客員研究員（JICA 人間開発部 国際協力専門員）を始めとした共同研究の参画者や一橋大学の研究者が集い、活発な質疑応答と議論が行われ、多くの有益な提案が得られました。特に今回は対象州の県別の分析を行ったため、今後の技術協力やインパクト評価へ資するデータとなるとともに、より具体的な政策への提言につながるような議論が行われました。
 
 web_IMG_2978 web_IMG_2984 web_IMG_2977
報告中の加藤（山内）珠比 HIAS Health研究員
（一橋大学社会科学高等研究院　特任助教）		会場の様子セネガルの地域事情についてコメントする
戸辺誠 HIAS Health客員研究員
（JICA 人間開発部 国際協力専門員）
 
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日時2018年5月30日（水）　16：30－18：00
会場西キャンパス　第2研究館　5階　HIASセミナー室（517号室）
報告者加藤（山内）珠比、一橋大学社会科学高等研究院、特任助教　（HIAS Health 研究員）
タイトルMonitoring governance, management and operational capacity of mutual health organizations in three regions of Senegal: Findings from the 2017 Survey
概要Background
Scaling up the role and capacity of the health insurance system is one of the key strategies of the government of Senegal to secure access to quality health care without imposing an excess financial burden on all Senegalese, namely to achieve universal health coverage. In 2017, the government of Senegal and the Japan International Cooperation Agency (JICA) agreed to implement the project for strengthening capacity for community health insurance system and free health care initiatives. The project is to support Universal Health Coverage Agency (l’Agence de la Couverture Maladie Universelle: ACMU), the mutual health organization (Mutuelle de Santé: MS), and health facilities, to bolster their operational and management capacity. There are two types of health insurance programme of MS: Standard programme, which is voluntary enrollment insurance system, and Family Security Grant (Bourses de Sécurité Familial: BSF), which is conditional cash transfer programme targeting the poor households. As part of the project, ACMU, JICA and Hitotsubashi University conducted a survey of MS to monitor and identify the key challenges of the governance, management and operational capacity of MS.
 
Data
The survey targeted all 206 MS in three regions: Thiès, Diourbel and Tambacounda. The data were collected through interviews with key staff members who make important decisions at the MS level via a structured questionnaire in November and December 2017.
 
Hilights
Here are the highlights of the findings.
  • The results show significant degrees of between- and within-region heterogeneity in almost all aspects of operation of MS. Overall MS in Thiès and Diourbel appeared to demonstrate better performance than that in Tambacounda.
  • The enrollment rates of Standard members were lower number than other countries, though this rate does not count the enrollment of formal health insurance scheme, thus it was made smaller than the reality.
  • As Standard programme is not compulsory, the programme may be subject to adverse selection.
  • BSF at least partially contribute to provide health access for the poorest population in the three regions.
  • Despite the support of Japanese government’s Development Policy Lending, the delivery of the BSF subsidy was found to be severely delayed (the amount of overdue accounted for 10.6 million CFA francs on average, with the figure being particularly high in Diourbel and Tambacounda).
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