On 30th May 2018, HIAS Health held its 27th regular seminar by a HIAS Health member, Dr. Tamahi KATO (YAMAUCHI), Adjunct Research Associate at Hitotsubashi Institute for Advanced Study (HIAS).
HIAS Health has been funded by JSPS to work on an impact evaluation of the Japanese government’s development policy loan (DPL) and technical cooperation project (TCP) to strengthen mutual health organizations in Senegal – a project being conducted jointly with the Japan International Corporation Agency (JICA) and the Universal Health Coverage Agency of Senegal. As part of the project, from November to December 2017, a survey was conducted to monitor and evaluate key indicators of governance, management and operational capacity of mutual health organizations in three regions of Senegal. In this seminar, Dr Kato presented the findings from the survey.
Dr Makoto Tobe, a Senior Advisor of JICA and a newly appointed adjunct member of HIAS Health, participated in the seminar. The presentation by Dr Kato included detailed analyses of the survey data at the level of department of the target regions of the TCP, offering valuable inputs to the impact evaluation project as well as informing future development of policies towards a sustainable universal health coverage in Senegal.
Dr Tamahi KATO (YAMAUCHI), Adjunct Research Associate at Hitotsubashi Institute for Advanced Study (HIAS)Seminar roomDr Makoto TOBE, Senior Advisor of JICA and an adjunct member of HIAS Health
Date & timeMay 30 (Wed), 2018  16:30-18:00
VenueHIAS Seminar Room (Faculty Building II, Room 517), Kunitachi West Campus, Hitotsubashi University
SpeakerDr. Tamahi KATO (YAMAUCHI), Adjunct Research Associate, Hitotsubashi Institute for Advanced Study, Hitotsubashi University
TitleMonitoring governance, management and operational capacity of mutual health organizations in three regions of Senegal: Findings from the 2017 Survey
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.
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.
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)