Mutuelles contract with private providers to increase access to affordable services

photo of participants at the signing event in Kaolack
SHOPS Plus Chief of Party for Senegal Dr. Isseu Touré (center in yellow) with local ASPS and aCMU leadership at the signing ceremony in Kaolack. 

SHOPS Plus is tackling financial barriers to health coverage and access in Senegal through a pilot centered on building a partnership between mutuelles, or community-based insurance schemes, and private providers in three departments in the country. At the signing ceremonies May through June, mutuelles and private providers in Kaolack, Dakar, and Thiès made 133 commitments for contracts, almost tripling the original goal of 50. 

The first of the signing ceremonies took place in Kaolack on May 7 and resulted in 124 of the 133 committed contracts. The success of the first signing ceremony was largely due to two factors. The first is that each of the 14 mutuelles in Kaolack came to an agreement that if one mutuelle decided to contract with a private provider, then each mutuelle would also make a commitment to contract with the same provider. As a result, there were 14 times as many contracts signed as was initially anticipated. In addition to this multiplier effect, the signing ceremony received national media attention, and the presence and support of a local champion in a visible, high-level role was key to the ceremony's success. The director general of the National UHC Agency, Dr. Bocar Mamadou Daff, opened the ceremony with remarks supporting this important partnership.

Daff talking to media
Director general of the National UHC Agency, Dr. Bocar Mamadou Daff, speaking with the media during the signing ceremony in May. 

According to the Strategic Development Plan and the Universal Health Coverage Agency Report, population coverage by mutuelles reached 19 percent in 2018, nearing the halfway point of the government’s 2021 goal of 45 percent. Although Senegal has more than 2,500 private health providers that deliver substantial amounts of care, most of them do not participate as contracted providers with the more than 600 mutuelles operating in the country. This means that clients of mutuelles must pay out of pocket to access care from private providers, creating a barrier to accessing a key part of the country’s health system.

To address this challenge, SHOPS Plus facilitated a framework agreement between two national stakeholders: the Private Sector Alliance (ASPS) and the Ministry of Health Universal Health Coverage Agency (aCMU). The agreement formalizes a public-private partnership that aims to reduce financial barriers to health care, support universal access to health coverage, and ultimately improve health outcomes for the people of Senegal. With this high-level commitment in place, the project worked with ASPS and aCMU to facilitate subsequent agreements regarding tariffs and other contracting terms between private providers and mutuelles in the three pilot departments. 

This activity was designed as a pilot, and the project will document results and lessons learned to share with local stakeholders and the global health community. These findings will help inform future contracting efforts by mutuelles as part of a larger strategy for Senegal, and other countries that share similar challenges. The idea for the pilot stemmed from research conducted in 2017 when SHOPS Plus, working closely with Health Systems Strengthening Plus, another USAID program, explored how private providers could help expand population coverage in mutuelles, and mitigate persistent bottlenecks in service delivery. 

Watch news coverage of the event below. SHOPS Plus chief of party for Senegal Dr. Isseu Touré is interviewed at 17:12.

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Sustaining Health Outcomes through the Private Sector (SHOPS) Plus is a five-year cooperative agreement (AID-OAA-A-15-00067) funded by the United States Agency for International Development (USAID). This website is made possible by the generous support of the American people through USAID. The information provided on this website is not official U.S. government information and does not represent the views or positions of USAID or the U.S. government.

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