@article{fdi:010093863,
  title = {{M}andatory membership of community-based mutual health insurance in {S}enegal : a national survey},
  author = {{R}idde, {V}al{\'e}ry and {G}aye, {I}. and {V}entelou, {B}. and {P}aul, {E}. and {F}aye, {A}.},
  editor = {},
  language = {{ENG}},
  abstract = {{W}ith the low adherence to voluntary mutual health insurance, {S}enegal's policymakers have sought to understand the feasibility of compulsory health insurance membership. {T}his study aims to measure the acceptability of mandatory membership in community-based mutual health insurance ({CBHI}) and to understand its possible administrative modalities. {T}he study consists of a national survey among a representative population sample selected by marginal quotas. {T}he survey was conducted in 2022 over the phone, with a random composition method involving 914 people. {T}he questionnaire measured the socio-economic characteristics of households, their level of acceptability concerning voluntary and compulsory membership, and their level of confidence in {CBHI}s and the health system. {R}espondents preferred voluntary (86%) over mandatory (70%) membership of a {CBHI}. {T}he gap between voluntary and compulsory membership scores was smaller among women (p = 0.040), people under 35 (p = 0.033), and people with no health coverage (p = 0.011). {V}oluntary or compulsory membership was correlated (p = 0.000) to trust in current {CBHI}s and health systems. {L}ack of trust in the {CBHI} management has been more disadvantageous for acceptance of the mandatory than the voluntary membership. {N}o particular preference emerged as the preferred administrative channel (e.g. death certificate, identity card, etc.) to enforce the mandatory option. {T}he results confirmed the well-known challenges of building universal health coverage based on {CBHI}s-a poorly appreciated model whose low performance reduces the acceptability of populations to adhere to it, whether voluntary or mandatory. {S}uppose {S}enegal persists in its health insurance approach. {I}n that case, it will be essential to strengthen the performance and funding of {CBHI}s, and to gain population trust to enable a mandatory or more systemic membership.},
  keywords = {{SENEGAL}},
  booktitle = {},
  journal = {{P}lo{S} {G}lobal {P}ublic {H}ealth},
  volume = {3},
  numero = {9},
  pages = {e0001859 [13 ]},
  ISSN = {2767-3375},
  year = {2023},
  DOI = {10.1371/journal.pgph.0001859},
  URL = {https://www.documentation.ird.fr/hor/fdi:010093863},
}