User perceptions and knowledges of the health micro-insurance system in the thiès region (Senegal) in 2023

Introduction: The State of Senegal maintains that the promotion of mutual health insurance is a priority for accessing universal health coverage. Despite the efforts of politicians, deficits in terms of knowledge and perceptions of the populations are noted for most micro health insurance systems, especially in the Thiés region. It is in this context that this work aims to study users' perceptions of the health micro insurance system in the Thiè s region. Methodology: This is a qualitative study that was conducted in the period from 2020 to 2024. The collection period was two (2) months. Individual interview guides were used for mutual fund managers and healthcare providers and focus group guides for members and non-members. The collection period was two (2) months. Content analysis was carried out using RQDA software and Epi info version 3.5.3 to determine trends. Results: Managers were aware of the role of mutual health insurance companies and understood the CMU agency guidelines. Most (22/30) had contracts with health structures through agreements and some (25/30) considered the penetration rates acceptable. The majority (28/30) recognized the delay in repaying state debts as a difficulty. Healthcare providers (18/20) favorably appreciated the services provided and the level of partnership. Others (15/18) encountered problems in practice, they were unanimous on the interest of strengthening the communication of mutual insurance companies and were involved in training and supervision activities. Members (9/12) knew the basic principles of a mutual insurance company, its usefulness in facilitating access to care stated that they had known of the existence of the mutual insurance company. Other members (8/12) recognized that the operation of mutual health insurance companies is going through enormous difficulties. Non-members (7/12) generally have basic knowledge of a mutual. The reasons for non-membership were often financial and a lack of information on how mutualist structures work. Even if most non-members were aware of the interest of mutuals. Conclusion: The problem of access to healthcare for populations has always been a major concern in developing countries through the health micro insurance system. This based on the perceptions of the different actors has made it possible to better understand the evolution of the indicators in order to facilitate decision-making by the competent authorities.