Analysis of free health care for the elderly in the context of the "Plan Sesame" in Senegal

作者：Leye Mamadou Makhtar Mbacke^*; Diongue Mayassine; Faye Adama; Coume Mamadou; Faye Abdoulaye; Tall Alioune Badara; Niang Khadim; Wone Issa; Seck Ibrahima; Ndiaye Papa; Tal Dia Anta

来源：Sante Publique, 2013, 25(1): 101-106.

• Analysis
• care provision and management
• free health care
• Senegal

Introduction: Access to health care remains a major problem in Senegal, particularly among vulnerable groups such as the elderly. In 2006, the Senegalese government introduced a national plan for the provision of free health care known as "Plan Sesame" to improve access to care. The purpose of this study was to examine the current state of the "Plan Sesame" in national hospitals four years after its implementation (2006-2009).
Methods: A qualitative study using individual interviews was conducted between 15 March and 14 May 2010 among five target populations: hospital directors, health care providers, managers of the "Plan Sesame" in hospital admission services, management accountants, and beneficiaries. Content analysis was used.
Results: Between 2006 and 2008, hospital attendance rates increased every year. However, attendance rates began to decrease in 2009, except in the main hospital. The state has been left with a growing debt because of issues surrounding the reimbursement of expenses related to the "Plan Sesame": As a result, national hospitals have been forced to restrict certain services included in the "Plan Sesame" and even to withdraw free health care for the elderly These difficulties are likely to undermine the sustainability of the "Plan Sesame".
Conclusion: The health authorities need to audit the "Plan Sesame", to comply with standard procedures through regular monitoring and to redefine conditions of access.

• 出版日期2013-2