Factors Associated with Membership in a Mutual Health Insurance Fund in the Thiès Region (Senegal) in 2023: Article

Abstract

 Introduction : Mutual health insurance constitutes a micro-insurance system which facilitates access to care by avoiding direct payment. They represent one of the pillars of our Universal Health Coverage. After years of existence and despite political commitment, community support for mutual health insurance remains low until now. The objective of our work was to study the factors linked to the membership of mutual health insurance companies in the Thiès region and to propose solutions.  Methodology : The study was cross-sectional, descriptive and analytical. It was carried out among a sample of 1,300 people, residing in the Thiès region for at least 6 months, chosen following a three-stage cluster survey. A questionnaire was used to collect data related to predisposing, facilitating and health system factors. These data were entered and analyzed using SPSS version 21 software. The significance value was P < 0.05. The Odds ratio was used to measure the strength of the link.  Results : The average age is 42 years and among the people surveyed 75.3% lived in an urban area, 84.5% claimed to know mutual insurance companies. The number of dependent children among the people surveyed was 9 and 90% had an income-generating activity, married people were 82.9% and 78.2% were educated. The mutual penetration rate was 69.3%. The analysis showed that membership in mutual health insurance was significantly influenced by the area of residence with P < 0.001 [OR: 2.0; CI:1.4-2.8], by age group with P < 0.001[OR:1.4; CI:1.1-2.0], by income-generating activity with P < 0.001 [OR:2.1; CI:1.1-4.1], by knowledge of a mutual with P < 0.001 [OR:81.6; CI: 42.2-157] and education with P < 0.001 [OR: 1.9; CI: 1.3-2.6]. Membership was also associated with marital status and the number of children in care with P < 0.001 and P < 0.002 respectively.  Conclusion : This study made it possible to evaluate the penetration rate of mutual health insurance in the Thiès region in 2023, but also to identify the factors associated with membership in a mutual health insurance. Strengthening communication and targeted awareness and improving the level of knowledge of the populations will help to boost the level of support of the populations of the Thiès region.