Health navigation: improving access to healthcare for the most vulnerable people in Senegal

In Senegal, although the Universal Health Coverage (CMU) policy was implemented in 2013, the poorest people face significant difficulties in accessing quality healthcare and services.

In 2019, in the regions of Fatick and Tambacounda, while 1,275,000 people were eligible for free mutual insurance membership, 66 % were not aware of it.

The innovation aims to mobilize and train community health workers, the “navigators”, in the villages to support beneficiaries of free membership in professionalized mutual health insurance schemes – known as Unités Départementales d’Assurances Maladies (UDAM).

The innovation is tested with 50 navigators for 750 eligible people in rural areas and 250 in urban areas in the regions of Fatick and Tambacounda.

The objective of this pilot is to:

• Assign navigators the role of intermediary between the population and the health system
• Be able to provide information on the situation of the beneficiaries, the barriers they encounter in particular non-financial barriers
• Discuss with health professionals the implementation of solutions

The research team, led by ISED, has already tested health navigation with populations suffering from infectious diseases and obtained promising results. However, no experiments have yet been conducted to verify its effectiveness with targeted populations. FID funding is oriented toward this objective.

This project aims to mobilize local and national actors to improve the use of healthcare for people receiving free UDAM membership and to test in real conditions whether health navigation:

• Enhances equity in access to healthcare
• Reduces health care costs
• Improves the physical and mental health of the most vulnerable

In the longer term, the results of this study will serve to inform larger scale tests through impact evaluations. The objective is to improve the overall health system, its equity and efficiency through better use of membership waiver resources, and better integration of community health workers into the system.