Maymouna Ba
PATH, Senegal
Posters & Accepted Abstracts: Pharm Regul Aff
Introduction & Aim: The majority of exemption policies in Sub-Saharan Africa provide, de facto, for so-called passive resource allocation arrangements. Plan Sesame is an exemption mechanism adopted in Senegal in 2006 and targeting those aged over 60 years is no exception to this rule. It is based on user fees as a service purchase method. This article examines the effects of the passive service purchase method on equitable access to care under Plan Sesame. Methodology: The analysis is based on a household survey conducted in Senegal from May 2012 to July 2013. It uses a mixed methodology, combining policy documents review, stakeholder analysis and a household survey. Findings: The analysis highlights three important results: Between 2006 and 2009, the Dakar region, home to 18.65% of the elderly, accounted for 69.67% of the payments made under the Sesame Plan, while the other regions benefited from limited resources (less than 30%). Over the same period, hospitals have captured a large part of the budgets allocated for the Sesame Plan, which favors older people living in urban areas to the detriment of those in rural areas. The wealthiest population quartile has a significantly higher probability of accessing Plan Sesame resources than the poorest quartile (odd ratio: 2.23 rate>0.01). Conclusion: Plan Sesame is characterized by hybrid funding, which advantages older persons in the formal sector who have greater access to hospitals. It is thus these people who capture the larger proportion of the budget allocated under the Plan. In sum, the most advantaged social groups and persons living in urban areas stand a greater chance of accessing Plan Sesame resources.
Pharmaceutical Regulatory Affairs: Open Access received 533 citations as per Google Scholar report
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