Décomposition des inégalités dans l'utilisation des soins de santé au Sénégal

This study seeks to measure horizontal equity in the use of health care in Senegal using the method of decomposition of the inequality concentration index. The distribution of care as required to follow the hierarchical organization present in the health system, we distinguished the care received in hospitals from those received in health centres and posts. The results of this first estimation shows that significant inequities exist in favor of higher income populations in the benefit of care in hospitals and health centres. The care provided in health posts benefit more to poor people. Noting that over 22% of patients with minor illnesses are treated in hospitals and over 60% of patients whose disease has a high level of severity are treated in health posts, we performed simulations, by reassigning patients to adequate healthcare facility regarding the severity, in order to measure the effects of non-compliance of patients on addressing on the equity index. With these reassignments, inequity in hospital care becomes pro-poor. Inequity in health posts is increasing for these poor. The inequity in health centres is in favor of the rich. The results obtained with the simulations suggest that inequities as they currently exist are mainly due to non-compliance of listing in the health system. Establishing austerity in referrals and raising public awareness of listing may help to make the health system more equitable.