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Déterminants de la demande de soins en milieu péri-urbain dans un contexte de subvention à Pikine, Sénégal

Author

Listed:
  • Anta TA DIAL
  • Moussa DIENG
  • Martine AUDIBERT

    (Centre d'Etudes et de Recherches sur le Développement International(CERDI))

  • Jean-Yves LE HESRAN

Abstract

Depuis les années 2000, le Sénégal a adopté des politiques nationales visant la suppression progressive du paiement direct au point de services pour rendre les soins de santé plus accessibles. La mise en place de ces politiques de subvention et de gratuité dans un espace dense hétérogène voire hétéroclite, présente une situation particulière. Pour comprendre ces interactions et étudier le comportement des ménages en matière de demande de soins, 5520 individus ont étés enquêtés à quatre reprises sur la période 2010-2011 dans la banlieue de Dakar (Pikine), un probit multinomial est estimé pour étudier la demande de soins de la population face à un épisode de maladie. Les résultats montrent que l’effet négatif du prix est en moyenne assez faible, mais qu’il varie en fonction du niveau de revenu et de la sévérité de la maladie. La qualité perçue des soins a un effet positif sur le recours aux services de santé privés pour lesquels on observe une compensation de l’effet négatif du prix par la qualité. L’effet de l’âge n’est pas linéaire et les enfants, plus touchés par la maladie, bénéficient de peu d’exemption ou du moins d’exemption partielle contrairement aux personnes âgées qui bénéficient d’exemption totale (plan SESAME).// Summary // Since 2000, Senegal has adopted national policies aimed at phasing out direct payments made at the point of service to make health care more accessible to the populations. The implementation of these policies subsidizing health care is particularly challenging in an environment with high density and important mix of population such as the suburbs of Dakar. To understand the underlying interactions and study the behavior of households' demand for care, 5520 individuals were surveyed four times over the period December 2010 to November 2011 in Pikine, one of the main suburbs of Dakar. A multinomial probit was estimated to assess the determinants of health care demand in an episode of illness. The results showed a negative effect of price but with a low coefficient. The magnitude of the price effect varies depending on individual income level and the severity of the disease. The quality of care (self-assessed by individuals) has a positive effect on the use of private health services and seems to compensate the negative effect of price in that case. The effect of age is not linear and children, who are most affected by diseases, receive no exemption or at most partial exemption compared to seniors who receive full exemption (SESAME plan).

Suggested Citation

  • Anta TA DIAL & Moussa DIENG & Martine AUDIBERT & Jean-Yves LE HESRAN, 2014. "Déterminants de la demande de soins en milieu péri-urbain dans un contexte de subvention à Pikine, Sénégal," Working Papers 201415, CERDI.
  • Handle: RePEc:cdi:wpaper:1584
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    More about this item

    Keywords

    Demande de soins; Subvention des soins; Probit multinomial; Pikine; Senegal;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis

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