Health Care Utilization in Rural Senegal: The Facts before the Extension of Health Insurance to Farmers

Microinsurance Innovation Facility's Research Paper No. 2 analyzes the determinants of health-seeking behavior in rural Senegal in the framework of the introduction of a health insurance scheme for farmers. It focuses on the effect of socioeconomic factors on health care utilization after controlling for the opportunity cost of time. The study collects information on 505 households and 18 health posts in order to better understand determinants of health care utilization before project implementation. It controls for unobserved effects at the household, and community level that affect health-seeking behavior. It also analyzes the impact of accessibility, price, and quality of medical services on health-seeking behavior. Findings include:

• Unobserved characteristics of household and community are important determinants of the use of medical services;
• Strong likelihood of being cured, and the availability and affordability of medical care explain the high rate of utilization of curative care;
• Household economic status, price, and quality of care are important determinants of likelihood of seeking treatment from a qualified provider.

The strong financial barrier to health care access and socioeconomic inequalities in the use of curative care suggest the importance of expanding health insurance coverage to low and middle-income households.