Community-Based Health Insurance, Digital Enrolment and the Informal Sector Strategy in Senegal
Download the Full PaperExemplar Overview
This exemplar examines how Senegal utilized digital systems, social protection linkages, and department-level pooling to scale community-based health insurance (CBHI) mutuelles and extend coverage to informal-sector workers.
In 2013, Senegal launched the Couverture Maladie Universelle (CMU) program, targeting coverage expansion through community-based mutuelles. A major innovation was department-level pooling, which consolidated risk pools to improve financial stability. Senegal integrated its national registry of poor households (RNU) with the CMU system, allowing beneficiaries to be automatically enrolled in local mutuelles with public subsidies. Digital payment platforms (SUNU-CMU) reduced transaction costs, enabling mobile and diaspora premium payments. By 2024, CMU coverage reached 53.6%.
Policy Recommendations
Integrating health insurance with cash-transfer programs (like the BSF registry) immediately registers and protects the most vulnerable.
Consolidating risk pools at a higher administrative level (department) prevents the bankruptcy of small, localized insurance mutuelles.
Digitalization of enrollment and payment workflows reduces transaction friction and makes informal-sector premium collection viable.
Sustaining community-based systems requires a clear transition from voluntary participation to mandatory enrollment guidelines.
Key Numbers
CMU health coverage achieved in Senegal by 2024
Doses of vaccines per year targeted by the MADIBA project
Department-level health insurance mutuelles established
Target mandatory enrollment rate by 2030
Key Findings
Senegal's CMU coverage reached 53.6% by 2024, driven by the expansion of community-based mutuelles.
Department-level pooling consolidated risk, resolving the financial instability of earlier, smaller village-level mutuelles.
The SUNU-CMU digital platform facilitated mobile and diaspora contributions, bypassing cash collection bottlenecks.
The Institut Pasteur de Dakar's MADIBA initiative scaled local vaccine manufacturing capacity toward a target of 300 million doses annually.