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Senegalese Market Women Get Low-Cost Health Insurance


A women's cooperative in Senegal is offering low-cost health insurance to previously-uninsured market women.

A horse cart loaded with empty bottles rattles down a dirt lane outside Senegal's capital, past a small wooden stand selling fresh vegetables and dried fish.

Oulimatta Tigerre has been selling beans and bullion cubes from this stand since 1995. Old tires weigh down the twisted metal sheeting that keeps out the rain.

Tigerre is an independent businesswoman who lives in a cash economy. Hard work earned her enough money to buy a plot of land in the suburbs. But with her husband out of work, she worried about how to cover the family's medical bills.

Then a neighbor told her about a low-cost health insurance program through the women's cooperative credit union of the Network of Programs for Urban and Rural Women. For the equivalent of two dollars a month, Tigerre's family of five is covered.

Tigerre says she got sick while she was pregnant, and when she went to the hospital, all the bills were covered by insurance. She says her children get malaria, especially during the rainy season, and when they go to the hospital, the cooperative insurance plan pays the bills.

Fatoumata Beye Gaye is the regional director for the cooperative that focuses on urban women in low-income families. The group provides low-interest loans to market women and sponsors literacy and computer training. But Gaye says it is the health insurance program that has most changed women's lives.

Gaye says women in this neighborhood no longer have problems with health care. In Senegal, she says there is a saying that health does not have a price, but it does have a cost. Big insurance companies do not want to work with informal sector workers like market women, so Gaye says the cooperative takes care of the women with health insurance.

The risk of more than 20,000 women is pooled in the insurance program in which each beneficiary has a separate account. When that person is ill, the program gives them a letter that they take to a participating health center, and the bill is sent to the cooperative where it is deducted from the account.

Gaye says Senegal's Ministry of Health has also helped the cooperative reach deals with several public hospitals and clinics to provide their clients with low-cost pre-natal and anti-natal care from ultrasound to delivery.

The program does not cover everything. No pre-existing conditions are covered nor are cancer, heart disease, or HIV/AIDS because, Gaye says, they take too much time and money to treat. Instead, the health scheme is meant to help low-income families cope with routine medical conditions without having to borrow money.

Tigerre says it has removed the stress of having to pay medical bills every time someone gets sick.

Tigerre says many of the people who are part of this program are poor and can not afford to pay their medical bills upfront. So she says the health insurance saves people from worrying about where they will find the money to pay the doctor.

Tigerre used some of the money she has saved to open a bread kiosk next to her vegetable stand where her daughter Koumba sells baguette and hard-boiled eggs.

If her mother had not joined the health insurance program, she says life would have been difficult for the family because her father is not working, and it is hard to pay medical bills.

With the ability to insure up to 15 family members and a 25 percent discount at participating pharmacies, Gaye says the essence of the health insurance program is best summarized by its Wolof-language name "Wer Werle" -- very roughly translated as "health for myself among others who are healthy."

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