Equity in access to healthcare: an econometric analysis of the determinants of healthcare use in Senegal

The right to health is at the heart of the World Health Organization’s Constitution, which states that 'the fundamental right of every human being is to enjoy the highest attainable standard of health'. The aim of this paper is to assess the level of equity in access to healthcare in three regions of Senegal. Our approach is based on the conceptual framework proposed by Andersen (1995), using a multilevel analysis. The data used come from the regional survey on poverty and universal health coverage (EPCMU) conducted in 2019 in the regions of Diourbel, Thieès and Tambacounda. Our results show that the structure of healthcare use is influenced by whether the head of household has been to school (75%) or not (63%). However, it remains identical according to the child's sex and the child's relationship to the head of household. There is also a higher use of healthcare among the richest and wealthiest (83% and 66%) than among the poorest or middle class (57% to 63%). In addition, having a medical history in the last three months rather than not having one is more likely to influence the use of healthcare. What's more, almost half (47%) of people who do not seek healthcare in a specialized institution do so because they self-medicate. We therefore recommend strengthening the policy of free health care and rethinking the strategy of access to care for vulnerable groups in order to achieve the sustainable development goals.