Summary (English)

Social security in Senegal covers less than 20 per cent of the population in terms of both personal and derived rights. The list of persons excluded also includes temporary workers and day labourers as well as workers in the informal sector.
Furthermore, it has transpired from studies conducted that the absence of protection is caused by problems of equity between protected workers and those who are not protected, which are related to the yield management strategies of undertakings related to international competition. A consequent challenge is that of finding relevant solutions that are balanced and that take account of the interests of all of the parties involved in labour relations.
Initiatives have been taken in Senegal, both at State level and in civil society, which have been designed to extend social security beyond the "formal" sector. These have included community initiatives developed since 1990 within the mutual health organisations (MHOs), offering separate coverage to essentially non-wage-earning population groups.
A survey conducted in May 2000 provided a better understanding of the socio-demographic characteristics of the persons concerned by social security in one way or another. The survey data reveal the needs in the social security field. The absence of contact with the social security institutions is to be explained by the lack of promotion and by the general lack of interest of the persons concerned. The overwhelming majority of the survey group wanted protection against short-term social risks -health, maternity, unemployment, employment injury- and some opt for coverage against long-term social risks - old age, disability and death. The problem is that the income of those desiring coverage gained from seasonal activities, and therefore cyclical in nature. The irregular income pattern and the relatively high contributions can prevent people from joining mutual organisations; on the other hand, when contributions are too low the mutual organisations do not ensure effective coverage of hospital care, which is costly for members. Furthermore, the mutual organisations generally lack negotiating power and do not have the management capacities for adopting the most efficient mechanisms for paying the service providers; 55 per cent offer only services relating to hospital care.
In the period from 1994 to 1998 the mutual organisations were extended throughout the various regions of the country. Their schemes, most of which are recent, are generally small or moderate in size in terms of membership. The mutual insurance activities concern only a small proportion of the population of the country. The likelihood of access to hospital services is greater when one is a member of a mutual insurance scheme than when one is not. Although very costly to cover, it is considered more advisable to focus efforts on financing life-threatening illnesses.
In conclusion, it is suggested that the State work together more effectively with the various institutions to create support services in order to complement statutory social security and voluntary insurance. The overall objective would be to involve the various trades, and then to focus efforts on developing a mutual-benefit savings and credit system (as a fundamental basis) and ultimately to incorporate social coverage (social services) into this system.
Furthermore, a solution would have to be found to the problem of financial barriers within the mutual organisations and the support structures.