Introduction: Despite the recognition of the role of Mutual Health Organization (MHO) as a mechanism to ensure the financial sustainability of health systems, recent studies have shown the existence of obstacles to enrolment and retention in these MHOs. The objective of this study was to examine the determinants of enrolment and retention in MHO in Senegal.Methods: Data collection was conducted from 22 June to 30 September 2015 in Ziguinchor, located 450 km from Dakar by stratified two-stage sampling (n = 912 households). The analysis was conducted by multiple logistic regression with selection of predictors in the Stepwise Backward method based on the likelihood ratio.Results: Low enrolment was significantly associated with rural residence, size of the household, low level of household head literacy and income, poor perception of the quality of care and distance from the nearest health facility. Low retention in MHO was also significantly associated with low household income, poor perception of quality of care, and presence of a person over the age of 60 years in the household.Conclusion: The determinants of enrolment and retention of consumers in MHO must be taken into account to ensure successful development of a Universal Health Coverage strategy.
Keywords: insurance; major medical; universal coverage; health knowledge; attitudes; practice; socioeconomic factors; Senegal.