Revue de droit comparé du travail et de la

sécurité sociale
3 | 2022
L’économie sociale et solidaire

Le rôle de l’Économie sociale et solidaire dans

l’extension de l’assurance maladie au Sénégal
Mohamed Bachir Niang

Édition électronique
URL : https://journals.openedition.org/rdctss/4419
DOI : 10.4000/rdctss.4419
ISSN : 2262-9815

Traduction(s) :
The role of the social and solidarity economy in the extension of health insurance in Senegal - URL :
https://journals.openedition.org/rdctss/4697 [en]

Éditeur
Centre de droit comparé du travail et de la sécurité sociale

Édition imprimée
Date de publication : 21 octobre 2022
Pagination : 178-195
ISSN : 2117-4350

Référence électronique
Mohamed Bachir Niang, « Le rôle de l’Économie sociale et solidaire dans l’extension de l’assurance
maladie au Sénégal », Revue de droit comparé du travail et de la sécurité sociale [En ligne], 3 | 2022, mis
en ligne le 21 octobre 2023, consulté le 20 novembre 2023. URL : http://journals.openedition.org/
rdctss/4419 ; DOI : https://doi.org/10.4000/rdctss.4419

Le texte seul est utilisable sous licence CC BY-NC-ND 4.0. Les autres éléments (illustrations, fichiers
annexes importés) sont « Tous droits réservés », sauf mention contraire.
 Mohamed Bachir Niang

/ƞƫǩƥƞƝƞƥō(ƜƨƧƨƦƢƞƬƨƜƢƚƥƞ
ƞƭƬƨƥƢƝƚƢƫƞƝƚƧƬƥōƞƱƭƞƧƬƢƨƧ
ƝƞƥōƚƬƬƮƫƚƧƜƞƦƚƥƚƝƢƞ
ƚƮ6njƧnjƠƚƥ

ABSTRACT

,Q$IULFDWKHVRFLDOVROLGDULW\EDVHGHFRQRP\VRXQGVOLNHDSURPLVHRIRYHUFRPLQJWKHKLVWRULFDOOLQN
EHWZHHQ VRFLDO VHFXULW\ DQG ZDJH HPSOR\PHQW ,Q 6HQHJDO WKH OHJDO DQFKRULQJ RI WKH SURFHVV RI
H[WHQGLQJ KHDOWK LQVXUDQFH LQ WKH ORJLF RI WKH VRFLDOVROLGDULW\EDVHG HFRQRP\ KDV EHHQ RYHUWDNHQ
E\FRQŴLFWVRISHUFHSWLRQRIWKLVIRUPRIHFRQRP\7KHQRUPDWLYHDQGLQVWLWXWLRQDOFRPPLWPHQWWRWKH
H[WHQVLRQRIKHDOWKFRYHUDJHKDVQRWSURGXFHGWKHH[SHFWHGUHVXOWV7KHSXEOLFƓQDQFLQJRIKHDOWK
LQVXUDQFHLVDVRXUFHRIEXGJHWDU\WHQVLRQZKLFKDOUHDG\VKRZVWKHIUDJLOLW\RIDV\VWHPYXOQHUDEOH
WR HQGRJHQRXV DQG H[RJHQRXV VKRFNV 7KH VRFLDO DQFKRULQJ RI KHDOWK LQVXUDQFH LQ LWV H[WHQVLRQ
SURMHFWLVDOVRVXSSRUWHGE\DGPLQLVWUDWLYHGHFHQWUDOLVDWLRQZKLFKLVVWUXJJOLQJWRƓQGDOLQNZLWKWKH
KLVWRULFDO VRXUFHV RI VRFLDOLVDWLRQ9ROXQWDU\ ZRUN ZRXOG SURGXFH D GLIIHUHQWLDWHG VRFLDO G\QDPLF E\
LQFUHDVLQJLQHTXDOLWLHV7KHIXWXUHRIKHDOWKLQVXUDQFHLQFRQMXQFWLRQZLWKWKHSUHVHUYDWLRQRIWKHERQG
RIVROLGDULW\HTXDOLW\DQGHTXLW\GHSHQGVRQWKHZLOOLQJQHVVWRPRELOLVHWKHFRQWULEXWRU\FDSDFLWLHVRI
WKHOLEHUDOSURIHVVLRQVLQGHSHQGHQWZRUNHUVLQWKHIRUPDODQGLQIRUPDOHFRQRP\

KEYWORDS : Social and Solidarity Economy, Health Insurance, Mutual Health Insurance,
Public Financing.

RÉSUMÉ

/ō«FRQRPLH VRFLDOH HW VROLGDLUH VRQQH HQ $IULTXH FRPPH XQH SURPHVVH GH G«SDVVHPHQW GX OLHQ
KLVWRULTXHHQWUHV«FXULW«VRFLDOHHWVDODULDW$X6«Q«JDObOōDQFUDJHMXULGLTXHGXSURFHVVXVGōH[WHQVLRQ
GHOōDVVXUDQFHPDODGLHGDQVODORJLTXHGHOō«FRQRPLHVRFLDOHHWVROLGDLUHD«W«UDWWUDS«SDUOHVFRQŴLWV
GHSHUFHSWLRQGHFHWWHIRUPHGō«FRQRPLH/ōHQJDJHPHQWQRUPDWLIHWLQVWLWXWLRQQHOGDQVOōH[WHQVLRQGH
ODFRXYHUWXUHPDODGLHQōDSDVSURGXLWOHVU«VXOWDWVHVFRPSW«V/HƓQDQFHPHQWSXEOLFGHOōDVVXUDQFH
PDODGLHHVWVRXUFHGōXQHWHQVLRQEXGJ«WDLUHTXLPRQWUHG«M¢ODIUDJLOLW«GōXQV\VWªPHYXOQ«UDEOHDX[
FKRFV HQGRJªQHV HW H[RJªQHV /ōDQFUDJH VRFLDO GH OōDVVXUDQFH VDQW« GDQV VRQ SURMHW GōH[WHQVLRQ
HVW DXVVL SRUW« SDU OD G«FHQWUDOLVDWLRQ DGPLQLVWUDWLYH TXL SHLQH ¢ WURXYHU XQ UHODLV DYHF OHV UHVVRUWV
KLVWRULTXHVGHODVRFLDOLVDWLRQ/HYRORQWDULDWVHUDLWSURGXFWHXUGōXQHG\QDPLTXHVRFLDOHGLII«UHQWL«H
HQ FUHXVDQW OHV LQ«JDOLW«V /ōDYHQLU GH OōDVVXUDQFH PDODGLH HQ OLDLVRQ DYHF OD FRQVHUYDWLRQ GX OLHQ
GHVROLGDULW«Gō«JDOLW«HWGō«TXLW«G«SHQGGHODYRORQW«¢PRELOLVHUOHVFDSDFLW«VFRQWULEXWLYHVGHV
SURIHVVLRQVOLE«UDOHVWUDYDLOOHXUVLQG«SHQGDQWVGHOō«FRQRPLHIRUPHOOHFRPPHLQIRUPHOOH

MOTS-CLÉS : Economie sociale et solidaire, assurance maladie, mutuelles de santé,

ƓQDQFHPHQWSXEOLF

178 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

L
D QDLVVDQFH GHV PXWXHOOHV GH VDQW« DX 6«Q«JDO YRLO¢ SOXV GH  DQV1 «SRXVH
SDUIDLWHPHQW OHV U«DOLW«V GH Oō«FRQRPLH VRFLDOH HW VROLGDLUH (Q DWWHVWHQW OD
VSRQWDQ«LW« GDQV OōDSSDULWLRQ GH FHV VWUXFWXUHV OHXU LPSODQWDWLRQ HW OHXU JHVWLRQ
IRUWHPHQWFRPPXQDXWDLUHVDLQVLTXHOōDEVHQFHGōXQHQFDGUHPHQWLQVWLWXWLRQQHOHW
QRUPDWLIGHG«SDUW2'HVWLQ«HV¢ODFRXYHUWXUHGHVVRLQVGHVDQW«SULPDLUHVFHVHQWLW«VRQW
DX6«Q«JDOFRPPHGDQVODSOXSDUWGHV(WDWVGō$IULTXHQRLUHIUDQFRSKRQHE«Q«ILFL«SDU
ODVXLWHGōXQSRUWDJHLQVWLWXWLRQQHOGHVSRXYRLUVSXEOLFVVXLWH¢XQHSULVHGHFRQVFLHQFH
QDWLRQDOHFRPPXQDXWDLUHHWLQWHUQDWLRQDOHVXUOHOLHQTXLOHVXQLWG«VRUPDLV¢OōREMHFWLI

 /D SUHPLªUH PXWXHOOH GH VDQW« DX 6«Q«JDO IXW FU««H HQ  GDQV OH YLOODJH GH )DQGHQH 9RLU
-$OHQGD'HPRXWLH]mb/HVPXWXHOOHVGHVDQW«DX6«Q«JDOIDFHDX[GLIƓFXOW«VGHFRRUGLQDWLRQGH
OHXUVDFWHXUVb}Revue internationale de l’économie socialeQrMXLOOHWS
 ([SRV« GHV PRWLIV GH OD ORL Qr GX  MXLQ  UHODWLYH DX[ PXWXHOOHV GH VDQW«b  mb /HV
PXWXHOOHVGHVDQW«FRQVWLWXHQWXQLQVWUXPHQWPRGHUQHSURPHWWHXUSRXUQRWDPPHQWG«YHORSSHU
OH V\VWªPH GōDVVXUDQFH PDODGLH HW DXGHO¢ FRQWULEXHU ¢ OōDP«OLRUDWLRQ GHV FRQGLWLRQV GH VDQW«
GHV SRSXODWLRQV /D SUHXYH HQ HVW IRXUQLH SDU OH G«YHORSSHPHQW VSRQWDQ« HW SURJUHVVLI GX
V\VWªPHPXWXDOLVWHDX6«Q«JDOb}-256 -RXUQDO2IILFLHOGHOD5«SXEOLTXHGX6«Q«JDO QrGX
MXLOOHWSHWVb&RPSO«W«SDUOHG«FUHWQrGXDYULOSRUWDQWDSSOLFDWLRQ
GHODORLQr9RLU«JDOHPHQW-$OHQGD'HPRXWLH]mb/HVPXWXHOOHVGHVDQW«DX6«Q«JDOIDFH
DX[GLIƓFXOW«VGHFRRUGLQDWLRQGHOHXUVDFWHXUVb}op. cit
 1RWDPPHQW OHV SURJUDPPHV GōDVVLVWDQFH HW GōDVVXUDQFH GH OD &RXYHUWXUH 0DODGLH 8QLYHUVHOOH
HQFDGU«HSDUOō$JHQFHGHOD&08 G«FUHWQrGXMDQYLHUFU«DQWOō$JHQFH1DWLRQDOH
GHOD&08 P¬PHVLOōHQFDGUHPHQWGHVPXWXHOOHVGHVDQW«GDWHGōXQHORLGH
 mb3ODQVWUDW«JLTXHGHOD&RXYHUWXUH0DODGLH8QLYHUVHOOHb}bPLQLVWªUHGHOD6DQW«HWGH
Oō$FWLRQVRFLDOHSbmb>/HVPXWXHOOHVGHVDQW«@VRQW¢Oō«WDWDFWXHOGXQLYHDXGHFRXYHUWXUH
HWGHOōDPSOHXUGHVVHFWHXUVLQIRUPHOVHWUXUDX[GDQVOHSD\VOHVVHXOHV¢GLVSRVHUGHSRWHQWLHOV
SRXUFRXYULUODPDMRULW«GHODSRSXODWLRQV«Q«JDODLVHb}9RLU«JDOHPHQWOHmb3ODQVWUDW«JLTXHGH
G«YHORSSHPHQWGHVPXWXHOOHVGHVDQW«DX6«Q«JDOb}PLQLVWªUHGHOD6DQW«MXLOOHWSbmb/D
IRUFHGHVPXWXHOOHVGHVDQW«HVWOHXUDFFHSWDELOLW«VRFLDOHb}
 &DGUH GH SROLWLTXH VRFLDOH GH Oō8QLRQ $IULFDLQH DGRSW« HQ b  &DGUH GōKDUPRQLVDWLRQ GH
OD JRXYHUQDQFH WHFKQLTXH ƓQDQFLªUH HW LQVWLWXWLRQQHOOH GHV RUJDQLVPHV GH V«FXULW« VRFLDOHb 
&RQYHQWLRQ*«Q«UDOHGHV«FXULW«VRFLDOHGHOD&RQI«UHQFH,QWHUDIULFDLQHGHOD3U«YR\DQFH6RFLDOH
&,35(6 b  $FWH DGGLWLRQQHO GH OD  &RPPXQDXW« (FRQRPLTXH GHV (WDWV GH Oō$IULTXH GH Oō2XHVW
&('($2  SRUWDQW &RQYHQWLRQ J«Q«UDOH GH V«FXULW« VRFLDOHb  5ªJOHPHQW Qr&08(02$
SRUWDQW U«JOHPHQWDWLRQ GH OD PXWXDOLW« VRFLDOH DX VHLQ GH Oō8QLRQ (FRQRPLTXH HW 0RQ«WDLUH
2XHVWDIULFDLQHb  5ªJOHPHQW GōH[«FXWLRQ Qr&208(0$2 GX  DR½W  Ɠ[DQW OHV
PRGDOLW«V HW SURF«GXUHV GH FRQVWLWXWLRQ GōDJU«PHQW HW GōLPPDWULFXODWLRQ GHV PXWXHOOHV VRFLDOHV
HW OHXUV VWUXFWXUHV ID°WLªUHVb  5ªJOHPHQW GōH[«FXWLRQ Qr&208(02$ UHODWLI DX[ UªJOHV
SUXGHQWLHOOHV GHYDQW HQFDGUHU OHV UHVVRXUFHV ƓQDQFLªUHV GHV PXWXHOOHV VRFLDOHb  5ªJOHPHQW
GōH[«FXWLRQQr&08(02$SRUWDQWDGRSWLRQGXSODQFRPSWDEOHGHVPXWXHOOHVVRFLDOHVDX
VHLQGHOō8(02$b,QLWLDWLYHGH%DPDNRbHWF
 6HORQOD%DQTXH0RQGLDOHOHG«YHORSSHPHQWG«SHQGGLUHFWHPHQWGHODFDSDFLW«GHVLQGLYLGXV¢
VXUPRQWHUOHVULVTXHVTXLGRLYHQWIDLUHOōREMHWGōDQWLFLSDWLRQHWGHFDOFXOVGHODSDUWGHVLQGLYLGXVb
YRLU OH 5DSSRUW VXU OH G«YHORSSHPHQW GDQV OH PRQGHmb 5LVTXHV HW RSSRUWXQLW«Vb  OD JHVWLRQ GX
ULVTXH ¢ OōDSSXL GX G«YHORSSHPHQWb } %DQTXH 0RQGLDOH b  5DSSRUW VXU OD VDQW« GDQV OH
PRQGHbmb/HƓQDQFHPHQWGHVV\VWªPHVGHVDQW«OHFKHPLQYHUVXQHFRXYHUWXUHXQLYHUVHOOHb}206
*HQªYH3UHVVHVGHOō206b'«FODUDWLRQGō$OPD$WD&RQI«UHQFHLQWHUQDWLRQDOHGō$OPD$WD
VXU OHV VRLQV GH VDQW« SULPDLUHV b  OHV VRLQV GH VDQW« SULPDLUHVmb H[LJHQW HW IDYRULVHQW XQH
DXWRQRPLHHWXQHSDUWLFLSDWLRQPD[LPDOHVGHODFRPPXQDXW«HWGHVLQGLYLGXV¢ODSODQLƓFDWLRQ¢
OōRUJDQLVDWLRQDXIRQFWLRQQHPHQWřb}

RDCTSS - 2022/3 179

 Mohamed Bachir Niang

GōH[WHQVLRQ GH OD FRXYHUWXUH VDQW« ¢ OōHQVHPEOH GH OD SRSXODWLRQ 8Q SHX SDUWRXW HQ
$IULTXH QRLUH IUDQFRSKRQH GHV O«JLVODWLRQV VS«FLƓTXHV FRQƓUPHQW FH OLHQ FRQVLG«U«
FRPPHLQG«IHFWLEOHHQWUHODPXWXDOLW«VRFLDOHHWODU«DOLVDWLRQ¢JUDQGH«FKHOOHGXGURLW
IRQGDPHQWDO¢ODSURWHFWLRQVRFLDOHSU«FLV«PHQWGXGURLW¢XQHFRXYHUWXUHVDQW«

/ō«FRQRPLHVRFLDOHHWVROLGDLUHUHQYRLHWRXWGōDERUG¢XQH«FRQRPLHHWQRQXQHDFWLYLW«
RX¢XQVHFWHXUGHOō«FRQRPLH(OOHDXUDLWYRFDWLRQ¢SRXYRLUVDLVLUWRXVOHVDVSHFWVGHODYLH
QDWLRQDOHSURGXFWLYHGHELHQVHWVHUYLFHV(OOHDXUDLWFRPPHFULWªUHVGLVWLQFWLIV¢ODIRLVVHV
PRGHVGHIRQFWLRQQHPHQWD[«VVXUODG«PRFUDWLHODOLEHUW«GōDGK«VLRQODVROLGDULW«HWF
HWVHVƓQDOLW«VSDUWLFXOLªUHVFHQWU«HVVXUOōKXPDLQ$X6«Q«JDOODORLGōRULHQWDWLRQUHODWLYH
¢Oō«FRQRPLHVRFLDOHHWVROLGDLUHGXMXLQU«DOLVHXQDQFUDJHMXULGLTXHGHFHWWHIRUPH
Gō«FRQRPLHHQYLVDQWOHVmbDFWLYLW«V«FRQRPLTXHVPHQ«HVDYHFXQHDSSURFKHFHQWU«HVXU
ODSHUVRQQHKXPDLQHYLVDQWXQHƓQDOLW«VRFLDOHRXHQYLURQQHPHQWDOHHWU«DOLV«HVSDUGHV
FRRS«UDWLYHV RX PXWXHOOHV GHV DVVRFLDWLRQV HQWUHSUHQDQWHV GHV HQWUHSULVHV VRFLDOHV RX
SDUGHVDFWHXUVGHOō«FRQRPLHSRSXODLUHb}
/ōDJU«PHQWmb(FRQRPLHVRFLDOHHWVROLGDLUHb}QōHVWDX[WHUPHVGHOōDUWLFOHGHODORL
GHG«OLYU«TXōDX[HQWUHSULVHVTXLDSSRUWHQWmb¢WUDYHUVOHXUDFWLYLW«XQVRXWLHQ¢GHV
SHUVRQQHVHQVLWXDWLRQGHIUDJLOLW«GXIDLWGHOHXUVLWXDWLRQ«FRQRPLTXHHWVRFLDOHb}DLQVL
TXō¢FHOOHVTXLVHGHVWLQHQW¢mbFRQWULEXHU¢ODOXWWHFRQWUHOHVH[FOXVLRQVHWOHVLQ«JDOLW«V
VDQLWDLUHV«FRQRPLTXHV¢Oō«GXFDWLRQ¢ODFLWR\HQQHW«RXDXPDLQWLHQHWDXUHQIRUFHPHQW
GHODFRK«VLRQWHUULWRULDOHb}/DORLGXMXLQUHODWLYHDX[PXWXHOOHVGHVDQW«FRQVLGªUH
GDQVVRQHVSULWWRXWDXPRLQVOHVPXWXHOOHVGHVDQW«GDQVXQHORJLTXHGō«FRQRPLHVRFLDOH
HW VROLGDLUH10 &HV YDOHXUV SRUW«HV SDU OD ORL V«Q«JDODLVH VōDVVLPLOHQW SDUIDLWHPHQW DX[
FULWªUHVGHOō«FRQRPLHVRFLDOHHWVROLGDLUH11P¬PHVLODGRFWULQHQHFHVVHHQP¬PHWHPSV
GHUDSSHOHUOHVDSSURFKHVUHQRXYHO«HVGXFRQFHSW12

 9RLU QRWDPPHQWb  ORL Qr GX  DYULO  SRUWDQW PXWXDOLW« VRFLDOH HQ 5«SXEOLTXH GH
*XLQ«HbORLRUJDQLTXHQrGXI«YULHUG«WHUPLQDQWOHVSULQFLSHVIRQGDPHQWDX[UHODWLIV
¢ODPXWXDOLW«bHQ5«SXEOLTXHD«PRFUDWLTXHGX&RQJRORLQrGXDYULOSRUWDQW
U«JLPHJ«Q«UDOGHVPXWXHOOHVGHVDQW«HQ5«SXEOLTXHGX1LJHUb&RGHGHVPXWXHOOHVGHVDQW«DX
0DOLbORLQrSRUWDQWU«JLPHGōDVVXUDQFHPDODGLHXQLYHUVHOOHDX%XUNLQD)DVRb
 ;,WFDLQDmb(FRQRPLHVRFLDOHHWVROLGDLUHb}Dictionnaire des politiques territorialesS
/ōDXWHXU\FLWH-)'UDSHULHW'&DVWLHObmb/DQRXYHOOH«FRQRPLHVRFLDOHRX«FRQRPLHVRFLDOHHW
VROLGDLUHVōDIƓUPHSDUGHQRXYHOOHVLQLWLDWLYHVGHVFLWR\HQVHQSDUWLFXOLHUHQPDWLªUHGHVROLGDULW«
GHSURWHFWLRQGHOōHQYLURQQHPHQWHWGHFU«DWLRQGHQRXYHDX[VHUYLFHVb}
 $UW  GH OD ORL GX  MXLQ  SRUWDQW ORL GōRULHQWDWLRQ UHODWLYH ¢ Oō«FRQRPLH VRFLDOH HW VROLGDLUH
-256QrGXDR½W
10 $UWGHODORLQrGXMXLQUHODWLYHDX[PXWXHOOHVGHVDQW«bmb/DPXWXHOOHGHVDQW«
HVWXQJURXSHPHQWGHSHUVRQQHV¢EXWQRQOXFUDWLITXLHVVHQWLHOOHPHQWDXPR\HQGHVFRWLVDWLRQV
GHVHVPHPEUHVVHSURSRVHGHPHQHUGDQVOōLQW«U¬WGHFHX[FLRXGHOHXUIDPLOOHXQHDFWLRQGH
SU«YR\DQFH GōHQWUDLGH HW GH VROLGDULW« HQ YXH QRWDPPHQW GōDVVXUHU OD SULVH HQ FKDUJH GH WRXW
RXSDUWLHGHVVRLQVGHVDQW« ř /HVPXWXHOOHVGHVDQW«VRQWWHQXHVGHUHVSHFWHUOHVSULQFLSHV
PXWXDOLVWHVVXLYDQWVbODVROLGDULW«ODOLEHUW«ODG«PRFUDWLHOōLQG«SHQGDQFHb}
11 -//DYLOOHmb(FRQRPLHHWVROLGDULW«(VTXLVVHGōXQHSUREO«PDWLTXHb}L’économie solidaire. Une
perspective internationale3DULV)D\DUGH«GSb
12 3'5RXVVHDXmb0DODLVHGDQVOō«FRQRPLHVRFLDOHHWVROLGDLUHb}SEREtudesS

180 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

/ō«FRQRPLH VRFLDOH HW VROLGDLUH SDUFH TXōHOOH HVW GōDERUG VRFLDOH VRQQH HQ $IULTXH
FRPPH XQH SURPHVVH GH FU«DWLRQ GōXQ OLHQ HQWUH SURWHFWLRQ VRFLDOH HW VRFL«W« HW GRQF
GōXQG«SDVVHPHQWGXOLHQKLVWRULTXHHQWUHODV«FXULW«VRFLDOHHWOHVDODULDWÀOōRSSRV«GH
OōHVSDFHIUDQ©DLVR»ODFDW«JRULHmbPXWXHOOHb}DSSDUD°WFRPPHXQLQVWUXPHQWGHFRPSO«PHQW
¢XQHSURWHFWLRQVRFLDOHGHEDVHHWGRQFYRORQWDLUHFHWWHFDW«JRULHƓJXUHHQSUHPLHU
OLHX HQ $IULTXH FRPPH XQ PR\HQ GH SUHPLªUH U«DOLVDWLRQ GX GURLW IRQGDPHQWDO ¢ OD
V«FXULW« VRFLDOH /D PXWXDOLW« TXL VH GHVWLQH ¢ ¬WUH FRPSO«PHQWDLUH ¢ XQH SURWHFWLRQ GH
EDVHVXEVLVWHFHSHQGDQWGHPDQLªUHU«VLGXHOOH
/H V\VWªPH GH V«FXULW« VRFLDOH DX 6«Q«JDO HVW FRQIURQW« DX G«Ɠ GH OōLQHIIHFWLYLW« GH
VHV UªJOHV SDU XQH «YDVLRQ VRFLDOH LPSRUWDQWH VXUWRXW GDQV Oō«FRQRPLH LQIRUPHOOH /D
TXHVWLRQ GH VRQ H[WHQVLRQ HVW SRXUWDQW SOXV ODQFLQDQWH GDQV OD PHVXUH R» HOOH FRQWUDLQW
OH GURLW V«Q«JDODLV ¢ XQH V\QWKªVH SUHVTXH LPSRVVLEOH /ōDVVXUDQFH VDQW« REOLJDWRLUH QH
FRXYUHTXHOHVIRQFWLRQQDLUHVHWOHVWUDYDLOOHXUVVDODUL«VUHSU«VHQWDQWHQVHPEOHPRLQV
GH  GH OD SRSXODWLRQ 'DQV OH FDGUH GHV PXWXHOOHV GH VDQW« OōDVVXUDQFH PDODGLH
E«Q«ƓFLH ¢ PRLQV GH  GH OD SRSXODWLRQ20 HW FRQVWLWXH OH OHYLHU LQFRQWRXUQDEOH GX
SURMHWGōH[WHQVLRQ/ōDQFUDJHMXULGLTXHGXSURFHVVXVGōH[WHQVLRQGHODFRXYHUWXUHPDODGLH
HVWUDSLGHPHQWUDWWUDS«SDUOHVFRQŴLWVGHSHUFHSWLRQGHFHWWHIRUPHGō«FRQRPLHHWSDU
OHV GLYHUJHQFHV FRQFHSWXHOOHV P¬PH VXU OD FDW«JRULHmb PXWXHOOHb VRFLDOH}21 /HV FRQŴLWV

 &%HFmb/DV«FXULW«VRFLDOHHQWUHVROLGDULW«HWPDUFK«b}5HYXH)UDQ©DLVHGH6RFLR«FRQRPLH
KRUVV«ULH
 -3 &KDXFKDUG -< .HUERXFōK & :LOPDQQ Droit de la sécurité sociale LGDJ H «G S b 
mb$ORUVTXHODV«FXULW«VRFLDOHHVWREOLJDWRLUHHW«WURLWHPHQWUªJOHPHQW«HSDUOō(WDWODPXWXDOLW«
HVWPDUTX«HSDUODOLEHUW«GōDGK«VLRQGHWRXWLQGLYLGXVRXFLHX[GōDP«QDJHUXQFRPSO«PHQWGH
SURWHFWLRQb}
 0XWXHOOH GHV DJHQWV GH Oō(WDW PXWXHOOH GHV GRXDQHV HW GHV IRUFHV DUP«HV LQWHUYLHQQHQW HQ
FRPSO«PHQWGXU«JLPHGHVIRQFWLRQQDLUHVTXLFRXYUHGHFHUWDLQHVG«SHQVHV
 (QXQHHQTX¬WHQDWLRQDOH¢WUDYHUVOD'$602 '«FODUDWLRQ$QQXHOOHVXUOD0DLQGōĐXYUH 
U«Y«ODLW TXH OHV ,30 QH FRXYUDLHQW TXH  GH OD SRSXODWLRQ GHV WUDYDLOOHXUV VDODUL«V UHFHQV«V
-,VVD6D\HJKLe droit sénégalais de la sécurité sociale1RXYHOOHV(GLWLRQV$IULFDLQHVSb
--'XSH\URX[0%RUJHWWR5b/DIRUH55XHOODQDroit de la sécurité socialeH«GS
 /HV G«SHQVHV GH VRLQV GH VDQW« GHV IRQFWLRQQDLUHV VRQW SULVHV HQ FKDUJH SDUWLHOOHPHQW SDU OH
EXGJHWQDWLRQDO/DUHWUDLWHHVWDVVXU«HSDUOH)RQGV1DWLRQDOGH5HWUDLUH )15 
 /HV WUDYDLOOHXUV VDODUL«V GX VHFWHXU SULY« HW GX VHFWHXU SXEOLF HW OHV DJHQWV IRQFWLRQQDLUHV
E«Q«ƓFLHQWVHXOVGōXQHV«FXULW«VRFLDOHGDQVOHFDGUHGHU«JLPHVREOLJDWRLUHV &RGHGHODV«FXULW«
VRFLDOHORLQrGXMXLOOHW-256QrGXDR½WS /DORLGXDYULO
 UHODWLYH DX[ LQVWLWXWLRQV GH SU«YR\DQFH VRFLDOH «WHQG OD FRXYHUWXUH DX[ ULVTXHV PDODGLH HW
IUDLVSKDUPDFHXWLTXHVHWOōDUU¬W«GXPDUVFRQIªUHQW¢Oō,QVWLWXWGH3U«YR\DQFH5HWUDLWHGX
6«Q«JDO ,35(6 
 (QOHVDVVXU«VHWE«Q«ƓFLDLUHVGXU«JLPHGHVIRQFWLRQQDLUHV«WDLHQWDXQRPEUHGHb
SHUVRQQHVHWFHX[GHVU«JLPHVREOLJDWRLUHVGHVVDODUL«VGHbVRLWXQQRPEUHGHb
SHUVRQQHVSRXUXQHSRSXODWLRQWRWDOHGHSOXVGHPLOOLRQVGōKDELWDQWVbRevue Globale et analyse
du système national de protection sociale au Sénégal2,7MDQYLHU
20 Revue Globale et analyse du système national de protection sociale au Sénégalop. cit
21 - $OHQGD'HPRXWLH] mb /HV PXWXHOOHV GH VDQW« DX 6«Q«JDO IDFH DX[ GLIƓFXOW«V GH FRRUGLQDWLRQ
GHOHXUVDFWHXUVb}op. cit6HORQOōDXWHXUHbm1RXVFKHUFKRQV¢PRQWUHUTXōXQHP¬PHLQVWLWXWLRQ
OD PXWXHOOH SHXW ¬WUH SRUW«H SDU GHV SULQFLSHV GH MXVWLƓFDWLRQ GLII«UHQWV SRXU OXL GRQQHU VHQV
FH TXL HQJHQGUH GHV SUREOªPHV GH FRRUGLQDWLRQ LPSRUWDQW HQWUH DFWHXUVb ř  /HV V\VWªPHV GH
UHSU«VHQWDWLRQGHODPXWXDOLW«VRQWGLYHUVHWOHFRQVHQVXVDSSDUHQWVXUODIRUPHDGRSW«HSDUODORL
FDFKHGHVUDSSRUWVGHSRXYRLUVUHPLVHQFDXVHb}

RDCTSS - 2022/3 181

 Mohamed Bachir Niang

UHODWLIVDX[GLII«UHQWHVVRXUFHVGXGURLW QDWLRQDOHLQWHUQDWLRQDOHHWFRPPXQDXWDLUH VRQW

SOXVSU«JQDQWVHWSHUWXUEHQWOōHVSRLUGōXQHDSSURFKHVLPSOLƓ«HGHODTXHVWLRQ/DSOXUDOLW«
GHVDFWHXUVLPSOLTX«VGDQVOHSURFHVVXVGōH[WHQVLRQGHODFRXYHUWXUHVDQW« EDLOOHXUVGH
IRQGVLQWHUQDWLRQDX[VRFL«W«FLYLOHDXWRULW«VFRPPXQDXWDLUHVSRXYRLUVSXEOLFV UHQYRLH¢
XQHmbFRPPXQDXW««SLVW«PLTXHb}22HWG«ERXFKHVXUXQFRQŴLWGHSHUFHSWLRQTXDQWDX[
ƓQDOLW«VHWDX[LQVWUXPHQWVGHOōH[WHQVLRQ
/DUHQFRQWUHHQWUHOō«FRQRPLHVRFLDOHHWVROLGDLUHHWOōH[WHQVLRQGHOōDVVXUDQFHPDODGLH
LQWHUSHOOH DLQVL OD SUREO«PDWLTXH SOXV J«Q«UDOH GH OōH[WHQVLRQ GX VRFOH GH SURWHFWLRQ
VRFLDOH GDQV OHV SD\V HQ G«YHORSSHPHQW HW VōLQVFULW GDQV OōDJHQGD GX 6«Q«JDO GōDQFUHU
VRQ DFWLRQ GDQV OH UHVSHFW GX GURLW LQWHUQDWLRQDO GH Oō2,7 HW FH P¬PH VL OD &RQYHQWLRQ
QrQōDSDV«W«UDWLƓ«HGDQVVHVDVSHFWVUHODWLIV¢ODPDODGLH/H6«Q«JDODFHSHQGDQW
DGK«U«¢GōDXWUHVLQVWUXPHQWVLQWHUQDWLRQDX[VS«FLƓTXHV¢ODFRXYHUWXUHVDQW«PLQLPDOH
8QHU«ŴH[LRQVXUOHVLQVWUXPHQWVMXULGLTXHVGHODFRQWH[WXDOLVDWLRQGHFHWWHSUREO«PDWLTXH
QRXVLQYLWH¢PHVXUHUHW¢H[DPLQHUOHVP«FDQLVPHVSDUOHVTXHOVODPXWXDOLW«VRFLDOHLQVFULW
VRQHQJDJHPHQWVXUOōH[WHQVLRQGHODFRXYHUWXUHVDQW«DX6«Q«JDO
/D UHQFRQWUH HQWUH Oō(66 HW OōH[WHQVLRQ GH OD FRXYHUWXUH PDODGLH HVW UDSSHO«H SDU OD
YRORQW«GōXQHDSSURFKHQDWLRQDOHGHG«FHQWUDOLVDWLRQGHOōDVVXUDQFHPDODGLH '(&$0 
/D G\QDPLTXH VRFLDOH HW SRSXODLUH GH OōH[WHQVLRQ GH OD FRXYHUWXUH PDODGLH LOOXVWU«H SDU
XQHSRUWDELOLW«U«JLRQDOHFRPPXQDOHXQHLQVFULSWLRQIDPLOLDOHRXYLOODJHRLVHDWWHVWHQWGH
ODUHFKHUFKHGōXQDQFUDJHVRFLDOVDQVOHTXHOOōREMHFWLIGōH[WHQVLRQHVWYDLQ/DTXHVWLRQGX
ƓQDQFHPHQWSXEOLFGHODV«FXULW«VRFLDOHHVWDLQVLDYDQF«HWRXWFRPPHFHOOHGHVHVOLPLWHV
IDFH¢XQ(WDWG«ELWHXUTXLQHSDLHSDV
/ōHQJDJHPHQW QRUPDWLI HW LQVWLWXWLRQQHO G«FHQWUDOLVDWLRQ  GDQV OD U«DOLVDWLRQ GH
OōH[WHQVLRQGHODFRXYHUWXUHPDODGLHSDUXQHLQVWUXPHQWDOLVDWLRQGHODPXWXDOLW«VRFLDOHQōD
SDVSURGXLWOHVU«VXOWDWVHVFRPSW«V/HVPDQLIHVWDWLRQVHQVRQWFRQQXHVbIDLEOHVVHGXWDX[
GōDGK«VLRQPRQWDQWGHSULPHVWUªVOLPLW«SULVHHQFRPSWHWUªVLQ«JDOHGHVEHVRLQVGHV
E«Q«ƓFLDLUHVYDULDELOLW«GHOōRIIUHGHVRLQVFRXYHUWVTXDOLW«LQVXIƓVDQWHGHVVRLQVWHQVLRQV

22 &'HYLOOH))HFKHU03RQFHOHWmb/HVPXWXHOOHVGHVDQW«VXEYHQWLRQQ«HVFRPPHLQVWUXPHQWVGH
OD&RXYHUWXUH0DODGLH8QLYHUVHOOHDX6«Q«JDOb}Rencontres des études Africaines en France,MXLOOHW

  FRQYHQWLRQV GH Oō2,7 VRQW UDWLƓ«HV SDU OH 6«Q«JDO GRQW  HQ YLJXHXU 3RXU OD &RQYHQWLRQ
Qr TXL G«ƓQLW HW «WDEOLW OHV QRUPHV PLQLPDOHV SRXU OHV  EUDQFKHV GH OD V«FXULW« VRFLDOH OH
6«Q«JDO QōD UDWLƓ« TXH OHV SDUWLHV 9, ¢ 9,,, UHODWLYHV DX[ SUHVWDWLRQV GōDFFLGHQWV GX WUDYDLO HW
PDODGLHVSURIHVVLRQQHOOHVDX[SUHVWDWLRQVDX[IDPLOOHVHWDX[SUHVWDWLRQVGHPDWHUQLW«/H6«Q«JDO
D «JDOHPHQW UDWLƓ« OD &RQYHQWLRQ Qr VXU OHV SUHVWDWLRQV HQ FDV GōDFFLGHQWV GX WUDYDLO HW GH
PDODGLHV SURIHVVLRQQHOOHV HW OD &RQYHQWLRQ Qr VXU OD SURWHFWLRQ GH OD PDWHUQLW« /H SD\V D
DXVVLDGK«U«¢OD5HFRPPDQGDWLRQQrGHOō2,7VXUOH6RFOHGHSURWHFWLRQVRFLDOHDGRSW«HHQ
TXLSU¶QHOōH[WHQVLRQYHUWLFDOHHWKRUL]RQWDOHGHODFRXYHUWXUHVRFLDOHSDUGHVmbVWUDW«JLHV
QDWLRQDOHVGōH[WHQVLRQGHODV«FXULW«VRFLDOHb}
 9RLU QRWDPPHQWb  OD 5«VROXWLRQ VXU OD FRXYHUWXUH VDQLWDLUH XQLYHUVHOOH GH Oō$VVHPEO«H J«Q«UDOH
GHV1DWLRQVXQLHVTXLLQYLWHOHV(WDV¢ƓQDQFHUOHXUV\VWªPHGHVDQW«SDUOHELDLVGHP«FDQLVPHV
«TXLWDEOHV HW VROLGDLUHVb  OD 5«VROXWLRQ GX  G«FHPEUH  GH Oō$VVHPEO«H J«Q«UDOH GHV
1DWLRQVXQLHVVXUOD&RXYHUWXUHVDQLWDLUHXQLYHUVHOOH
 3ODQGH'«YHORSSHPHQWGHOD&RXYHUWXUHXQLYHUVHOOHSDUOō$VVXUDQFH0DODGLHGDQVOHFDGUHGHOD
G«FHQWUDOLVDWLRQ

182 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

HQWUHRUJDQLVPHVPXWXDOLVWHVHWSUHVWDWDLUHVDPDWHXULVPHGHODJHVWLRQ/ōDSSURFKHGHV
SRXYRLUVSXEOLFVSDUODIRUPDOLVDWLRQDLQVWDOO«XQV\QFU«WLVPHMXULGLTXHHQWUHOHVYDOHXUV
WLU«HVGHODSURWHFWLRQVRFLDOHDVVXUDQWLHOOHFHOOHVGHOō(66HWFHOOHVGXGURLW2+$'$GHV
VRFL«W«V/HVU«SRQVHVGXGURLWV«Q«JDODLVPHWWHQWHQOXPLªUHXQU«JLPHmbFRLQF«b}HQWUH
OHV VWDQGDUGV LQWHUQDWLRQDX[ HW OHXU Q«FHVVDLUH FRQWH[WXDOLVDWLRQ VRFLR«FRQRPLTXH HW
FXOWXUHOOH (Q G«SLW GōXQ SRUWDJH LQVWLWXWLRQQHO HW QRUPDWLI FRQV«TXHQW OH SDUDGR[H GH
OōHVSDFHV«Q«JDODLVH[LVWHSDUXQHQJDJHPHQWGHOō(WDWTXLDFFUR°WVDFRQWULEXWLRQƓQDQFLªUH
PDLVTXLVHG«VHQJDJHGDQVOōHQFDGUHPHQWGXFRQWHQXGHVSUHVWDWLRQV
/D G«FHQWUDOLVDWLRQ GH OD FRXYHUWXUH VDQW« SURPHVVH GōXQ ƓO GōXWLOLW« VRFLDOH DXUDLW
G½ SHUPHWWUH GōREWHQLU OD UHFRQQDLVVDQFH GōXQH VS«FLƓFLW« PXWXDOLVWH /H ƓQDQFHPHQW
SXEOLF LQVWUXPHQW PDMHXU GH OōREMHFWLI GōH[WHQVLRQ HVW SDUDGR[DOHPHQW OD FDXVH GH
Oō«FKHF GHV SU«YLVLRQV HW OD G\QDPLTXH VRFLDOH UHFKHUFK«H ¢ WUDYHUV OD G«FHQWUDOLVDWLRQ
DGPLQLVWUDWLYHP«FRQQDLWOHVU«DOLW«VVRFLDOHVSURIRQGHV/ōHQJDJHPHQWGHOō(WDW¢DVVXUHU
XQVRFOHGHSURWHFWLRQSDUODVDQW«EXWHVXUODIDLEOHVVHGHVRQLQWHUYHQWLRQVXUOHFRQWHQX
GHV SUHVWDWLRQV HW OH UHFXO GH OD VROLGDULW« SURIHVVLRQQHOOH HQ P¬PH WHPSV TXōXQH
DSSURFKHWURSXQLƓ«HGHODPXWXDOLW«VRFLDOHDƓQLSDUUHQGUHLPSRVVLEOHVRQDGDSWDWLRQ
DX[ GLII«UHQWHV FDW«JRULHV FRQFHUQ«HV SDU OōH[WHQVLRQ /ōDUVHQDO QRUPDWLI HW OHV GRQQ«HV
SXEOL«HVPHWWHQWDLQVLHQOXPLªUHXQFRPSURPLVG«IDYRUDEOH¢OōREMHFWLIGōH[WHQVLRQGHOD
FRXYHUWXUHVDQW«(I)HWXQFRPSURPLVSU«MXGLFLDEOH¢XQV\VWªPHGHSURWHFWLRQVRFLDOHSOXV
MXVWHHW«TXLWDEOH(II)

I - UN COMPROMIS DÉFAVORABLE À L’OBJECTIF D’EXTENSION DE

LA COUVERTURE SANTÉ
/HVGRQQ«HVUHODWLYHVDX[PXWXHOOHVGHVDQW«DXJXUHQWG«M¢GHVOLPLWHVGXƓQDQFHPHQW
SXEOLFHWGHODG«FHQWUDOLVDWLRQFRPPHLQVWUXPHQWVGōH[WHQVLRQGHODFRXYHUWXUHVDQW«(A)
/DVROLGDULW«VLE«Q«ƓTXH¢ODFRK«VLRQHW¢ODFRQƓDQFHSXEOLTXHDXUDLWQ«FHVVLW«XQHSOXV
JUDQGHVRXSOHVVHVXUFHUWDLQVDVSHFWVGHOōHQFDGUHPHQWGHVPXWXHOOHV&HWWHVRXSOHVVH
UHQGXH LPSRVVLEOH SDU XQH O«JLVODWLRQ XQLIRUPLV«H ¢ OōH[FªV QXLW WRXW DXWDQW ¢ OōREMHFWLI
GōH[WHQVLRQ(B)

$/ƞƬƥƢƦƢƭƞƬƝƞƬƢƧƬƭƫƮƦƞƧƭƬƝƞƥōƞƱƭƞƧƬƢƨƧ
/HƓQDQFHPHQWSXEOLFGHOōH[WHQVLRQGHOōDVVXUDQFHPDODGLHHVWVRXUFHGōXQHWHQVLRQ
EXGJ«WDLUHTXLPRQWUHG«M¢ODIUDJLOLW«GōXQV\VWªPHYXOQ«UDEOHDX[FKRFVHQGRJªQHVHW
H[RJªQHV(1)/ōDQFUDJHVRFLDOGHOōDVVXUDQFHVDQW«GDQVVRQSURMHWGōH[WHQVLRQHVWDXVVL
SRUW«SDUODG«FHQWUDOLVDWLRQDGPLQLVWUDWLYHTXLSHLQH¢WURXYHUXQUHODLVDYHFOHVUHVVRUWV
KLVWRULTXHVGHODVRFLDOLVDWLRQ(2)

 &'HYLOOH))HFKHU03RQFHOHWmb/HVPXWXHOOHVGHVDQW«VXEYHQWLRQQ«HVFRPPHLQVWUXPHQWVGH
OD&RXYHUWXUH0DODGLH8QLYHUVHOOHDX6«Q«JDOb}op. citbStratégie Nationale de Financement de la
Santé (SNFS) pour tendre vers la couverture sanitaire universelle au SénégalPLQLVWªUHGHOD6DQW«
HWGHOō$FWLRQVRFLDOH
 -&*UD]la gouvernance de la mondialisation3DULV/DG«FRXYHUWHSbmbÀGHVGHJU«V
GLYHUV OHV VRFL«W«V GHYURQW WURXYHU GHV U«SRQVHV GLII«UHQFL«HV SRXU IRQGHU OHV OLPLWHV HW OHV
UHQRQFHPHQWVQ«FHVVDLUHV¢ODFRQVWLWXWLRQGXOLHQVRFLDOGDQVOHFDGUHFRQWUDLJQDQWGXYLYDQWb}

RDCTSS - 2022/3 183

 Mohamed Bachir Niang

/HSDUDGR[HGXƓQDQFHPHQWSXEOLFFRPPHLQVWUXPHQWHWOLPLWHGH
OōREMHFWLIGōH[WHQVLRQ
$X6«Q«JDOOHƓQDQFHPHQWSXEOLFGHODSURWHFWLRQVRFLDOHHVWKLVWRULTXHPHQWWRXUQ«
YHUVOōDLGHHWOōDFWLRQVRFLDOH,OLQW«UHVVHOōDVVXUDQFHPDODGLHDYHFOHSURJUDPPHQDWLRQDOGH
&RXYHUWXUH0DODGLH8QLYHUVHOOH &08 TXLVHGHVWLQH¢ƓQDQFHUGHODFRWLVDWLRQDQQXHOOH
GHVE«Q«ƓFLDLUHVGHPXWXHOOHVGHVDQW«VLWX«VGDQVOHVFRXFKHVOHVSOXVG«IDYRULV«HVGH
ODSRSXODWLRQ&HWWHRSWLRQVDOXWDLUHSRXUXQHIUDQJHLPSRUWDQWHGHODSRSXODWLRQQōHQ
LQWHUSHOOHSDVPRLQVVXUODVRXWHQDELOLW«GHFHPRGHGHƓQDQFHPHQWbFōHVWXQHTXHVWLRQ
SDUWDJ«HDYHFGHV(WDWVSRVWLQGXVWULDOLV«V/HVUHWDUGVFRQVWDW«VGDQVOHYHUVHPHQWGHV
VXEYHQWLRQV RQW ORXUGHPHQW SHUWXUE« Oō«TXLOLEUH ƓQDQFLHU GHV RUJDQLVPHV YLV«V DORUV
P¬PHTXHOHQLYHDXGōDIƓOLDWLRQHVWORLQGō¬WUHFRQV«TXHQW/DWHQVLRQEXGJ«WDLUHFU««H
DX QLYHDX GH Oō(WDW HW GHV PXWXHOOHV FRQFHUQ«HV FRQWUHGLW OD SU«YLVLRQ GōXQH SULVH HQ
FKDUJH SOXV «WHQGXH GDQV OH IXWXU /D SHUWLQHQFH GH OD G«PDUFKH GHV SRXYRLUV SXEOLFV
U«VXOWDWGōXQHRSWLRQGDQVOō«ODERUDWLRQGHVSROLWLTXHVSXEOLTXHVHVWUHPLVHHQFDXVHSDU
OHV U«SRQVHV GLII«UHQWHV DSSRUW«HV SDU OHV DFWHXUV ¢ OD TXHVWLRQ GX ƓQDQFHPHQW SDU OD
VROLGDULW«QDWLRQDOH&HWWHRSWLRQLQVWDOOHOHG«ƓFLWFRPPHFRQVXEVWDQWLHODXV\VWªPHGHV
PXWXHOOHV$X6«Q«JDOFRPPHDLOOHXUVOōDUJXPHQWRSSRV«¢XQHLQWHUYHQWLRQSXEOLTXH
HVWHQFRUHHQWUHWHQX
/ōH[WHQVLRQGHODFRXYHUWXUHVDQW«DX6«Q«JDOVHGHVWLQH¢DYRLUFRPPHOLPLWHVFHOOHV
GXƓQDQFHPHQWSXEOLFGDQVXQH«FRQRPLHYXOQ«UDEOHDX[FKRFVHQGRJªQHVHWH[RJªQHV
/HVWUDQVIHUWVFRQWULEXWLIVGHOō(WDWSDUWLFLSHQWFHSHQGDQWGōXQHO«JLWLPDWLRQSROLWLTXHGX

 9RLUQRWDPPHQWbOHSURJUDPPHGHJUDWXLW«GHVVRLQVSRXUOHVHQIDQWVGH¢DQVbODSULVHHQ
FKDUJHGHV«WXGLDQWVSDUOHV&HQWUHVGHVĐXYUHVXQLYHUVLWDLUHVbODJUDWXLW«GHVVRLQVSRXUOHVSOXV
GHVRL[DQWHDQVG«IDYRULV«V bE«Q«ƓFLDLUHVHQ bODFRXYHUWXUHFRPSOªWHGHVRLQVGH
VDQW«SRXUOHVSHUVRQQHVYLYDQWDYHFXQKDQGLFDS bE«Q«ƓFLDLUHVHQ bODFRXYHUWXUH¢
GHODF«VDULHQQHbODSULVHHQFKDUJHGHVV«DQFHVGōK«PRGLDO\VHbHWFb
 6RLWbbE«Q«ƓFLDLUHVSRXUbDGK«UHQWVDXWLWUHGHOōDQQ«HbRevue globale et
analyse du système de sécurité sociale au Sénégal2,7
 &%HFmb/DV«FXULW«VRFLDOHHQWUHVROLGDULW«HWPDUFK«b}op. cit
 &'HYLOOH))HFKHU03RQFHOHWmb/HVPXWXHOOHVGHVDQW«VXEYHQWLRQQ«HVFRPPHLQVWUXPHQWVGH
OD&RXYHUWXUH0DODGLH8QLYHUVHOOHDX6«Q«JDOb}op. cit
 mb +HDOWK LQVXUDQFH LQ ORZLQFRPH FRXQWULHVb } OXFAM Brieting paper S b  Plan national de
G«YHORSSHPHQW VDQLWDLUH  'DNDU PLQLVWªUH GH OD 6DQW« HW GH Oō$FWLRQ VRFLDOH 
Sbm/HIDLEOHG«YHORSSHPHQWGHVPXWXHOOHVGHVDQW«GDQVOHSD\VHVWOL«HQSDUWLH¢ODIDLEOH
LPSOLFDWLRQGHVSDUWLHVSUHQDQWHVFO«VGDQVODPLVHHQSODFHGHVPXWXHOOHV ř /HIDLEOHDSSXLGH
Oō(WDWFHQWUDOHWGHVFROOHFWLYLW«VORFDOHVDX[PXWXHOOHVFRPPXQDXWDLUHVQōDSDVSHUPLVMXVTXōLFLGH
WUDQVIRUPHUOHVPXWXHOOHVGHVDQW«HQUHODLVGDQVOōH[WHQVLRQGHODFRXYHUWXUHGXULVTXHPDODGLH/H
IDLEOHDSSXLGHVSRXYRLUVSXEOLFVHWODPRGLFLW«GHVPRQWDQWVGHFRWLVDWLRQRQWFRQWUDLQWODSOXSDUW
GHVPXWXHOOHV¢RIIULUGHVSDTXHWVGHSUHVWDWLRQVSDVDWWUDFWLYHV¢OHXUVDGK«UHQWVb}
 % )RQWHQHDX 6 9DHV - 9DQ 2QJHYDO mb 7RZDUG UHGLVWULEXWLYH VRFLDO SURWHFWLRQb " ,QVLJKW IURP
6HQHJDODQG0RURFFRb}FLW«SDU95LGGH$$VRPDQLQJ$QWZL%%RLGLQ%&KHPRXQL)+DQH
/7RXUHUmb/HVG«ƓVGHVPXWXHOOHVFRPPXQDXWDLUHVHQ$IULTXHGHOōRXHVWb}in 95LGGHVers une
FRXYHUWXUHVDQLWDLUHXQLYHUVHOOHHQb"5HIRUPHHQ$IULTXHVXEVDKDULHQQH(GLWLRQ6FLHQFHHW
%LHQ&RPPXQ
 9RLU-/6RXFKHWmb/HPRXYHPHQWPXWXDOLVWHGDQVOHV«YROXWLRQVGXV\VWªPHGHSURWHFWLRQVRFLDOH
IUDQ©DLVb}Vie socialeQrS/ōDXWHXUU«VXPHDLQVLODORJLTXHQ«ROLE«UDOHTXōLOFRQWHVWHb
mb/DORJLTXHGHELHQ¬WUHHWGHTXDOLW«GHYLHGHOō206WURXYHDORUVHQWUDYHUVGHVDG\QDPLTXHOD
ORJLTXHGHPDUFKDQGLVDWLRQGX)0,HWGHOD%0b}b

184 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

V\VWªPHGōDVVXUDQFHPDODGLHHWGHV«FXULW«VRFLDOH/DO«JLVODWLRQVXUOHVPXWXHOOHVGHVDQW«
LQLWLDOHPHQWFRQ©XHFRPPHXQLQVWUXPHQWMXULGLTXHHVWUDWWUDS«HSDUOHSURMHWSROLWLTXH
GHOō(WDWTXLG«VRUPDLVODIDLWFR±QFLGHUDYHFOD&RXYHUWXUH0DODGLH8QLYHUVHOOHFRPPH
YHFWHXUGōXQHVRFL«W«SOXVMXVWHHW«TXLWDEOHGDQVODPHVXUHR»mbOHVFKRFV«FRQRPLTXHV
QRQ FRXYHUWV SHXYHQW SU«FLSLWHU GHV QRQ SDXYUHV GDQV OD SDXYUHW«b} /D G«PDUFKH HVW
SROLWLTXHHWLQVWUXPHQWDOHSHXW¬WUHSROLWLFLHQQHPDLVSU«VHQWHOōLQW«U¬WGō¬WUHFRQVLG«U«H
GX SRLQW GH YXH GX UHVVHQWL QDWLRQDO FRPPH XQ DFTXLV GH OōLQVWDOODWLRQ GH OD VROLGDULW«
QDWLRQDOHGDQVODV«FXULW«VRFLDOH
'ōXQHORJLTXHWRWDOHPHQWFRQWULEXWLYHLPSRV«HDX[XQV¢XQHORJLTXHSDUWLHOOHPHQW
FRQWULEXWLYHRIIHUWHDX[DXWUHVOō«YROXWLRQGHVPXWXHOOHVGHVDQW«VHUDDXVVLWULEXWDLUHGX
UHOªYHPHQWGXQLYHDXGHYLHGHV6«Q«JDODLV/ōDXJPHQWDWLRQGHVUHYHQXVQRWDPPHQWGX
PRQGHUXUDOHWGHOō«FRQRPLHLQIRUPHOOHVHGHVWLQH¢¬WUHVHXOHDSWH¢U«GXLUHOō«WUHLQWHVXU
OHƓQDQFHPHQWSXEOLF/HVGRQQ«HVSXEOL«HVLOOXVWUHQWODU«DOLW«GōXQHmbV«OHFWLRQDGYHUVHb}
DOLPHQW«HSDUODIDLEOHVVHGHVUHYHQXV$ORUVTXōXQHIDPLOOHPR\HQQHDX6«Q«JDOFRPSWH
SHUVRQQHVLOHVWVXUSUHQDQWGHFRQVWDWHUTXHODWDLOOHPR\HQQHGHVP«QDJHVLQVFULWV
GDQVOHVPXWXHOOHVGHVDQW«HVWGHSHUVRQQHVLQFOXDQWOōDGK«UHQWHWOHVE«Q«ƓFLDLUHV
'DQVOHVPXWXHOOHVSURIHVVLRQQHOOHVGōHQYHUJXUHFHWDX[DWWHLQWSHUVRQQHV«WDEOLVVDQW
DLQVLOHOLHQHQWUHDGK«VLRQHWQLYHDXGHUHYHQXV6HWURXYHDLQVLLQVWDOO«XQP«FDQLVPH
GōH[WHQVLRQTXLQōLQVWDXUHSDVGHFRQFXUUHQFHHQWUHOHVU«JLPHVGHSURWHFWLRQPDLVDIƓFKH
FHSHQGDQW XQH U«JUHVVLRQ GX FDUDFWªUH REOLJDWRLUH GH OD V«FXULW« VRFLDOH VLJQH GōXQH
U«JUHVVLRQGHODVROLGDULW«

2 - Un ancrage social à réinventer

/ō«FRQRPLH VRFLDOH HW VROLGDLUH HVW GōDERUG XQH «FRQRPLH VRFLDOH 6L OHV RUJDQLVPHV
GH Oō«FRQRPLH VRFLDOH HW VROLGDLUH VRQW DSSDUXV GH PDQLªUH VSRQWDQ«H LO \ D SOXV GH
DQVOō(WDWGX6«Q«JDODHXXQHDSSURFKHXWLOLWDULVWHGHFHWWHU«DOLW«SDUODFDSWDWLRQGH
OHXUFDFKHWVRFLDOGDQVOōREMHFWLIGōH[WHQVLRQGHOōDVVXUDQFHPDODGLH/DG\QDPLTXHVRFLDOH
HVW¢ODIRLVXQHƓQHWXQPR\HQ/DWUDGXFWLRQMXULGLTXHGHFHWWHQ«FHVVLW«DSSDUD°W¢WUDYHUV
OHOLHQ«WDEOLHQWUHPXWXHOOHVGHVDQW«HWG«FHQWUDOLVDWLRQOLHQFRQVDFU«FRPPHFDW«JRULH
VS«FLƓTXHGHVSROLWLTXHVSXEOLTXHV¢WUDYHUVOH3ODQGH'«YHORSSHPHQWGHOD&RXYHUWXUH
XQLYHUVHOOH SDU Oō$VVXUDQFH 0DODGLH GDQV OH FDGUH GH OD G«FHQWUDOLVDWLRQ '(&$0  6L OHV
PXWXHOOHVGHVDQW«WUDGXLVHQWODYRORQW«GX6«Q«JDOGHFRQVHUYHUXQHORJLTXHDVVXUDQWLHOOH
GHODSURWHFWLRQFRQWUHODPDODGLHODSDUWLFLSDWLRQFRPPXQDXWDLUHHVWSHU©XHFRPPHXQH

 ,QLWL«HQHWUHSRVDQWmbVXUODYLVLRQGōXQ6«Q«JDOR»WRXVOHVLQGLYLGXVWRXVOHVP«QDJHVHW
WRXWHV OHV FROOHFWLYLW«V E«Q«ƓFLHQW GōXQ DFFªV XQLYHUVHO ¢ GHV VHUYLFHV GH VDQW« SURPRWLRQQHOV
SU«YHQWLIV FXUDWLIV HW U«DGDSWDWLIV GH TXDOLW« VDQV DXFXQH IRUPH GōH[FOXVLRQb } PLQLVWªUH GH OD
6DQW«HWGHOō$FWLRQVRFLDOHS
 < *XLFKRXDmb 6ROLGDULW« SURIHVVLRQQHOOH HW SDUWDJH GHV ULVTXHV SDUPL OHV WUDYDLOOHXUV LQIRUPHOV
8QH«WXGHGHFDV¢$ELGMDQb}Presses de Sciences PoQrS
 Revue globale et analyse du système national de protection sociale du Sénégal
 ([SRV« GHV PRWLIV GH OD ORL GX  MXLQ  UHODWLYH DX[ PXWXHOOHV GH VDQW«b mb /HV PXWXHOOHV GH
VDQW« FRQVWLWXHQW XQ LQVWUXPHQW PRGHUQH SURPHWWHXU SRXU QRWDPPHQW G«YHORSSHU OH V\VWªPH
GōDVVXUDQFH PDODGLH HW DXGHO¢ FRQWULEXHU ¢ OōDP«OLRUDWLRQ GHV FRQGLWLRQV GH VDQW« GHV
SRSXODWLRQVb}b5ªJOHPHQWQr&08(02$SRUWDQWU«JOHPHQWDWLRQGHODPXWXDOLW«VRFLDOH
DXVHLQGHOō8(02$mb/DQ«FHVVLW«GHPHWWUHHQSODFHDYHFODSHLQHLPSOLFDWLRQGHVSRSXODWLRQV
GHV(WDWVPHPEUHVXQHSROLWLTXHGHJHVWLRQGHVULVTXHVVRFLDX[ ř b}

RDCTSS - 2022/3 185

 Mohamed Bachir Niang

PLVHHQDFWLYLW«GHVSRSXODWLRQVPHWWDQWHQDYDQWOōDXWRG«WHUPLQDWLRQ/DG«FHQWUDOLVDWLRQ
GRLWLQFLWHU¢mbDYRLUXQFRPSRUWHPHQWSOXVUHVSRQVDEOHHWSOXVSU«YHQWLIb}/DFRQYLFWLRQ
GHVSRXYRLUVSXEOLFVHQmbODIRUFHGHVPXWXHOOHVGHVDQW«HWOHXUDFFHSWDELOLW«VRFLDOHb}
P«ULWHXQHPLVHHQĐXYUHSOXVDERXWLH/HVXFFªVGHVJUDQGHVPXWXHOOHVSURIHVVLRQQHOOHV
GLWHVPXWXHOOHVGōHQYHUJXUHLOOXVWUHOōLPSRUWDQFHGXOLHQLFLSURIHVVLRQQHOGDQVOōREMHFWLI
GōLQW«JUDWLRQ
$X 6«Q«JDO HW HQ $IULTXH VXEVDKDULHQQH OD UHQFRQWUH HQWUH OD VDQW« OD SURWHFWLRQ
VRFLDOHHWOō«FRQRPLHVRFLDOHHWVROLGDLUHGHYUDLWSHUPHWWUHXQHIDFLOLWDWLRQGHOōLQWHUDFWLRQ
HQWUHODUªJOHHWODFXOWXUHORFDOHDSSUHQWLVVDJHGHODG«PRFUDWLH2QPHVXUHDORUVWRXWH
OōLPSRUWDQFH GH OD VRFL«W« FLYLOH VXU FH FKHPLQ YHUV XQ V\VWªPH O«JLWLPH FDU VRXWHQX HW
SDUWDJ«8QHIRUWHVROLGDULW«DXVHLQGōXQJURXSHVRFLDOFRQVWLWXHXQHLQFLWDWLRQSRXUOHV
PHPEUHV¢DFFHSWHUTXHOHXUVFRWLVDWLRQVVHUYHQWDX[DXWUHV
/D G«FHQWUDOLVDWLRQ SU«VHQWH OōLQFRQY«QLHQW GH VD SRUWDELOLW« LQVXIƓVDQWH PDLV
RIIUH OōDYDQWDJH GH VD FRQIRUPLW« DYHF OD 5«SXEOLTXH FRQWUDLUHPHQW DX[ DSSURFKHV
FRQIHVVLRQQHOOHV RX HWKQLTXHV /HV OLHQV VRFLDX[ WURS LGHQWLWDLUHV GHYUDLHQW VXVFLWHU
SOXV GH U«VHUYHV 8QH FHUWDLQH GRFWULQH IDLW UHPDUTXHU TXōHQ $IULTXH mb OHV FKDQFHV
VRQW IDLEOHV GH YRLU GHV DJHQWV LQLWLDOHPHQW G«VRFLDOLV«V IRUPHU VSRQWDQ«PHQW GHV
GLVSRVLWLIV GōDVVXUDQFHb } $XGHO¢ GH OD G«FHQWUDOLVDWLRQ DGPLQLVWUDWLYH GōDXWUHV IRUPHV
GHVRFLDOLVDWLRQSHUPHWWUDLHQWGHIDYRULVHUODVROLGDULW«DVVXUDQWLHOOHSXLVTXōHOOHVUHFªOHQW
G«M¢ XQH IRUPH GH VROLGDULW« VRFLDOHb  DVVRFLDWLRQV VSRUWLYHV HW FXOWXUHOOHV DVVRFLDWLRQV
GH IHPPHV SDUWLV SROLWLTXHV VRXVVHFWHXUV GH Oō«FRQRPLH LQIRUPHOOH /HV SURSRVLWLRQV
UHODWLYHV¢OōLQFLWDWLRQSDUODFRQGLWLRQQDOLW«GHFHUWDLQHVSURF«GXUHVDGPLQLVWUDWLYHV¢XQH
DGK«VLRQ¢XQHPXWXHOOHGHVDQW«QōRQWSDV«W«H[S«ULPHQW«HV

 -$OHQGD'HPRXWLH]mb/HVPXWXHOOHVGHVDQW«DX6«Q«JDOIDFHDX[GLIƓFXOW«VGHFRRUGLQDWLRQGH
OHXUVDFWHXUVb}op. cit
 Ibid
 Plan stratégique de développement des mutuelles de santé au Sénégal PLQLVWªUH GH OD 6DQW«
MXLOOHWS
 %%RLGLQmb([WHQVLRQGHOōDVVXUDQFHPDODGLHHWU¶OHGHVPXWXHOOHVGHVDQW«HQ$IULTXHbOHVOH©RQV
GHOōH[S«ULHQFHV«Q«JDODLVHb}Revue de l’Institut d’économie politiqueSbm/HU«JLPHGHV
URXWLHUVVōHVWFU««VXUODEDVHGHVH[S«ULHQFHVSDVV«HVGHFHWWHFDW«JRULHHQWHUPHVGōHQWUDLGHGH
VROLGDULW«HWGHSUDWLTXHVGHFRQWU¶OHVRFLDOb}
 -$OHQGD'HPRXWLH]mb/HVPXWXHOOHVGHVDQW«DX6«Q«JDOIDFHDX[GLIƓFXOW«VGHFRRUGLQDWLRQGH
OHXUVDFWHXUVb}op. cit
 * ) *DQNSH ( & *DQNSH $ 1 %DOHED / =LQ]RX & 0HVVHQJH mb /HV PXWXHOOHV GH VDQW«
UHSURGXLVHQWHOOHVOHVLQ«JDOLW«VGHVDQW«DX%HQLQb"b}Santé publiqueYROS
 $UW  GX 5ªJOHPHQW Qr&08(02$ SRUWDQW U«JOHPHQWDWLRQ GH OD PXWXDOLW« VRFLDOH
DX VHLQ GH Oō8QLRQ (FRQRPLTXH HW 0RQ«WDLUH 2XHVW$IULFDLQHb  mb /ōDGK«VLRQ YRORQWDLUH HW QRQ
GLVFULPLQDWRLUHFRQVLVWHHQXQDFWHYRORQWDLUHGHSDUWLFLSDWLRQ¢XQHPXWXHOOHVRFLDOHQRQIRQG«H
VXUOHVH[HODUDFHODQDWLRQDOLW«OōDSSDUWHQDQFHSROLWLTXHRXUHOLJLHXVHb}
 < *XLFKRXDmb 6ROLGDULW« SURIHVVLRQQHOOH HW SDUWDJH GHV ULVTXHV SDUPL OHV WUDYDLOOHXUV LQIRUPHOV
8QH«WXGHGHFDV¢$ELGMDQb}op. cit
 1RWDPPHQWm8QHREOLJDWLRQDWWDFK«HRXFRXSO«H¢GHVE«Q«ƓFHVbREWHQWLRQGHSHUPLVGōRFFXSHU
UHJLVWUH GH FRPPHUFH 1,1($ DFFªV DX PLFUR FU«GLWV GLVWULEXWLRQ GH VHPHQFHVřb } Stratégie
QDWLRQDOHGHƓQDQFHPHQWGHODVDQW«SRXUWHQGUHYHUVODFRXYHUWXUHVDQLWDLUHXQLYHUVHOOH 61)6 
PLQLVWªUHGHOD6DQW«HWGHOō$FWLRQVRFLDOHS

186 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

%/ōƢƧƬƭƢƭƮƭƢƨƧƝōƮƧƫnjƠƢƦƞƣƮƫƢƝƢƪƮƞƮƧƢƟƢnjƜƨƦƦƞƟƫƞƢƧ
ƺƥōƞƱƭƞƧƬƢƨƧ
/D ORL GX  MXLQ  LQVFULW OōHQVHPEOH GHV FDW«JRULHV VRFLRSURIHVVLRQQHOOHV QRQ
FRXYHUWHVSDUODV«FXULW«VRFLDOHREOLJDWRLUH¢VRQDJHQGD,OVōDJLWGōXQDJHQGDXQLTXHTXL
LQVWDXUHSHXGHSODFH¢XQHFRQWH[WXDOLVDWLRQHQIRQFWLRQGHVVS«FLƓFLW«VSURIHVVLRQQHOOHV
RX VRFLDOHV &HWWH ODFXQH TXH OH GURLW FRPPXQDXWDLUH GH Oō8(02$ D VX «YLWHU HVW
SRUWHXVHGHORXUGHXUHWGHSDUDO\VLH6LOHƓQDQFHPHQWSXEOLFHWODG«FHQWUDOLVDWLRQVRQW
HVS«U«VFRPPHLQVWUXPHQWVGHOōH[WHQVLRQGHOōDVVXUDQFHPDODGLHOHXULPSDFWVXUODFLEOH
SURIHVVLRQQHOOHHVWWUªVOLPLW«'ōXQHSDUWOHVVXEYHQWLRQVGHOō(WDWQHVRQWSDVGHVWLQ«HV
¢FHWWHFDW«JRULHHWGōDXWUHSDUWOHOLHQFHQV«XQLUOHVWUDQVSRUWHXUVRXOHVFRPPHU©DQWV
QōHVW SDV FRPPXQDO RX G«SDUWHPHQWDO /HV FDW«JRULHV GH WUDYDLOOHXUV LQG«SHQGDQWV GX
VHFWHXUIRUPHORXP¬PHGHOō«FRQRPLHLQIRUPHOOHVRQWVRFLRORJLTXHPHQWSOXVSURFKHV
GHFHOOHVGHVVDODUL«VGXSULY«HQWHUPHVGHFDSDFLW«GHFRQWULEXWLRQHWGHPRELOLVDWLRQ
DYHFOōDSSDULWLRQGHV\QGLFDWVHWGōXQLRQVGHV\QGLFDWVGHOōLQIRUPHO
&ōHVW FHUWDLQHPHQW ¢ OHXU GHVWLQDWLRQ TXH OH 5ªJOHPHQW GH Oō8(02$ SU«YRLW TXH
mbQRQREVWDQWOHSULQFLSHGHODOLEHUW«GōDGK«VLRQLOSHXW¬WUHG«FLG«SDUYRLHGHPHVXUH
VS«FLDOH HQ IRQFWLRQ GH OD VLWXDWLRQ SURIHVVLRQQHOOH GHV DGK«UHQWV TXH OōDGK«VLRQ
¢ OD PXWXDOLW« VRFLDOH HVW DFTXLVH GX VHXO IDLW GH OōDSSDUWHQDQFH ¢ XQH FDW«JRULH
SURIHVVLRQQHOOHb } /ōDUWLFOH  GX 5ªJOHPHQW DFFUR°W OHV LQVWUXPHQWV GH OōH[WHQVLRQ HQ
SU«YR\DQW OD SRVVLELOLW« GH PXWXHOOHV D\DQW XQ FDUDFWªUH REOLJDWRLUH FōHVW¢GLUH GRQW OD
FU«DWLRQQōHVWSDVODLVV«H¢ODGLVFU«WLRQGōXQJURXSHVRFLRSURIHVVLRQQHO/HSDUWLFXODULVPH
GHV DVVXUDQFHV VRFLDOHV FRPPDQGH DLQVL XQ HQFDGUHPHQW VS«FLƓTXH ¢ XQ SULQFLSH GH
Oō«FRQRPLHVRFLDOHHWVROLGDLUHbODOLEHUW«GōDGK«VLRQ$LQVLVHPDQLIHVWHQWOHVLQWHUDFWLRQV
HQWUHOHVGHX[FDW«JRULHV/DPDVVLƓFDWLRQJDUDQWHGōXQHSDUIDLWHPXWXDOLVDWLRQHVWJDJH
GōXQHVROLGDULW«SURIHVVLRQQHOOHHWLQWHUSURIHVVLRQQHOOHSOXVGHQVH
/HVGLVSRVLWLRQVGHOō8(02$DGRSW«HVVL[DQQ«HVDSUªVOōHQWU«HHQYLJXHXUGHODORL
GX  MXLQ  DEURJHQW WRXWHV OHV GLVSRVLWLRQV DQW«ULHXUHV FRQWUDLUHV PDLV GHPHXUHQW
QRQDSSOLTX«HV/HFRQVWDWHVWFHOXLGōXQHULJLGLW«GXGURLWV«Q«JDODLVHWVRQLQDSWLWXGH¢
DVVHRLUXQHDSSURFKHSOXULHOOHIDFH¢ODPXOWLSOLFLW«GHVFDW«JRULHVVRFLRSURIHVVLRQQHOOHV
LPSOLTX«HVGDQVOHSURMHWGōH[WHQVLRQGHOōDVVXUDQFHPDODGLH&HWWHLQDSWLWXGHƓOOHGōXQ
U«JLPHMXULGLTXHXQLƓ«¢OōH[FªVSHUWXUEHOHVSHUVSHFWLYHVGōH[WHQVLRQGHOōDVVXUDQFHVDQW«
GDQVFHUWDLQHVFDW«JRULHVDORUVTXHOHGURLWFRPSDU«G«YRLOHTXHFHUWDLQVSD\VDIULFDLQV
RQWG«M¢FRQVDFU«DYHFVXFFªVOHFDUDFWªUHREOLJDWRLUHGHVPXWXHOOHVSURIHVVLRQQHOOHV
/DTXHVWLRQGHODFRQVHUYDWLRQGHFHSRLQWGHYXHGHOōHVSULWKLVWRULTXHGHOō«FRQRPLH
VRFLDOHHWVROLGDLUHRXGHVDUHIRUPXODWLRQVHWURXYHDXFHQWUHGHFRQŴLWVGHFRQFHSWLRQ
HQWUH DFWHXUV /ō8(02$ FRQVDFUH OH FDUDFWªUH YRORQWDLUH GH OōDGK«VLRQ DX[ PXWXHOOHV
GH VDQW« WRXW HQ DXWRULVDQW OD SRVVLELOLW« GōXQH DGK«VLRQ REOLJDWRLUH U«VHUY«H DX[
FDW«JRULHV SURIHVVLRQQHOOHV DORUV TXH Oō206 DIƓUPH GHSXLV  TXōDWWHLQGUH OD

 0%1LDQJmb$QFUDJHMXULGLTXHHWSHUVSHFWLYHVGXGLDORJXHVRFLDODX6«Q«JDOb}in 3$XYHUJQRQ

&b.HQRXNRQDialogue social dans l’espace OHADA et ailleurs dans le monde/ō+DUPDWWDQ
S
 $UWGX5ªJOHPHQW
 1RWDPPHQWOH5ZDQGDHWOH*KDQD9RLU95LGGH$$VRPDQLQJ$QWZL%%RLGLQ%&KHPRXQL
)+DQH/7RXUHUmb/HVG«ƓVGHVPXWXHOOHVFRPPXQDXWDLUHVHQ$IULTXHGHOōRXHVWb}op. cit

RDCTSS - 2022/3 187

 Mohamed Bachir Niang

FRXYHUWXUH VDQW« XQLYHUVHOOH HVW LPSRVVLEOH DYHF GHV U«JLPHV YRORQWDLUHV 3OXVLHXUV
DQDO\VWHV HVWLPHQW TXH VōDJLVVDQW GHV PXWXHOOHV GH VDQW« OH VXFFªV GHV V\VWªPHV
YRORQWDLUHVHVWPRGHVWHHWP¬PHDVVH]IDLEOHHWGDQVFHUWDLQVSD\VLOVRQW«W«OōREVWDFOH¢
XQHFRXYHUWXUHVDQW«XQLYHUVHOOH
/HYRORQWDULDWVHUDLWSURGXFWHXUGōXQHG\QDPLTXHVRFLDOHGLII«UHQWL«HHQFUHXVDQWOHV
LQ«JDOLW«Vb
LOLQVWDXUHXQHGLVFRQWLQXLW«GHOōDGK«VLRQVHORQOō¤JHODVH[HOōHWKQLHODUHOLJLRQOHVWDWXW
PDWULPRQLDOOHQLYHDXGHVFRODULVDWLRQOHQLYHDXGHFRQƓDQFHDX[UHVSRQVDEOHVHWFb
 LO H[FOXUDLW VHORQ OHV VWDWLVWLTXHV FHUWDLQHV FDW«JRULHV QRWDPPHQW OHV SHUVRQQHV Gō¤JH
MHXQHOHVIDPLOOHVQRPEUHXVHVOHVIHPPHVOHVSHUVRQQHV¢IDLEOHVUHYHQXVHWFb
LOHVWSURGXFWHXUGōLQ«JDOLW«VDXVHLQGōXQV\VWªPHTXLVHFKHUFKH¢U«GXLUHOHVLQ«JDOLW«V

II - UN COMPROMIS PRÉJUDICIABLE À UN SYSTÈME DE SÉCURITÉ

SOCIALE PLUS JUSTE ET ÉQUITABLE
/ōXQLW« LQVWLWXWLRQQHOOH GH OōDVVXUDQFH PDODGLH DX 6«Q«JDO HVW LPSRVVLEOH /HV
FLUFRQVWDQFHVGHODFU«DWLRQGXU«JLPHREOLJDWRLUHGōDVVXUDQFHPDODGLHHQUHODWLRQDYHF
OHVFRQTX¬WHVGXVDODULDWDFRQGXLW¢XQHRUJDQLVDWLRQLQVWLWXWLRQQHOOHTXLSHLQHUDLW¢¬WUH
UHSURGXLWHGDQVOHFDGUHGHOōH[WHQVLRQGHODSURWHFWLRQ¢GHVFDW«JRULHVSURIHVVLRQQHOOHV
LQG«SHQGDQWHV RX GHV FDW«JRULHV QRQ DFWLYHV /D ORL SURFªGH ¢ XQH VHJPHQWDWLRQ SOXV
SRXVV«HGHOōDVVXUDQFHPDODGLHHQPXOWLSOLDQWOHVVWDWXWV(OOHLQWURGXLWXQHIUDFWXUHGDQVOD
VROLGDULW«HQDVVXUDQFHPDODGLH(A)HWLOOXVWUHDLQVLXQUHFXOGHVYDOHXUVFRPPXQHV¢Oō(66
HW¢ODV«FXULW«VRFLDOH(B)

$/ƚƝƢƥƮƭƢƨƧƝƞƥƚƬƨƥƢƝƚƫƢƭnjƩƫƨƟƞƬƬƢƨƧƧƞƥƥƞƞƭ
ƬƨƜƢƨƩƫƨƟƞƬƬƢƨƧƧƞƥƥƞ
$XGHO¢GHVHVVHUYLFHVHWGHVRQƓQDQFHPHQWODV«FXULW«VRFLDOHHVWHQHIIHWSRUW«H
SDUXQFRQVHQVXVFROOHFWLIGHVROLGDULW«/DVROLGDULW«VHUDLWXQHWHFKQLTXHGRQWODƓQDOLW«
FRQVLVWHUDLW GDQV OD UHGLVWULEXWLRQ VDQV ODTXHOOH OD QRWLRQ GH U«JLPH GH V«FXULW« VRFLDOH
SHUGUDLW GH VRQ VHQV SRXU VH U«GXLUH ¢ XQH VLPSOH PXWXDOLVDWLRQ SU«VHQWH P¬PH GDQV

 5DSSRUWVXUODVDQW«GDQVOHPRQGHbOHƓQDQFHPHQWGHVV\VWªPHVGHVDQW«OHFKHPLQYHUVXQH
couverture universelle3UHVVHGHOō206b$/HWRXUP\$3DY\/HWRXUP\mb/DPLFURDVVXUDQFH
GHVDQW«GDQVOHVSD\V¢IDLEOHUHYHQXb}AFDSb%)RQWHQHDX69DHV-9DQ2QJHYDO
mb7RZDUGUHGLVWULEXWLYHVRFLDOSURWHFWLRQb",QVLJKWIURP6HQHJDODQG0RURFFRb}op. cit 
* ) *DQNSH ( & *DQNSH $ 1 %DOHED / =LQ]RX & 0HVVHQJH mb /HV PXWXHOOHV GH VDQW«
UHSURGXLVHQWHOOHVOHVLQ«JDOLW«VGHVDQW«DX%HQLQb"b}op. cit
 Ibid
 Ibidbmb(QUHQGDQWOōDGK«VLRQREOLJDWRLUHXQSOXVJUDQGQRPEUHGHSHUVRQQHVSRXUUDLHQWE«Q«ƓFLHU
GōXQHSURWHFWLRQVRFLDOHb}FDUVHORQOHVDXWHXUVOHV\VWªPHDFWXHOmbSHXWP¬PHFRQWULEXHU¢XQH
UHSURGXFWLRQGHVLQ«JDOLW«VHQPDWLªUHGHVDQW«b}
 - ,VVD6D\HJK Le droit sénégalais de la sécurité sociale 1($  S b  2 .DXIPDQQ
mb /ōLPSODQWDWLRQ HW Oō«YROXWLRQ GX GURLW GH OD V«FXULW« VRFLDOH HQ$IULTXH IUDQFRSKRQH DX VXG GX
6DKDUDb}op. citS
 -,VVD6D\HJKLe droit sénégalais de la sécurité socialeop. citS

188 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

OōDVVXUDQFHSULY«H8QLYHUVDOLW«HWVROLGDULW«VHUDLHQWKLVWRULTXHPHQWOL«HV/DSURWHFWLRQ
VRFLDOH H[LVWHUDLW SDU OD U«XQLRQ GH SHUVRQQHV D\DQW GHV IDFXOW«V FRQWULEXWLYHV DVVH]
mbK«W«URJªQHVSRXUWUDQVI«UHUOHVXUSOXVGHUHVVRXUFHVb}
/ōDVVXUDQFH PDODGLH REOLJDWRLUH DX 6«Q«JDO U«DOLVH OD WHFKQLTXH GH OD VROLGDULW« HW
DWWHLQW OōREMHFWLI GH UHGLVWULEXWLRQ SDU OōLQVWLWXWLRQ GōXQ WDX[ SURJUHVVLI GH FRWLVDWLRQ
LPSDFWDQW GDYDQWDJH OHV KDXWV UHYHQXV HW OD SU«YLVLRQ GōXQ QLYHDX GH SUHVWDWLRQV
LGHQWLTXHVSRXUWRXVOHVDVVXU«VHWOHXUVD\DQWVGURLWV5«FHPPHQWODU«DOLVDWLRQGōXQH
VROLGDULW«SOXVDJLVVDQWHHQWUHOHV,QVWLWXWLRQVGH3U«YR\DQFH0DODGLH ,30 HVWFRQVWDW«H
SDU Oō,&$02 /ōLQVWLWXWLRQ GōXQ IRQGV GH JDUDQWLH DOLPHQW« SDU OHV FRWLVDWLRQV GHV ,30
VH GHVWLQH ¢ VRXWHQLU OHV GLIƓFXOW«V GHV RUJDQLVPHV HW LQVWDOOH XQH VROLGDULW«
LQWHUSURIHVVLRQQHOOHGDQVOHVDODULDW
/ō,30 D SRXU REMHW OD SULVH HQ FKDUJH SDUWLHOOH GHV IUDLV P«GLFDX[ SKDUPDFHXWLTXHV
HW GōKRVSLWDOLVDWLRQ HQJDJ«V DX 6«Q«JDO SDU OHV PHPEUHV E«Q«ƓFLDLUHV VXLYDQW GHV
SRXUFHQWDJHV Ɠ[«V SDU VRQ UªJOHPHQW LQW«ULHXU PDLV VRXPLV ¢ OōDSSUREDWLRQ GX 0LQLVWUH
FKDUJ« GHV UHODWLRQV SURIHVVLRQQHOOHV /D U«JOHPHQWDWLRQ DII«UHQWH ¢ FHWWH PLVH HQ
UHVSRQVDELOLW« SURFªGH ¢ OD G«WHUPLQDWLRQ GHV E«Q«ƓFLDLUHV WUDYDLOOHXUV SHUPDQHQWV
GH OōHQWUHSULVH DLQVL TXH Oō«SRXVH HW OHV HQIDQWV ¢ OHXU FKDUJH DX VHQV GHV SUHVWDWLRQV
IDPLOLDOHV /HVWDX[GHSULVHHQFKDUJHSDUWLHOOHGHVIUDLVGHPDODGLHVRQWG«WHUPLQ«VSDU
OHUªJOHPHQWLQW«ULHXUPDLVGRLYHQW¬WUHOHVP¬PHVSRXUWRXVOHVPHPEUHVE«Q«ƓFLDLUHV
&HV WDX[ SHXYHQW YDULHU HQ KDXVVH RX HQ EDLVVH HQ IRQFWLRQ GHV U«VXOWDWV HQUHJLVWU«V ¢
ODFRQGLWLRQTXHODKDXVVHRXODEDLVVHVRLWDSSOLTX«HXQLIRUP«PHQWHW¢ODP¬PHGDWH
¢WRXVOHVE«Q«ƓFLDLUHVHWGDQVODOLPLWHGHVSODIRQGVHWGHSODQFKHUVUªJOHPHQWDLUHV/H
U«JLPHGōDVVXUDQFHPDODGLHGHVIRQFWLRQQDLUHVHVW«PLQHPPHQWSOXVIDYRUDEOH

 --'XSH\URX[0%RUJHWWR5/DIRUH55XHOODQDroit de la sécurité socialeop. citSbmb,O

UHYLHQW DORUV ¢ OD FROOHFWLYLW« GH UHFRPSRVHU DX WUDYHUV GōLQVWLWXWLRQV VS«FLƓTXHV XQ OLHQ VRFLDO
«EUDQO«SDUOHVIRUFHVGXPDUFK«b}b53HOHWmb5«JLPHVEUDQFKHVHWIRQGVGHODV«FXULW«VRFLDOHb}
RDSSSbmb3DUH[WHQVLRQ ř HOOH>ODQRWLRQGHU«JLPHGHV«FXULW«VRFLDOH@VXSSRVHDXVVL
ODPLVHHQĐXYUHGōXQHVROLGDULW«HQWUHPHPEUHVGōXQJURXSHG«WHUPLQ«IDFHDX[ULVTXHVTXHOD
ORLG«VLJQHODV«FXULW«VRFLDOH«WDQWIRQG«HVXUXQHLG«HGHUHGLVWULEXWLRQb}
 3&KDXFKDUG-<.HUERXFōK&:LOPDQQDroit de la sécurité socialeop. citS
 & 9LDQQH\ mb 8QH KLVWRLUH FRQWUDVW«Hb } Informations sociales Qr  S b  3 %DWLIRXOLHU
9 'XFKHVQH $6 *LQRQ mb /D FRQVWUXFWLRQ GōXQ PDUFK« «GXTX« GH OōDVVXUDQFH VDQW«b  XQH
U«RULHQWDWLRQGHODVROLGDULW«b"b}Revue de l’IRESSb-,VVD6D\HJKLe droit sén«JDODLV
GHODV«FXULW«VRFLDOHop. citSbmb2QQHSHXWSDUOHUGHV\VWªPHGHV«FXULW«VRFLDOHTXHVLOD
SURWHFWLRQFRQWUHOHVULVTXHVVRFLDX[HVWRUJDQLV«HGHID©RQFROOHFWLYHHWVS«FLƓTXHb}
 /HVWDX[GHSULVHHQFKDUJHSDUWLHOOHGHVIUDLVGHPDODGLHVRQWG«WHUPLQ«VSDUOHUªJOHPHQWLQW«ULHXU
GHOō,30HWVRQWOHVP¬PHVSRXUWRXVOHVPHPEUHVE«Q«ƓFLDLUHV&HVWDX[SHXYHQWYDULHUHQKDXVVH
RXHQEDLVVHHQIRQFWLRQGHVU«VXOWDWVHQUHJLVWU«V¢ODFRQGLWLRQTXHODKDXVVHRXODEDLVVHVRLW
DSSOLTX«XQLIRUP«PHQWHW¢ODP¬PHb$UU¬W«QrGXMXLOOHWƓ[DQWOHVPRGªOHVW\SHV
GHVVWDWXWVGHUªJOHPHQWVLQW«ULHXUGHV,30DLQVLTXHOHSDTXHWGHSUHVWDWLRQVSULVHVHQFKDUJH
 ,QVWLWXWLRQGH&RRUGLQDWLRQGHOō$VVXUDQFH0DODGLH2EOLJDWRLUH
 (Q  OHV ,30 DVVXUDLHQW OD SULVH HQ FKDUJH SDUWLHOOH GH OōHQVHPEOH GHV IUDLV P«GLFDX[
RFFDVLRQQ«V SDU OD PDODGLH QRQ SURIHVVLRQQHOOH GX WUDYDLOOHXU HW GH VHV D\DQWVGURLWV GDQV XQH
IRXUFKHWWHGH¢
 6RLW XQH SULVH HQ FKDUJH ¢  GH OōHQVHPEOHV GH IUDLV P«GLFDX[ VRLW GōKRVSLWDOLVDWLRQ GH
FRQVXOWDWLRQH[DPHQVHWDQDO\VHVGDQVOHVVWUXFWXUHVGHVDQW«SXEOLTXHVHWSULY«HVDJU«HVbRevue
globale et analyse du système national de protection sociale du Sénégal

RDCTSS - 2022/3 189

 Mohamed Bachir Niang

/D FRQVHUYDWLRQ GōXQH ORJLTXH GH VROLGDULW« HW Gō«JDOLW« GDQV OH V\VWªPH GHV
PXWXHOOHV GH VDQW« FRPSO«WDQW FHOOH TXL H[LVWH GDQV OHV U«JLPHV O«JDX[ HW REOLJDWRLUHV
GHV«FXULW«VRFLDOHDXUDLWSHUPLVGōDQFUHUODPXWXDOLW«VRFLDOHFRPPHXQmbYHFWHXUGōXQH
«JDOHOLEHUW«HWSHUPHWWDQWOōDUWLFXODWLRQGHVOLEHUW«VLQGLYLGXHOOHV¢OōHQVHPEOHVRFLDOb}
/ōREMHFWLI GH U«GXFWLRQ GHV LQ«JDOLW«V HW GHV H[FOXVLRQV SURFODP« SDU OH GURLW QDWLRQDO
HW FRPPXQDXWDLUH QH SHXW ¬WUH DWWHLQW VDQV XQH FRQMXJDLVRQ GHV VROLGDULW«V QDWLRQDOH
HW VRFLR SURIHVVLRQQHOOH /HV LQVWUXPHQWV GH OD VROLGDULW« GDQV OHV U«JLPHV REOLJDWRLUHV
VRQW QHXWUDOLV«V VōDJLVVDQW GHV PXWXHOOHV SDU XQ SULQFLSH GH WDX[ QRQ SURJUHVVLI
GHV FRWLVDWLRQV /ōDUWLFOH  DOLQ«D SUHPLHU GH OD ORL GH  GLVSRVH TXH OHV
mbFRWLVDWLRQVSHXYHQW¬WUHPRGXO«HVHQIRQFWLRQGHVUHYHQXVGHVPHPEUHVSDUWLFLSDQWVb}
/D VROLGDULW« SDU OD PRGXODWLRQ GHV FRWLVDWLRQV QōHVW GRQF SDV XQ SULQFLSH PDLV XQH
VLPSOHSHUPLVVLRQ
/H OLHQ HQWUH OHV DOLQ«DV SUHPLHU HW VHFRQG GX P¬PH DUWLFOH SHUPHW UDSLGHPHQW GH
FRPSUHQGUHTXHFHWWHSHUPLVVLRQFRQVWLWXHOHIRQGHPHQWSRXUXQHSRVVLELOLW«GōLQVWDOOHU
XQH LQ«JDOLW« GHV SUHVWDWLRQV $X[ WHUPHV GH OōDOLQ«D SUHPLHU mb OHV PXWXHOOHV GH VDQW«
QH SHXYHQW LQVWLWXHU HQ FH TXL FRQFHUQH OH QLYHDX GHV SUHVWDWLRQV HW GHV FRWLVDWLRQV
GHV GLVFULPLQDWLRQV HQWUH PHPEUHV RX FDW«JRULHV GH PHPEUHV SDUWLFLSDQWV VL FHV
GLVFULPLQDWLRQV QH VRQW SDV MXVWLIL«HV SDU GHV VLWXDWLRQV SDUWLFXOLªUHVb } /HV VLWXDWLRQV
SDUWLFXOLªUHVYLV«HVSDUODORLQHVRQWSDVH[SOLFLW«HVPDLVLOHVWSUREDEOHTXHODGLII«UHQFH
GH FRWLVDWLRQV SXLVVH HQ FRQVWLWXHU XQH &HWWH GLVSRVLWLRQ GH OD ORL V«Q«JDODLVH VHPEOH
GōDLOOHXUV DYRLU LQVSLU« Oō8(02$ ¢ WUDYHUV OH UªJOHPHQW SRUWDQW U«JOHPHQWDWLRQ GH OD
PXWXDOLW«VRFLDOH/ōDUWLFOHGX5ªJOHPHQWGLVSRVHTXHmbOHVPHPEUHVSDUWLFLSDQWVVRQW
«JDX[HQGURLWHWHQREOLJDWLRQV7RXWHIRLVOHVPXWXHOOHVVRFLDOHVRQWODIDFXOW«GōLQVWDXUHU
GHVU«JLPHVVS«FLILTXHVHQUDLVRQGHODQDWXUHGHVULVTXHVVXSSRUW«HVHWGHVFRWLVDWLRQV
IRXUQLHV /HV FRWLVDWLRQV SHXYHQW «JDOHPHQW ¬WUH PRGXO«HV HQ IRQFWLRQ GH OD FDSDFLW«
FRQWULEXWLYHGHVPHPEUHVSDUWLFLSDQWVb},OIDXWDYRLUXQHOHFWXUHFLUFXODLUHGHODGLVSRVLWLRQ
SRXUFRPSUHQGUHTXHVDILQDOLW«QōHVWSDVGōDVVHRLUOHSULQFLSHGHQRQGLVFULPLQDWLRQPDLV
GōLQVWDOOHUXQHDXWRULVDWLRQ¢SU«YRLUGHVVWDWXWVGLII«UHQWV/DPRGXODWLRQGHVFRWLVDWLRQV
HQIRQFWLRQGHODFDSDFLW«FRQWULEXWLYHGHVPHPEUHVSDUWLFLSDQWVQōHVWXQLQVWUXPHQWGH
VROLGDULW«TXHORUVTXōHOOHVōDFFRPSDJQHGōXQHLGHQWLW«GHSUHVWDWLRQVFHTXHOHWH[WHQH
VS«FLƓHSDVVDQVTXHVRQOLEHOO«QHOōLQWHUGLVHFHSHQGDQW

%/ƚƫƞƥnjƠƚƭƢƨƧƝƞƬƨƛƣƞƜƭƢƟƬƩƫƞƦƢƞƫƬƝƞƥō(66ƞƭƝƞƥƚƬnjƜƮƫƢƭnj
ƬƨƜƢƚƥƞ
/ōH[WHQVLRQ GH OD FRXYHUWXUH VDQW« DX 6«Q«JDO PHW HQ VFªQH XQ FRQŴLW HQWUH OLEHUW«
VROLGDULW«HWDXWRQRPLHGHJHVWLRQbGHVSULQFLSHVGHOō«FRQRPLHVRFLDOHHWVROLGDLUHTXHOD

 3RXUUHSUHQGUHOHVWHUPHVGH&%HFmb/DV«FXULW«VRFLDOHHQWUHVROLGDULW«HWPDUFK«b}op. cit

 3U«DPEXOH GX 5ªJOHPHQW GH Oō8(02$ TXL LQGLTXH mb OōHQJDJHPHQW GH OōHQVHPEOH GHV (WDWV
PHPEUHVHWGHOō8QLRQFRQWUHODSDXYUHW«b}/DORLGōRULHQWDWLRQVXUOō«FRQRPLHVRFLDOHHWVROLGDLUH
Ɠ[H HQ VRQ DUWLFOH  OHV FRQGLWLRQV SRXU OH E«Q«ƓFH GH OōDJU«PHQW mb (FRQRPLH VRFLDOH HW
VROLGDLUHb}bmb$SSRUWHU¢WUDYHUVVRQDFWLYLW«XQVRXWLHQ¢GHVSHUVRQQHVHQVLWXDWLRQGHIUDJLOLW«GX
IDLWGHOHXUVLWXDWLRQ«FRQRPLTXHHWVRFLDOHbVDODUL«VXVDJHUVFOLHQWVPHPEUHVRXE«Q«ƓFLDLUHV
GHFHWWHHQWUHSULVHb}HWmbFRQWULEXHU¢ODOXWWHFRQWUHOHVH[FOXVLRQVHWOHVLQ«JDOLW«VVDQLWDLUHVRX
VRFLDOHV «FRQRPLTXHV ¢ Oō«GXFDWLRQ ¢ OD FLWR\HQQHW« RX DX PDLQWLHQ HW DX UHQIRUFHPHQW GH OD
FRK«VLRQWHUULWRULDOHb}

190 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

V«FXULW«VRFLDOHSHLQH¢FRQFLOLHU/HFRPSURPLVTXHODORLV«Q«JDODLVHHWOHUªJOHPHQWGH
Oō8(02$LQVWDOOHQWHVWFHSHQGDQWODUJHPHQWHQIDYHXUGōXQHOLEHUW«DFFRUG«HDX[RUJDQHV
PXWXDOLVWHVSDUXQHVRUWHGōDXWRULVDWLRQ¢V«OHFWLRQQHUOHVULVTXHVHWOHVSUHVWDWLRQV(1)FH
TXLHVWVRXUFHGōXQHFRQVHUYDWLRQGHVLQ«JDOLW«VG«M¢FRQVWDW«HV(2)

1 - L’autorisation de la sélection
‹YLWHUGHVSURWHFWLRQVGLII«UHQWL«HVGDQVODSD\VWRXWHQSU«VHUYDQWOō«TXLOLEUHƓQDQFLHU
GHVPXWXHOOHVVHPEOH¬WUHLFLHWDLOOHXUVXQREMHFWLIGLIƓFLOH¢U«DOLVHU‚G«IDXWGHIDLUH
GLVSDUD°WUHOHVLQ«JDOLW«VLOIDXGUDLWWRXWDXPRLQVJDUDQWLUXQVRFOHPLQLPDOGHSURWHFWLRQ
TXLSHUPHWWUDLWTXHODPDODGLHFHVVHGō¬WUHV\QRQ\PHGHPLVªUHHWTXHODV«FXULW«VRFLDOH
SXLVVHSHUPHWWUHGHURPSUHODFKD°QHLQWHUJ«Q«UDWLRQQHOOHGHODSDXYUHW«/D&RQYHQWLRQ
QrGHOō2,7GRQWOHVGLVSRVLWLRQVUHODWLYHV¢ODFRXYHUWXUHPLQLPDOHHQPDWLªUHGHVDQW«
QōRQW SDV «W« UDWLƓ«HV QōHQ FRQVWLWXH SDV PRLQV XQ U«I«UHQWLHO DEVROXPHQW Q«FHVVDLUH ¢
QRWUHWHPSVTXLP«ULWHUDLWXQHUDWLƓFDWLRQFRPSOªWHSDUOH6«Q«JDO
/HV LQVWUXPHQWV MXULGLTXHV TXL SHUPHWWHQW HQ GURLW V«Q«JDODLV XQH V«OHFWLRQ GHV
ULVTXHVHWGHVSHUVRQQHVDLQVLTXōXQQLYHDXGHSUHVWDWLRQVWUªVIDLEOHVVRQWLGHQWLƓ«VSDUOD
OLEHUW«GHƓ[DWLRQGXQLYHDXGHVFRWLVDWLRQVHWGHSUHVWDWLRQSDUOHVVWDWXWVRXOōDVVHPEO«H
J«Q«UDOH GH OD PXWXHOOH &HV GLVSRVLWLRQV SU«YRLHQW XQH DXWRULVDWLRQ SRXU OD PXWXHOOH
GōDVVXUHU OHV VRLQV OHV PRLQV FR½WHX[ PDLV SOXV U«JXOLHUV DYHF XQH IRUWH SUREDELOLW«
GōRFFXUUHQFHHQ«YLWDQWFHX[TXLVRQWSOXVUDUHVHWSOXVFR½WHX[bWHOVOHVKRVSLWDOLVDWLRQV
HWOHVSDWKRORJLHVORXUGHV/HFR½WGHOōDVVXUDQFHODUHFKHUFKHGō«FRQRPLHHWOō«TXLOLEUH
ƓQDQFLHUGHVVWUXFWXUHVLQW«UHVV«HVWUDQVIRUPHQWOHVU«DOLW«VFRPSWDEOHVHWƓQDQFLªUHVHQ
IDFWHXUVSULPRUGLDX[GDQVODUHFKHUFKHGHFRPSURPLV
$X[OLPLWHVSROLWLTXHVHWLG«RORJLTXHV WK«RULHVQ«ROLE«UDOHV HWVWUXFWXUHOOHV PRGLFLW«
GHVEXGJHWVGHV(WDWVDIULFDLQV VōDMRXWHQWGHVFRQWLQJHQFHVSURSUHV¢ODJRXYHUQDQFHHW
¢ODJHVWLRQ,OFRQYLHQWGHVōDWWDUGHUVXUOōLPSRUWDQFHGHVGLVSRVLWLRQVUHODWLYHVDXFRQWU¶OH

 - $OHQGD'HPRXWLH] mb /HV PXWXHOOHV GH VDQW« DX 6«Q«JDO IDFH DX[ GLIƓFXOW«V GH FRRUGLQDWLRQ
GHOHXUVDFWHXUVb}op. citbmb/DFRQYHQWLRQPXWXDOLVWHV«Q«JDODLVHHVW«WLU«HHQWUHGHX[JUDQGV
U«I«UHQWLHOVGōDSUªVQRWUH«WXGHbXQU«I«UHQWLHOUHODYDQWGHOōDVVXUDQFHSULY«HGōXQF¶W«¢WUDYHUV
XQHYLVLRQLQVWUXPHQWDOHHWXQU«I«UHQWLHOSRUW«SDUOHVYDOHXUVGHOō«FRQRPLHVRFLDOHHWVROLGDLUHGH
OōDXWUHb}
 -/ 6RXFKHWmb /H PRXYHPHQW PXWXDOLVWH GDQV OHV «YROXWLRQV GX V\VWªPH GH SURWHFWLRQ VRFLDOH
IUDQ©DLVb}Vie socialeQrS
 &RQYHQWLRQQrGHOō2,7VXUODV«FXULW«VRFLDOH QRUPHPLQLPXP DGRSW«H¢*HQªYHOHMXLQ

 $UW  GH OD ORL GX  MXLQ  UHODWLYH DX[ PXWXHOOHV GH VDQW«b mb /HV VWDWXWV G«WHUPLQHQWb  OHV
REOLJDWLRQV HW OHV DYDQWDJHV GHV PHPEUHV SDUWLFLSDQWV RX GH OHXU IDPLOOHb }b  DUW  HW  GX
5ªJOHPHQWGHOō8(02$SRUWDQWU«JOHPHQWDWLRQGHODPXWXDOLW«VRFLDOH
 6XUOHVPXWXHOOHVGōXQ«FKDQWLOORQQDJHXQHODUJHPDMRULW«  FRXYUDLHQWXQLTXHPHQWGHVSHWLWV
ULVTXHVFRQWUHPXWXHOOHVFRXYUDQWGHJURVULVTXHVOL«V¢OōKRVSLWDOLVDWLRQHWDX[LQWHUYHQWLRQV
FKLUXUJLFDOHVGDQVOHVVWUXFWXUHVKRVSLWDOLªUHV mb3ODQVWUDW«JLTXHGHG«YHORSSHPHQWGHVPXWXHOOHV
GH VDQW« DX 6«Q«JDOb } PLQLVWªUH GH OD 6DQW«   9RLU «JDOHPHQW OH mb 3ODQ VWUDW«JLTXH GH
G«YHORSSHPHQWGH&RXYHUWXUH0DODGLH8QLYHUVHOOHDX6«Q«JDOb}PLQLVWªUHGHOD6DQW«
HWGHOō$FWLRQVRFLDOH
 0*DXFKHWLe nouveau monde*DOOLPDUG&ROOmbVFLHQFHVKXPDLQHVb}3DULVS/ōDXWHXU
«YRTXHOHVWK«RULHVTXLWHQWHQWmbGōDOLJQHUOHIRQFWLRQQHPHQWGXWRXWVXUOHVUªJOHVGHODSDUWLH
«FRQRPLTXHVXSSRV«HVIRXUQLUODIRUPXOHRSWLPDOHGHODG\QDPLTXHFROOHFWLYHb}

RDCTSS - 2022/3 191

 Mohamed Bachir Niang

HWDX[VDQFWLRQVGHVRUJDQHVPXWXDOLVWHVSRXUVHFRQYDLQFUHTXHOHXUYLDELOLW«ƓQDQFLªUH
HVWGHYHQXHXQHYDOHXUFRQFXUUHQWLHOOH¢FHOOHVTXLVRQWLQWULQVªTXHV¢ODV«FXULW«VRFLDOHHW
GHOō«FRQRPLHVRFLDOHHWVROLGDLUH
&H TXL VHPEOH HQFRUH IRQGHU XQH GLII«UHQFH HQWUH PXWXHOOH GH VDQW« HW DVVXUDQFH
SULY«H U«VLGH GDQV OD SU«VHQFH GōXQH WXWHOOH H[HUF«H VXU OHV SUHPLªUHV PDLV TXL ¢ ELHQ
GHV«JDUGVQōHVWSDVWURSGLII«UHQWHGHFHOOHGHOD&RPPLVVLRQ5«JLRQDOHGH&RQWU¶OHGHV
$VVXUDQFHVGHOD&,0$
/DORLGHVRXPHWOHVPXWXHOOHVGHVDQW«¢ODWXWHOOHGX0LQLVWUHHQFKDUJHGHOD
VDQW« PDLV VRQ FRQWHQX HVW XQLTXHPHQW FRPSWDEOH HW ƓQDQFLHU /H FRPSURPLV HQWUH
OLEHUW« HW UHVSRQVDELOLW« GHYUDLW FRQGXLUH ¢ HPS¬FKHU TXH OHV PXWXHOOHV SHUGHQW OHXU
VS«FLƓFLW«SURSUH¢ODPLVHHQSODFHGōXQHLGHQWLW«WRXWHQOHXULPSRVDQWXQDJHQGDVRFLDO
PLQLPDO/ōDWW«QXDWLRQGXFDUDFWªUH WURS XQLIRUPHGHODO«JLVODWLRQDXUDLWSHUPLVSOXVGH
FRQWH[WXDOLVDWLRQVXUOHFDUDFWªUHYRORQWDLUHRXREOLJDWRLUHGHOōDGK«VLRQRXVXUOHQLYHDX
GH VROLGDULW« /ōHVSDFH WURS LPSRUWDQW RFFXS« SDU OD ORL HW VRQ G«VHQJDJHPHQW VXU OD
UHVSRQVDELOLW«VRFLDOHFRQGXLVHQW¢XQHYHUWLFDOLVDWLRQHWXQHUHFHQWUDOLVDWLRQGDQVODSULVH
GHG«FLVLRQVXUGHVDVSHFWVR»SOXVGHOLEHUW«DXUDLW«W«VRXKDLWDEOH FDUDFWªUHYRORQWDLUHRX
REOLJDWRLUHGHOōDGK«VLRQGDQVOHVPXWXHOOHVSURIHVVLRQQHOOHVHQYXHGōDOLPHQWHUGDYDQWDJH
ODPXWXDOLW« /HVYDOHXUVGLVWLQFWLYHVGHODPXWXDOLW«DSSOLTX«H¢ODV«FXULW«VRFLDOHGHYUDLHQW
DSSDUD°WUHSOXVFODLUHPHQWDYHFXQHGHQVLƓFDWLRQGHFULWªUHVKXPDLQVHWTXDOLWDWLIV
/ōRSWLRQWUªVOLE«UDOHGXO«JLVODWHXUV«Q«JDODLVVXUOHFRQWHQXGHVRIIUHVGHSUHVWDWLRQV
GHV PXWXHOOHV GH VDQW« HVW HQ FRQWUDGLFWLRQ DYHF OōDSSURFKH G«ƓQLH SDU OHV KXLW (WDWV
PHPEUHVDXVHLQGHOō8(02$&HWWHDSSURFKHGRQQHXQHDXWUHOHFWXUHGHVUDSSRUWVHQWUH
PXWXDOLW«VRFLDOHHWVROLGDULW«/DSU«YLVLRQGHPXWXHOOHVREOLJDWRLUHVFU««HVGōDXWRULW«SDU
G«FLVLRQDGPLQLVWUDWLYHFRPPHFHOOHGōXQHDGK«VLRQREOLJDWRLUHGDQVFHUWDLQHVFDW«JRULHV
SURIHVVLRQQHOOHVVRQWOHVRSWLRQVGXGURLWFRPPXQDXWDLUHGRQWOHGURLWV«Q«JDODLVGHYUDLW
VōLQVSLUHU6HXOHVGHWHOOHVGLVSRVLWLRQVVRQWVXVFHSWLEOHVGHGRQQHUFRUSV¢XQFRPSURPLV
YLDEOHPDQLIHVWDQWOōmbLG«HTXHOō(WDWHWOHPDUFK«QHVRQWSDVRSSRV«V}

 $UW  ¢  GX 5ªJOHPHQW GH Oō8(02$ Qr&08(02$ SRUWDQW U«JOHPHQWDWLRQ GH
OD PXWXDOLW« VRFLDOHb  5ªJOHPHQW GōH[«FXWLRQ Qr&208(0$2 GX  DR½W  Ɠ[DQW
OHV PRGDOLW«V HW SURF«GXUHV GH FRQVWLWXWLRQ GōDJU«PHQW HW GōLPPDWULFXODWLRQ GHV PXWXHOOHV
VRFLDOHV HW OHXUV VWUXFWXUHV ID°WLªUHVb  5ªJOHPHQW GōH[«FXWLRQ Qr&208(02$ UHODWLI DX[
UªJOHV SUXGHQWLHOOHV GHYDQW HQFDGUHU OHV UHVVRXUFHV ƓQDQFLªUHV GHV PXWXHOOHV VRFLDOHV GH Ɠ[HU
OHV PRGDOLW«V GōRUJDQLVDWLRQ HW GōLQWHUYHQWLRQ GX )RQGV GH JDUDQWLH GH SU«FLVHU OHV PRGDOLW«V
GH FRQWU¶OH GHV PXWXHOOHV VRFLDOHV HW GH G«WHUPLQHU OHV SURF«GXUHV GH SULVH GH PHVXUHV GH
VDXYHJDUGH GH VDQFWLRQV DGPLQLVWUDWLYH HW GH UHWUDLW GōDJU«PHQW SDU OHV DXWRULW«V DGPLQLVWUDWLYH
FRPS«WHQWHV5ªJOHPHQWGōH[«FXWLRQQr&08(02$SRUWDQWDGRSWLRQGXSODQFRPSWDEOH
GHVPXWXHOOHVVRFLDOHVDXVHLQGHOō8(02$
 &RQI«UHQFH,QWHUDIULFDLQHGHV0DUFK«VGō$VVXUDQFH
 9RLUQRWDPPHQWbOōDUWGX5ªJOHPHQWGHOō8(02$SRUWDQWUªJOHPHQWDWLRQGHODPXWXDOLW«VRFLDOHb
m OHV PXWXHOOHV VRFLDOHV RQW OōREOLJDWLRQ ř  GH SURGXLUH HW FRPPXQLTXHU OHV UDSSRUWV DQQXHOV
WHFKQLTXHPRUDOHHWƓQDQFLHU ¢OōRUJDQHDGPLQLVWUDWLIGHODPXWXDOLW«VRFLDOHHWDX[PHPEUHV
 mb /HV SUHVWDWLRQV GHV PXWXHOOHV GH VDQW« GH OD &08 VRQW SU«FDLUHV HW QH VRQW SDV JDUDQWLHV \
FRPSULVSRXUOHVDGK«UHQWVTXLRQWYHUV«OHXUFRWLVDWLRQVb}Revue globale du système de protection
sociale au Sénégalopcit
 $UWGX5ªJOHPHQW
 3%DWLIRXOLHU9'XFKHVQH$6*LQRQmb/DFRQVWUXFWLRQGōXQPDUFK««GXTX«GHOōDVVXUDQFHVDQW«b
XQHU«RULHQWDWLRQGHODVROLGDULW«b"b}op. citS

192 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

2 - La persistance des inégalités et des exclusions

/HVLQ«JDOLW«VGDQVOHV\VWªPHGōDVVXUDQFHPDODGLHDX6«Q«JDOVRQWFRQVXEVWDQWLHOOHV
¢ OD QDLVVDQFH GX V\VWªPH LO \ D SUªV GH FLQTXDQWH DQV DYHF GHV QLYHDX[ GH SUHVWDWLRQ
GLII«UHQFL«V HQWUH OD FDW«JRULH GHV IRQFWLRQQDLUHV HW FHOOH GHV WUDYDLOOHXUV VDODUL«V
&HVLQ«JDOLW«V«WDLHQWORLQGō¬WUHLQTXL«WDQWHVFDUHOOHVQHUHPHWWDLHQWQXOOHPHQWHQFDXVH
OHGURLWIRQGDPHQWDO¢ODFRXYHUWXUHVDQW«/ō«YROXWLRQGXV\VWªPHV«Q«JDODLVDDFFHQWX«
ODSU«VHQFHGHVROLGDULW«VFDW«JRULHOOHVFRQWUHGLVDQWODVROLGDULW«HWODFRK«VLRQQDWLRQDOH
/DORLGHHWODSUDWLTXHDGPLQLVWUDWLYHTXōHOOHDJ«Q«U«HRQWH[DFHUE«OHSK«QRPªQH
/ōDFWLRQ GHV SRXYRLUV SXEOLFV HQ YXH GH OXWWHU FRQWUH OHV QLYHDX[ GH SUHVWDWLRQV WUªV
EDV D «W« LQFLWDWLYH 'DQV OD SUDWLTXH OD &08 HW OD '(&$0 LQFLWHQW OHV PXWXHOOHV
VRXKDLWDQWE«Q«ƓFLHUGXVRXWLHQGHOō(WDW¢UHQRQFHU¢OHXUVSU«URJDWLYHVGHƓ[HUOHPRQWDQW
GH OD FRWLVDWLRQ HW OH FRQWHQX GX SDTXHW GH VRLQV RIIHUWV 0DLV P¬PH HQYLVDJ«H VRXV
FHW DQJOH OD PXWXDOLW« VRFLDOH UHVWH HQFRUH G«ILFLWDLUH VXU OD TXDOLW« /D QRQ SULVH HQ
FKDUJH GHV DIIHFWLRQV GH ORQJXH GXU«H GHPHXUH HW H[FOXW VXEV«TXHPPHQW OHVmb JUDQGV
PDODGHVb}GXV\VWªPHGHFRXYHUWXUH/HVVRXUFHVGHVLQ«JDOLW«VQHVRQWSDVVHXOHPHQW¢
FKHUFKHUGDQVOHƓQDQFHPHQWSXEOLFPDLVDXVVLGDQVOHPDQTXHGHYRORQW«GōDVVHRLUXQH
VROLGDULW«FDUFHVLQ«JDOLW«VVXEVLVWHQWP¬PHDXVHLQGHODFDW«JRULHTXLQHE«Q«ƓFLHSDV
GHVXEYHQWLRQV
/ōH[WHQVLRQ GH OōDVVXUDQFH PDODGLH HVW DOLPHQW«H SDU XQH ORJLTXH GH U«GXFWLRQ GHV
LQ«JDOLW«V HW QRQ GH U«VRUSWLRQ HQ RIIUDQW XQ PLQLPXP GH VRLQV TXL SRXU FHWWH IUDQJH
WUªVG«IDYRULV«HGHODSRSXODWLRQGHYUDLWDSSDUD°WUHFRPPHXQmbOX[Hb}&HWHIIHWSHUYHUV
GHWRXWHWHQWDWLYHGōH[WHQVLRQGHVFRXYHUWXUHVHVWODUJHPHQWSDUWDJ«DYHFGōDXWUHV(WDWV
DIULFDLQVHWGHVDXWHXUVKRUVGXFRQWLQHQWDIULFDLQQHFHVVHGHODG«FULUH
/HPDODLVHQ«GHODIDLEOHVVHGHOōDGK«VLRQDX[PXWXHOOHVGHVDQW«HWODIDLEOHVVHGH
OōRIIUHGHSUHVWDWLRQVLQWHUSHOOHVXUOHVU«DOLW«VH[SOLFDWLYHVGXFRQVWDW(OOHVVRQWFXOWXUHOOHV
WUªVFHUWDLQHPHQW«FRQRPLTXHVPDLV«JDOHPHQWMXULGLTXHV6XUODYRLHGōXQHVROLGDULW«HW
GōXQH DFWLRQ SOXV G\QDPLTXHV GHX[ YRLHV P«ULWHUDLHQW Gō¬WUH GDYDQWDJH H[SORU«HV /HV
SROLWLTXHVGōLQFLWDWLRQGHVPXWXHOOHV¢«WRIIHUOHVSDTXHWVGHVRLQVYHUVSOXVGHVROLGDULW«

 9RLU OH WDEOHDX mb 'HVFULSWLRQ GH FDUDFW«ULVWLTXHV GX PRGªOH GH PXWXHOOHV GDQV OH SURMHW GH
'«FHQWUDOLVDWLRQGHOōDVVXUDQFH0DODGLH '(&$0 6«Q«JDOb}FLW«SDU,6HFN$7'LD26DJQD
mb '«WHUPLQDQWV GH OōDGK«VLRQ HW GH OD ƓG«OLVDWLRQ DX[ PXWXHOOHV GH VDQW« GDQV OD U«JLRQ GH
=LJXLQFKRU 6«Q«JDO b}Santé publiqueS
 * ) *DQNSH ( & *DQNSH $ 1 %DOHED / =LQVRX & 0HVVHQJH mb /HV PXWXHOOHV GH VDQW«
UHSURGXLVHQWHOOHVOHVLQ«JDOLW«VGHVDQW«DX%HQLQb"b}op. citSbmb/ōLPSDFWGHPXWXHOOHV
WHOOHVTXōHOOHVIRQFWLRQQHQWDFWXHOOHPHQWUHVWHGRQFPDUJLQDOHVHWSHXWP¬PHFRQWULEXHU¢XQH
UHSURGXFWLRQGHVLQ«JDOLW«VHQPDWLªUHGHVDQW«b}
 0 %RUJHWWR mb /D VROLGDULW« Oō«JDOLW« HW OD UHVSRQVDELOLW« IDFH DX[ WUDQVIRUPDWLRQV GH Oō(WDW
SURYLGHQFHb } in &b %HF * 3URFDFFL GLU  De la responsabilité solidaire. Mutations dans les
SROLWLTXHV VRFLDOHV GōDXMRXUGōKXL 6\OOHSVH 3DULV  S b  5 %LJRW ( 'DXGH\ 6 +DLELDQ
mb 1RWH GH V\QWKªVH GX &5('2&b} VHSWHPEUH  Qrb $6 *LQRQmb /ōDVVXUDQFH PDODGLHb 
TXHOOH SODFH SRXU OH PDUFK«b "b } in 0 %RUJHWWR $6 *LQRQ )b *XLRPDUG GLU  Quelle(s)
SURWHFWLRQ V  VRFLDOH V  GHPDLQb " 'DOOR] 3DULV b  5 /DIRUH mb /D &08 XQ QRXYHO °ORW GDQV
OōDUFKLSHOGHOōDVVXUDQFHPDODGLHb}Droit SocialMDQYLHUSb'7DEXWHDXmb8QHUDWLRQDOLVDWLRQ
LQDFKHY«HGXƓQDQFHPHQWGHODV«FXULW«VRFLDOHb}RDSSHSDUWLHS
 (Q  VHXOHV  GHV SHUVRQQHV VRQW ¢ MRXU GH OHXUV FRWLVDWLRQV HW PRLQV GH  GHV
E«Q«ƓFLDLUHV SD\HQW HX[P¬PHV OHXUV FRWLVDWLRQVb  9 5LGGH $ $VRPDQLQJ $QWZL % %RLGLQ
%&KHPRXQL)+DQH/7RXUHUmb/HVG«ƓVGHVPXWXHOOHVFRPPXQDXWDLUHVHQ$IULTXHGHOōRXHVWb}
op. cit.

RDCTSS - 2022/3 193

 Mohamed Bachir Niang

HW GH UHVSRQVDELOLW« VRFLDOH GHYUDLHQW ¬WUH SRXUVXLYLHV HW UHQIRUF«HV /ōDUWLFXODWLRQ GH
Oō«FRQRPLHVRFLDOHHWVROLGDLUHDYHFOōDVVXUDQFHPDODGLHGHYUDLWVHGHVWLQHU¢LQŴ«FKLUmbOHV
UªJOHVGXPDUFK«GHID©RQTXHFHGHUQLHUVRLWGōLQW«U¬WJ«Q«UDOVROLGDLUHHW«TXLWDEOHb}
/DSRXUVXLWHGHOōREMHFWLImbSDQLHUGHVVRLQVPLQLPDOb}GHYUDLWVōDFFRPSDJQHUGHOLPLWDWLRQV
WDULIDLUHVSODIRQGVGHSULVHHQFKDUJHWDULIVGHUHPERXUVHPHQWSUL[GHSUHVWDWLRQSODIRQQ«V
HWF/ōKDUPRQLVDWLRQGDQVODƓ[DWLRQGHVWLFNHWVPRG«UDWHXUVSRXUOHVFRQVXOWDWLRQVFKH]OHV
SURIHVVLRQQHOVGHVDQW«OHVP«GLFDPHQWVHWDQDO\VHVP«GLFDOHVGRLWDXVVLDFFRPSDJQHU
OōHIIRUWSRXUXQQLYHDXGHJDUDQWLHVREOLJDWRLUHV/HVRXWLOVGōXQHWHOOHmb«GXFDWLRQb}GX
V\VWªPHSDUOōKRPRORJDWLRQGōXQmbFDKLHUGHVFKDUJHVSOXVUHVSRQVDEOHVb}GHmbFRQWUDWV
UHVSRQVDEOHVb}RXGHmbFRQWUDWVVROLGDLUHVHWUHVSRQVDEOHVb}RQW«W«H[S«ULPHQW«VDLOOHXUV
HWRQWSURGXLWGHVHIIHWVDSSU«FLDEOHV
/DSRXUVXLWHGHODSROLWLTXHGōLQFLWDWLRQGHPHXUHXQHRSWLRQGHWUDQVLWLRQTXLSDUWLFLSH
¢U«VRXGUHODTXHVWLRQGHOō«FDUWGDQVOHVSUHVWDWLRQVPDLVQHUªJOHSDVFHOOHGXƓQDQFHPHQW
IDFH ¢ GHV G«SHQVHV GHYHQXHV LQVRXWHQDEOHV SRXU Oō(WDW 8QH U«IRUPH SOXV DERXWLH DX
GHO¢GHVSROLWLTXHVLQFLWDWLYHVHVWXUJHQWH/HleadershipWURSPRG«U«GHVSRXYRLUVSXEOLFV
TXLWUDGXLWODFRH[LVWHQFHGHGLII«UHQWHVYLVLRQVDXQLYHDXQDWLRQDODERXWLW¢mbXQPDQTXH
GH G«EDW VXU OHV TXHVWLRQV VWUDW«JLTXHV PDMHXUHV HW OH PDQTXH GH G«YHORSSHPHQW GH
SROLWLTXHVHWGRFXPHQWVGōRULHQWDWLRQQDWLRQDX[b}/ōDYHQLUGHOōH[WHQVLRQGHOōDVVXUDQFH
PDODGLHHQOLDLVRQDYHFODFRQVHUYDWLRQGXOLHQGHVROLGDULW«Gō«JDOLW«HWGō«TXLW«FRPPH
LQGLFDWHXU GH OōKXPDQLVPH GX V\VWªPH GōDVVXUDQFH PDODGLH G«SHQG GH OD YRORQW«
¢ PRELOLVHU OHV FDSDFLW«V FRQWULEXWLYHV GHV SURIHVVLRQV OLE«UDOHV LQG«SHQGDQWHV GH
PDQLªUHJ«Q«UDOHOHVJUDQGVFRPPHU©DQWVHWHQWUHSUHQHXUVSRXUDOLPHQWHUODVROLGDULW«
LQWHUSURIHVVLRQQHOOHHWQDWLRQDOH
/ōLPSOLFDWLRQGHWHOOHVSURIHVVLRQVSDUOōLQVWDOODWLRQGHPXWXHOOHVREOLJDWRLUHVGDQVOHV
FDW«JRULHVSURIHVVLRQQHOOHVGHOō«FRQRPLHIRUPHOOHHWLQIRUPHOOHHVWVHXOHDSWH¢DOLPHQWHU
OD PXWXDOLW« HW ¢ VRXWHQLU OHV HIIRUWV GH Oō(WDW HQYHUV OHV SOXV G«PXQLV /HV FDSDFLW«V
FRQWULEXWLYHVGHFHVFDW«JRULHVP«ULWHUDLHQWGō¬WUHPLVHVHQPRXYHPHQWHQYXHGōDVVXUHU
OHU¶OHGLVWULEXWLIGHWRXWV\VWªPHIRQG«VXUODVROLGDULW«
8QHVHQVLELOLVDWLRQVXUOōRSSRUWXQLW«GHWHOOHVPHVXUHVVHUDQ«FHVVDLUHPDLVODYRORQW«
GH Oō(WDW ¢ OHV PHWWUH HQ ĐXYUH QH GHYUDLW SDV IDLOOLU 8QH IRLV OHV PXWXHOOHV REOLJDWRLUHV
LQVWDOO«HV OōREMHFWLI GōDIƓOLDWLRQ HIIHFWLYH GHV SHUVRQQHV YLV«HV FRQVWLWXHUD XQH VHFRQGH
«WDSH,QFLWHUOHVLQG«SHQGDQWV¢XQHDIƓOLDWLRQPDVVLYHSRXUUDLWE«Q«ƓFLHUGōXQHSROLWLTXH
GH FRQGLWLRQQDOLW« DX[ DLGHV ƓVFDOHV HW VRFLDOHV OōREWHQWLRQ GH 1,1($ OōLQVFULSWLRQ DX
5&&0ODVRXPLVVLRQDX[PDUFK«VSXEOLFVVHUDLHQWDXWDQWGōLQVWUXPHQWV¢ODGLVSRVLWLRQGH
Oō(WDWSRXULQFLWHUOHVLQG«SHQGDQWV¢XQHDIƓOLDWLRQ/DSU«YLVLRQGōXQIRQGVGHVROLGDULW«
HQWUHPXWXHOOHVGHVDQW«GHYUDLWSDUDFKHYHUOHOLHQGHVROLGDULW«GDQVOHFDGUHGHOōH[WHQVLRQ
GHOōDVVXUDQFHPDODGLH

 -)'UDSHULFLW«SDU6&WLQ0DU[HW0+HOO\mb/HSURMHWGHOō«FRQRPLHVRFLDOHHWVROLGDLUHbIRQGHU
XQH«FRQRPLHDFDSLWDOVLWH(QWUHWLHQDYHF-HDQ)UDQ©RLV'UDSHULb}Mouvements, Qui est le patron
GHVDVVRFLDWLRQVb"S
 3%DWLIRXOLHU9'XFKHVQH$6*LQRQmb/DFRQVWUXFWLRQGōXQPDUFK««GXTX«GHOōDVVXUDQFHVDQW«b
XQHU«RULHQWDWLRQGHODVROLGDULW«b"b}op. cit
 Ibid
 5DSSRUW «YDOXDWLRQ ƓQDOH GX SURJUDPPH GōDSSXL GH OD PLFUR DVVXUDQFH VDQW« DX 6«Q«JDO &7%
$JHQFHEHOJHGHG«YHORSSHPHQWS

194 REVUE DE DROIT COMPARÉ DU TRAVAIL ET DE LA SÉCURITÉ SOCIALE - 2022/3

 ESS et assurance maladie au Sénégal

/ōH[WHQVLRQGHOōDVVXUDQFHPDODGLHDX6«Q«JDOGDQVODSHUVSHFWLYHGHVRQXQLYHUVDOLW«
FRQYRTXH XQH YRORQW« IHUPH HW VRXWHQXH GH Oō(WDW PDLV DXVVL ¢ «JDOH LPSRUWDQFH XQH
FRQVFLHQFHSRSXODLUHSXLVQDWLRQDOHVDQVODTXHOOHGōDLOOHXUVOō«FRQRPLHVRFLDOHHWVROLGDLUH
QōHVWSDV

MOHAMED BACHIR NIANG

Agrégé des Facultés de droit, Université Cheikh Anta Diop

Thèmes de recherche : Droit du travail, dialogue social, mutations du salariat, contrats

atypiques.

Publications :
~ M. B. Niang, « Ancrage juridique et perspectives du dialogue social au Sénégal », in
P. Auvergnon, C. Kenoukon (dir.), Dialogue social dans l’espace OHADA et ailleurs dans le monde,
L’Harmattan, 2018, p. 221.
~ M. B. Niang, « Travail intellectuel et salariat au Sénégal », Mélanges en l’honneur du Professeur
Paul-Gérard Pouguoué, CREDIJ, 2014, p. 593.

RDCTSS - 2022/3 195