In the context of the national debate on the extension of health insurance to farming households in Senegal, information on 504 households and 18 public primary health care (PHC) facilities was collected to analyse health care utilisation in an area where people live on 1.17 USD per day and where only 6% have health insurance coverage. Despite the high level of poverty, 84% of the individuals sought treatment from a qualified health provider during their last illness. The high rate of utilisation in the area is found to be attributable to the characteristics of the PHC facilities. Indeed, PHC facilities are highly accessible and offer good medical services at a low price. The low price of medical services in the sample explains why the dema...