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The article titled “Scaling Up Departmental Health Insurance Units in Senegal: A Mixed-Method Study,” authored by Valéry Ridde, Mouhamadou Faly Ba, Babacar Kane, Anouk Chouaïd, and Adama Faye, and published in the Journal of Health Systems and Reform, examines the implementation of departmental community-based health insurance (CBHI) in Senegal. In light of the challenges faced by municipal-level CBHIs, Senegal has initiated a campaign to expand the departmental CBHI model, which began in 2014, to enhance universal health coverage. This study presents stakeholders’ perspectives on the factors influencing the successful scaling up of departmentalisation, utilising a mixed-methods approach that incorporates quantitative and qualitative analyses. The findings highlight 125 critical factors categorised into nine clusters, revealing challenges related to governance, resource allocation, and stakeholder engagement. The study also emphasises the importance of negotiation and public funding in facilitating this health insurance model’s expansion. Ultimately, the authors propose actionable recommendations to promote the successful scaling of CBHI departmentalisation in Senegal.