By Estelle Monique Sidze, Associate Research Scientist and Cheikh Mbackè Faye, Senior Research Officer, APHRC
Located in the West Africa’s Sudano-Sahelian region, Senegal features among the world’s Least Developed Countries and qualified for the Highly Indebted Poor Country Initiative in April 2004. The country is characterized by a rapid growth in population (2.6% per annum) and a high proportion of young people: 58% of the population is under 25. The total fertility rate, pulled by a relatively high demand of children and a low contraceptive prevalence (12% among married women of reproductive age), remains high at 5 children per woman[i]. Senegal is also the country with the one of the highest unmet need for family planning services in the West Africa region (29.4%).
It is argued that – Meeting the unmet need for family planning – can reduce population growth and make achieving the Millennium Development Goals (MDGs) more affordable in developing countries, in addition to directly contributing to the goals of reducing child mortality and improving maternal health.
Senegal may be one step closer to achieving this target, thanks to new results from the MLE Senegal baseline survey APHRC conducted in joint collaboration with The University of North Carolina (UNC-CPC), as a part of The Senegalese Urban Health Initiative (l’Initiative Sénégalaise de Santé Urbaine (ISSU)).
What is The Senegalese Urban Health Initiative (ISSU) plan?The ISSU’s plan (2010-2014) is to implement specific programs as part of a pilot project to show how using innovative approaches based on quality health care delivery in the public and private sectors, as well as demand creation and advocacy efforts, can significantly increase the use of modern family planning (FP) methods by the urban poor in francophone Africa. The larger project goals are to improve the quality of life of the urban poor across Senegal through the increased access, quality and use of family planning services.
Step One: Identify the priority areas for interventions
The baseline survey conducted by The University of North Carolina (UNC-CPC) and APHRC identified several priority areas for project interventions that will greatly help for the ISSU work plan (see full report here). These priority areas include:
– Strengthening and scaling interventions that improve FP services (both quality and integration): By allocating additional resources to these interventions it is expected that more providers will be able to offer quality FP products and services throughout the health system.
– Focusing FP communication on spacing messages: Research in the six cities has shown that unmet need for spacing is greater than unmet need for limiting births.
– Exploring the role of pharmacies in the provision of FP methods: Although Senegalese law limits the sale of contraceptives to those who have a prescription; the development of the private sector (especially pharmacies) is a priority to expand access.
– Reducing barriers to the adoption of FP: Pervasive myths and misperceptions about FP and contraceptives must be addressed, and potential users must be provided accurate information on FP and feel that products are reliable and safe.
– Seeking the public endorsement of FP by religious leaders: Although very few people mentioned religious interdictions as part of the reasons for not using FP, Islam is a major influence on Senegalese social and cultural environment, and religious leaders need to be involved so that they can provide accurate information on FP to their followers.
These important findings were shared and discussed during a national conference held in Dakar on May 16, 2012. The event was presided over by Mame Abdoulaye Guèye, “Directeur de Cabinet” of the Senegalese Minister of Health and Social Action.
Step Two: The Way Forward
Anchored in the results from the MLE baseline survey, strategic supply- and demand-oriented activities will be intensively carried on in four cities in the coming days (Dakar, Guédiawaye, Pikine and Mbao) for a period of about one year.
The demand side activities will focus on making significant advances in increasing the social and cultural acceptability of family planning within the community. The project will use both interpersonal, and mid and mass media channels to provide tailored information to a variety of audiences.
The supply side activities will focus on ensuring quality family planning services are available at multiple points in the focus cities. Services should be accessible to poor populations and available when clients want them. A key factor in the provision of quality services is the availability of a woman’s method of choice.
The advocacy activities will focus on using available research to influence decision-makers to—not only understand the benefits of family planning—but also act on and own the approaches. The project will provide decision-makers with the opportunity to become family planning advocates and provide them with the tools necessary to consistently and accurately talk about family planning options.
[i] DHS 2010-2011, now available online at http://www.measuredhs.com/publications/publication-FR258-DHS-Final-Reports.cfm