Senegal

Senegal’s reputation as a model West African nation is built on its smooth transition to a democracy, low level of government corruption, successful economic reforms, and history of community participation in health care. Indeed, on several fronts, Senegal’s health care system has vastly improved in the past 20 years:

• From 1990 to 2000, the number of births assisted by an attendant increased from 40 to 51 percent
• Maternal mortality was cut in half (from 1,200 deaths per 100,000 live births to 690)
• HIV prevalence remained low, at 1.8 percent for adults
• Total fertility fell from 6.5 lifetime births per woman to 5.5

EngenderHealth has been part of this transformation. Since 1992, we worked with communities and the government alike to tailor programs and services to local needs, respecting cultural values, traditions and beliefs. Our work in Senegal focused on:

• Expanding contraceptive choice
• Improving the quality of reproductive health care
• Making motherhood safer

 
Expanding Contraceptive Choice
Advances in the Senegalese health system have brought increased needs for skilled providers and adequate supplies to meet the family planning demands of its citizens. At the same time, continued lack of information about modern contraceptive methods precludes men’s and women’s use of them. Through the USAID-funded ACQUIRE Project, EngenderHealth collaborated with Senegal's Ministry of Health, Pathfinder International, and other agencies to:

• Increase awareness of long-acting methods;
• Increase availability of long-acting contraceptive methods, such as the intrauterine device (IUD) and Norplant implants;
• Improve the quality of sterilization services by upgrading providers’ skills;
• Upgrade providers’ infection prevention practices.

 
Improving the Quality of Reproductive Health Care
Senegal was one of 21 West African countries included in EngenderHealth’s Action for West Africa Region—Reproductive Health (AWARE-RH) Project. This USAID-funded project worked in Senegal to:

• Establish a strategy to improve reproductive health care in every region of the country;
• Introduce COPE® and facilitative supervision—two quality improvement tools that help health care staff identify and resolve problems on their own;
• Train staff and expand family planning services at 35 health care sites.  To date,
  • 29 facilities in Senegal now provide Norplant implants
  • 6 service providers adopted minilaparotomy sterilization techniques
• Promote health care reform through the use of national health accounts, a tool designed to measure health expenditures, so administrators can better understand how health resources are used;
• Implement routine use of Quantimed, a specially designed software system that allows health care works to gather data about malaria, HIV, and other reproductive health indicators;
• Raise awareness of how legislative action can improve reproductive health
  • In July 2005, Senegal passed the Reproductive Health Law promoting access to family planning and reproductive health care.

 
Making Motherhood Safer
In six rural districts in Senegal, EngenderHealth trained doctors and midwives to provide comprehensive postabortion care services, including counseling, referral, and infection prevention, and have strived to integrate postabortion care into routine maternal care services. To ensure sustainability, we trained providers to monitor and evaluate their programs with an eye to identifying needs for long-term supplies of necessary equipment, providing client counseling, and ways to control costs.