Senegal

Situated in West Africa, Senegal has a population of approximately 12 million people. An estimated 42% of the population lives in urban areas and this number is expected to grow to more than 45% by 2015 and 53% by 2030. Senegal has at least eight cities with more than 100,000 people: Dakar, Guédiawaye, Kaolack, Mbour, Pikine, Rufisque, Saint-Louis and Thiès.

Almost one-third of married urban poor women have an unmet need for family planning (FP) (24% for spacing and 8% for limiting births). Senegal is “on track” to achieve the reductions in child mortality set forth by Millennium Development Goal (MDG) 4, but “off track” in improving maternal health (Goal 5). Increasing the use of modern contraception is a key strategy for achieving maternal and child health (MCH) goals and a high priority in the government of Senegal’s MDG Road Map. Estimates suggest that if Senegal meets existing unmet need for FP, it will reduce maternal mortality by 20% to 30% and infant mortality by 12% to 20%, helping the country meet the MDGs.

The total fertility rate among urban women of reproductive age is 5.3 (5.6 among urban poor and 3.2 among urban wealthy). Current use of modern contraceptives is 18% among married urban women, 12% among the urban poor, and 23% among the urban wealthy. Key barriers to use are opposition (or perceived opposition) by husbands and religious leaders, and health concerns.

The country-level program of the Urban Reproductive Health Initiative in Senegal (l’Initiative Sénégalaise de Santé Urbaine (ISSU)) will be implemented in Dakar, Guediawaye, Kaolack, Mbao, Mbour and Pikine. ISSU, led by IntraHealth International, is a 5-year (2010-2015) project designed to assist the government of Senegal in the revitalization of its family planning programs in the six selected urban areas.

ISSU will focus its efforts on promoting spacing and limiting methods, especially increasing access to FP among the lowest three wealth quintiles, in an effort to significantly increase contraceptive prevalence rate (CPR) by 2015 in the selected cities.

This will be accomplished by:

• Developing cost-effective interventions for integrating quality family planning with maternal and child health and HIV services;
• improving the quality of family planning services for the urban poor with emphasis on high volume clinical settings;
• testing innovative private-sector approaches to increase access to and use of family planning by the urban poor;
• developing interventions that create demand for and sustain the use of contraceptives; and
• disseminating Initiative findings, mobilizing resources, and developing a supportive policy environment to enhance access to family planning services for the urban poor in Senegal and in the Francophone Africa region.
   

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