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Senegal Protects Women Through Family Planning

FrontLines - October 2009

By Sue Telingator

A man and his daughter from the Ranerou district in northern Senegal.

DAKAR, Senegal—In a recent promotional film shown in Senegal during a family planning event, the camera zooms in on a health professional who is talking about one of the most tragic cases she had witnessed.

"She was a girl of 17," Clara Cissé, a family planning counselor begins. "And she was pregnant. She had refused all methods of family planning. She had refused a cesarean section, even though it was recommended.

After seven months, she became pregnant again. This time, she had a uterine rupture and finally, had to have a complete hysterectomy after having only one child."

Though the specifics change, this story is common.

In 2005, according to the USAID-funded Demographic and Health Survey (DHS), five mothers and 41 newborns in Senegal die each day from complications related to giving birth. For each mother who dies, there are at least 10 more who suffer from serious obstetric complications.

In 2005, only 12 percent of women used contraception.

The government of Senegal, together with USAID and other partners, is changing its family planning campaign and emphasizing the importance of birth spacing.

USAID’s Senegal office is carrying out a five-year, $20 million campaign to address the needs of families in their reproductive years, including increased access to care before and after the baby’s birth, trained counselors to help mothers with family planning and reproductive health issues, malaria prevention programs, easier access to birth control, and specialized nutrition programs. There is also a special activity designed to encourage more male involvement in family planning issues.

Aïssatou Faye, wife of Imam Ibrahima Seck, and one of their six children

Mothers risk the loss of their own life, as well as the lives of their children, by spacing births too close together and not following a pre-natal and post-natal healthcare program.

The causes are varied.

Uncertainty over who is responsible for family planning within a couple can result in neither taking proper action. Some women hide contraception from their spouses, for fear their husbands will accuse them of being unfaithful. When the husband is the decision maker, wives are sometimes forced into having closely-spaced pregnancies, sacrificing their health and the health of their children.

Religion can also play a part in family planning constraints. Senegal is a predominantly Muslim country, and while the tenets of Islam promote safe birth spacing practices, there is a lot of misinterpretation among the population.

USAID is conducting national public information and education campaigns, including outreach and family planning services to Senegal’s 15 largest employers; and outreach to Senegal’s growing adolescent population through a reproductive health curriculum in high school.

USAID hopes that providing a safety net will ensure fewer women will end up like the 17-year-old in the movie.

And if, in spite of all these measures, a family is still not taking advantage of family planning opportunities, external forces could play a role. Ibrahima Seck, an imam from the town of Khodoba in eastern Senegal and the father of six children, sees the economy as a strong influence on family planning decisions.

"I think the mentality is starting to change," he said. "I know of a woman who used family planning and after 12 years had only two children because the family couldn’t afford more. A lack of income and unemployment are having an impact on the size of families." ★

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