The dedicated efforts of the government of Senegal have impelled continuous RMNCAH progress since 1990:
- The under-five mortality rate dropped from 185 to 54 deaths per 1,000 live births between 1990 and 2015 (Countdown to 2015, 2015);
- The adolescent birth rate declined from 154 to 90 births to women aged 15–19 per 1,000 women aged 15–19 between 1990 and 2014 (DHS, 2014);
- Antenatal care attendance—at least one visit—reached 96 percent in 2014; and
- Deliveries in a health facility reached 77 percent in the same year (DHS, 2014).
Despite these improvements, maternal mortality remains high, with 315 deaths per 100,000 live births (World Bank, 2015); and undernutrition continues to hamper the attainment of better results—with a notable 60 percent prevalence rate for anemia (DHS, 2014). These constraints are further exacerbated by persisting economic and geographic disparities—for instance, in 2012, 95.5 percent of women among the richest 20 percent delivered with a skilled provider compared to 30 percent among the poorest 20 percent (UNICEF, 2012). Moreover, in spite of impressive successes in increasing contraceptive prevalence, the transition to lower fertility in Senegal remains very slow. In only three years, the contraceptive prevalence increased from 10 to 16 percent—a very rare achievement, mostly due to a strong and adequately implemented policy on family planning. But this policy needs a further boost as the total fertility rate continues to stagnate at approximately five children per woman (World Bank, 2015).
During preliminary discussions, it was agreed that the country platform will be based on existing structures.
The Investment Case will build on existing strategies, such as the emergency plan on Mother, Newborn, Children and Adolescents Health (i.e., SMNEA) prepared by the Ministry of Health in 2015 with the support of all technical and financial partners.
Health financing strategy
The health financing strategy will include the universal health insurance program (i.e., “Couverture Maladie Universelle”), which is currently under development.