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Senegal: A Leader in Access to FP/RH Care During COVID-19

COVID-19 is demonstrating the impact of epidemics on the continuity of care provision, particularly for FP/RH. This is why, in addition to the measures taken to fight COVID-19, we realized the importance of carrying out parallel actions that guarantee the availability and continuity of essential RMNCAH services.

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The COVID-19 context in Senegal and West Africa

“The virus is spreading throughout the country and no one is safe.” This common assertion is not reassuring. With a first case officially declared on March 2, 2020, Senegal now has 14,044 cases and 292 deaths as of September 8, 2020. It is one of the most affected countries in West Africa, after Nigeria (55,160), Ghana (44,869), and Côte d’Ivoire (18,701). Senegalese people are learning to live with the virus. As of this same date, the 17 countries of West Africa have a combined total of 173,147 confirmed coronavirus cases, including 147,613 people recovered and 2,712 deaths. Confronted with COVID-19, the fragility of African health systems has aroused much fear.

Senegal’s experience with epidemics, including Ebola in 2013 and 2014, helped Senegal quickly develop anticipatory, surveillance, and coordination reflexes, such as closing borders, to avoid the spread of the pandemic. This made it possible to limit the number of imported cases very early on. On March 23, the government declared a state of emergency accompanied by strong health measures. A vast community mobilization campaign was undertaken by health authorities in collaboration with local authorities, and community and traditional leaders to support community involvement.

A woman in Senegal (photo d’Arne Hoel/World Bank sous licence CC BY 2.0)

The impact of COVID-19 on health care — specifically FP/RH care — and our response

We are fearful of health facilities. The speed at which the virus is contracted, the numerous asymptomatic cases in Senegal, and the stigmatization of COVID-19 patients have been the reasons why people are not seeking health care and services. This was the case for me. At the end of July, when I was informed that I may have been in contact with someone who had a confirmed case of coronavirus, having to go to the hospital was my greatest source of anxiety. For me, it was a way of exposing myself to the virus more than anything else. In the end, I didn’t go and took the option of staying in quarantine at home. Like me, many men and women adopt this attitude every day.

The situation has been more worrisome for FP/RH care. In Senegal, the frequency of home births, recurrent missed antenatal visits, the overall decline in visits to health facilities for FP/RH care, and the disruption in the family planning supply chain have alerted the Department of Maternal and Child Health. “We immediately noticed that services were less frequent because of the fear surrounding COVID-19 and in part because of the perception of messages about staying home.” The same trend was observed in Burkina Faso. A survey revealed that a quarter of the women interviewed have had difficulty accessing family planning care since the beginning of the pandemic.

“In order to respond to rumors from the field, particularly regarding an increase in home births, and at the suggestion of the Department of Maternal and Child Health validated by experts, we organized supervision efforts. A contingency plan was then drawn up in collaboration with all technical and financial partners, following the six essential areas recommended by the WHO in the context of COVID-19.” As part of the implementation of this plan estimated at 500 million FCFA, “we developed a guide intended to help providers with structuring health services, making essential Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) care available, protecting staff, communication, and implementing new strategies based on lessons learned. The early use of registers and files has also made it possible to take stock of the potential needs of women and offer them solutions in complete safety.”

These different response strategies to the COVID-19 pandemic put in place by the Senegalese government have been reinforced by the actions of FP/RH partners such as Family Planning 2020, the Ouagadougou Partnership, as well as projects and programs in Senegal and throughout the region.

A mother in Senegal (photo d’Arne Hoel/World Bank sous licence CC BY 2.0)

Senegal’s current status on providing FP/RH care during this period

COVID-19 is demonstrating the impact of epidemics on the continuity of care provision, particularly for FP/RH. Some populations have abandoned health facilities for fear of contracting the virus. This is why, in addition to the measures taken to fight COVID-19, we realized the importance of carrying out parallel actions that guarantee the availability and continuity of essential RMNCAH services to avoid rolling back the important progress made in reducing maternal, neonatal and child mortality during this decade. Six months after the first case of coronavirus, I am pleased that “the feedback we have from the regions bodes well for the FP/RH indicators, which would not be in decline and this would certainly be linked to these actions taken, including communication.”

Dr Marème Mady Dia Ndiaye

Cheffe de la Division Planification Familiale || Family Planning Division Head, Direction de la Santé de la Mère et de l’Enfant (DSME) || Department of Maternal and Child Health (DSME)

Dr Marème Mady Dia Ndiaye est cheffe de la division planification familiale à la direction de la Santé de la Mère et de l’Enfant (DSME). Elle capitalise plus de 20 ans d’expérience dans le système de santé au Sénégal où elle a eu à occuper des postes depuis le niveau opérationnel au niveau central. Sa passion pour la planification familiale s’est affirmée en 2010 en tant que Médecin chef du District de Pikine où elle a contribué à la mise en œuvre du Projet ISSU (Initiative Sénégalaise de Santé Urbaine) avant de rejoindre en 2013 le niveau central au sein de la DSME en tant que Conseillère Technique dans le cadre du projet de Renforcement des Prestations de Services de Intrahealth. Marème est spécialiste en Santé Publique, épidémiologie et bio statistiques. || Dr. Marème Mady Dia Ndiaye is the head of the family planning division in the Department of Maternal and Child Health (DSME). She has more than 20 years of experience in the health system in Senegal where she has held positions from the operational level to the central level. Her passion for family planning was affirmed in 2010 as Chief Medical Officer of the district of Pikine where she contributed to the implementation of the Senegalese Urban Health Initiative (ISSU) before joining the DSME as Technical Advisor for IntraHealth’s Strengthening of Service Delivery project in 2013. Marème is a specialist in public health, epidemiology and biostatistics.

Aïssatou Thioye

West Africa Knowledge Management and Partnerships Officer, Knowledge SUCCESS, FHI 360

Aïssatou Thioye est dans la division de l'utilisation de la recherche, au sein du GHPN de FHI360 et travaille pour le projet Knowledge SUCCESS en tant que Responsable de la Gestion des Connaissances et du Partenariat pour l’Afrique de l’Ouest. Dans son rôle, elle appuie le renforcement de la gestion des connaissances dans la région, l’établissement des priorités et la conception de stratégies de gestion des connaissances aux groupes de travail techniques et partenaires de la PF/SR en Afrique de l’Ouest. Elle assure également la liaison avec les partenaires et les réseaux régionaux. Par rapport à son expérience, Aïssatou a travaillé pendant plus de 10 ans comme journaliste presse, rédactrice-consultante pendant deux ans, avant de rejoindre JSI où elle a travaillé dans deux projets d’Agriculture et de Nutrition, successivement comme mass-media officer puis spécialiste de la Gestion des Connaissances.******Aïssatou Thioye is in the Research Utilization Division of the GHPN of FHI 360 and works for the Knowledge SUCCESS project as the Knowledge Management and Partnership Officer for West Africa. In her role, she supports the strengthening of knowledge management in the region, setting priorities and designing knowledge management strategies at the FP/RH technical and partner working groups in West Africa. She also liaises with regional partners and networks. In relation to her experience, Aïssatou worked for more than 10 years as a press journalist, then as an editor-consultant for two years, before joining JSI where she worked on two Agriculture and Nutrition projects, successively as a mass-media officer and then as a Knowledge Management specialist.