Neonatal and maternal mortality reduction in Senegal

Exemplars in Global Health program

The Exemplars in Global Health program aims to learn from countries that have made rapid progress in improving health outcomes and disseminate this evidence to inform health policy and funding decisions. Our aim is to research success stories from low- and middle-income countries and share findings that can be useful for leaders looking to act in comparable contexts.

In selecting Exemplar countries, we review evidence to identify countries that outperformed their peers in vital areas of public health, controlling for factors such as economic growth. In this way, we aim to provide more actionable, policy-relevant insight for stakeholders about how health progress can be made despite resource limitations.

Guided by research partners and technical advisors, we conduct quantitative and qualitative analyses to validate our initial assessments and assess factors that contribute to a country’s exemplary performance.

Research in and across Exemplar countries could help ministries, nongovernmental organizations, and multinational bodies better deploy finite resources to address key public health issues in low- and middle-income countries.

By studying proven strategies to prevent disease, malnutrition, and other conditions that burden populations of low- and middle-income countries, we aim to create a repository of data-driven narratives that can serve as resources for leaders looking to improving health within their own countries. The following narrative focuses on factors that contributed to rapid reductions in neonatal and maternal mortality in the Exemplar country of Senegal.

Introduction to Senegal

Located on the coast of West Africa, Senegal became independent in 1960 following a transfer of power agreement with France. In the decades since, Senegal has established itself as one of the most stable democracies in Africa and as a key arbiter of peace in the region.

Senegal is divided into 14 administrative regions, which are further disaggregated into 45 departments and 113 arrondissements. The capital city of Dakar is located in the Dakar region, which is the most populous of all regions despite being the smallest geographically. Generally, population density is highest along the western coast than in the eastern portions of the country, which are predominantly rural .¹ Senegal has become increasingly urban in recent decades, with 48% of the population living in urban areas in 2020 as compared to 40% in 2000.²

The Senegalese economy began a generally steady upward trend during the mid-1990s. From 1995 to 2020, GDP per capita rose from US$984 to US$1,391 (2015 US dollars).³ This reflects a 41% increase in GDP per capita over that 25-year span, which stands in stark contrast to the 7% decrease observed in the previous 25 years from 1970 to 1995.³ This has translated to a better economic outlook for many people in the country, as in 2018, 9.3% of the population lived in poverty (i.e., less than 2017 US$2.15 per person per day) compared with 70.1% in 1991.⁴

Although this economic progress is impressive, our country selection analysis suggests that it does not completely explain Senegal’s success in reducing neonatal and maternal mortality. Additional details about Senegal are included in the Context section, and the majority of this narrative will highlight key indicators, interventions, policies, and programs that contributed to rapid neonatal and maternal mortality reduction in Senegal.

Funding Acknowledgment: This research was supported by the Bill & Melinda Gates Foundation — Grant Number INV-007594.