Why is Senegal an Exemplar?

The mortality rate for children under the age of five in Senegal has declined significantly since the turn of the 21st century. The Institute for Health Metrics and Evaluation (IHME) estimates that under-five mortality in Senegal dropped from 117 deaths per 1,000 live births in 2000 to 52 in 2015 – a 56 percent reduction.¹

While this improvement occurred across economic categories^1,2 some geographic disparities remained. Under-five mortality declined rapidly in and around Dakar – the country’s capital and largest city – and in other parts of the relatively affluent west coast and northwest. Progress came more slowly in the poorer southeast.²

Aside from neonatal disorders, some of the other leading causes of death among children under five in Senegal during the 2000–2015 study period were diarrheal diseases, respiratory infections (including pneumonia), and malaria. Mortality rates for all three of these leading killers declined over this period – especially for malaria, which fell by 90 percent between 2000 and 2015.¹

Like other countries that are under-five mortality exemplars, Senegal has had difficulty reducing death rates among the very youngest children – those still in their first month of life. Among this vulnerable age group, the mortality rate declined by 38 percent, from 35 deaths per 1,000 live births in 2000 to 22 in 2015.¹

Nevertheless, this progress in reducing neonatal mortality placed Senegal ahead of its neighbors, and ahead of western sub-Saharan Africa as a whole.³

As with overall reduction in under-five mortality, this decline in neonatal mortality occurred in all of Senegal’s wealth quintiles and regions, but with some remaining geographic disparities. Here too, the southeast lagged behind the rest of the country, with the north-central area also showing relatively modest reductions in newborn deaths.^1,2

Nationally, the foremost causes of neonatal mortality were preterm birth complications, birth asphyxia and birth trauma, and sepsis and other neonatal infections.⁴

Senegal’s improvements in reducing under-five mortality and neonatal mortality are comparable to those of countries with similar levels of gross domestic product (GDP), such as Côte d'Ivoire – and even Ghana, a West African neighbor with a substantially higher GDP than Senegal’s.⁵

• Significant improvements in data, research, and health surveillance capacity.
• Investments in infrastructural and logistical systems relevant to public health, including supply chains that deliver medicines to facilities and water and sanitation networks.
• An emphasis on community ownership, equity, and decentralized accountability—as illustrated by the country’s diverse and highly empowered community health worker (CHW) network.
• Close coordination with donors, partners, local researchers, and international organizations.