In Senegal, contraception is mainly used by unmarried women and girls, and pills and injectables remain the most common methods. This was indicated by Ramatoulaye Diouf Samb, midwife and Information and Communication Officer of the National Association of Midwives of Senegal.
Can you provide an update on the practice of family planning in Senegal, particularly the latest figures?
The latest demographic and health surveys (EDS) of 2023, carried out by the National Agency for Statistics and Demography (ANSD), show that in Senegal, 27% of women of reproductive age, aged 15 to 49 years old and in union, use at least one modern contraceptive method. Among unmarried women, this rate reaches 42%. Contraceptive prevalence is higher among unmarried and sexually active women. It should be noted that this rate varies according to region: in urban areas, it is 34%, compared to 20.4% in rural areas.
Also read: Adverse effects of family planning: When temporary relief hides lifelong suffering
What are the existing family planning methods and those most used in Senegal?
There are several methods of family planning in Senegal: Pills, to be taken daily; injectables, administered every three months; the implant, valid for three years with regular follow-ups (1 month after the injection, then 6 months later, and then annual follow-up); the intrauterine device, which can be placed for a period of 12 years, generally chosen by multiparous or hypertensive women; the progesterone vaginal ring, which was tested but withdrawn from public health structures; condoms, both female and male; the LAMA method (Breastfeeding and Amenorrhea Method), very popular among women, but presenting a high risk, because only 2% of women succeed in this method; the fixed days method or cycle necklace, which consists of beads to signal the fertile period (white beads) and the non-fertile period (brown beads), as well as a red bead to mark the first day of menstruation .
Women can also resort to observational methods, based on daily taking of body temperature to determine the period of ovulation. Finally, there is tubal ligation, often performed on multiparous women, as well as emergency contraception, which is increasingly used by young girls.
Although there is no specific study yet showing which method is most used in Senegal, we see that pills, especially combined ones, are very popular among women. In our health structures, pills and injectables are the most requested.
Is the implant seen as a “risky” method?
The implant is a long-term contraceptive method. Injected under the skin, it releases hormones, mainly progestins. It is accessible, available, and efficient. Although this is not a free method, it remains affordable, costing less than 500 CFA francs, and installation is free. Special family planning days are organized to offer certain methods free of charge. We take care not to impose any method, but to inform women and support them in their choice, based on their state of health. Some women report side effects such as abdominal pain during menstruation, stopping of periods, or weight changes. However, these effects are generally manageable.
What can you say about the side effects of family planning?
It is true that whatever the choice, side effects can occur, but these are generally manageable. When women come for a consultation, we explain to them that there are possible side effects, such as headaches, abdominal pain, or bleeding. These symptoms are temporary and can be relieved. On the other hand, certain negative effects are often amplified by rumors. We help women understand these effects and make an informed decision. In case of doubt, if the first contact goes well, they accept advice more easily. We have communication strategies to support women throughout their contraceptive journey.
How do you support women in their choice of contraceptive method?
We use a disk that presents the medical criteria for the adoption of contraceptive methods. This disk is based on the guidelines of the World Health Organization (WHO) and facilitates our work by making orientation faster and more efficient.
Are men increasingly adhering to family planning?
In Dakar, notable progress has been made, although there is still some resistance, particularly among some husbands. In rural areas, obstacles remain. However, we see that awareness is progressing.
Are there health risks associated with family planning for girls outside of marriage?
No, there are no specific risks. We have launched a policy to support teenage girls, put them at ease and avoid stigmatizing them. The objective is to prevent unwanted pregnancies and to avoid taking the morning after pill in an anarchic manner. Poor planning can create complications, such as taking the morning after pill incorrectly, which could affect future fertility. We raise awareness among young girls and women, particularly in schools, in order to prevent these behaviors.
Regarding the cost, the pill pack costs 100 CFA francs in health structures, but can reach 400 CFA francs in private pharmacies. Good care and better information on contraception will help avoid problematic situations.
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