At a glance…

  • Senegal has a high total fertility rate as well as a high unmet need for family planning (FP).
  • The Senegalese Urban Health Initiative (ISSU) has worked with the Ministry of Health and Social Action (MSAS), municipalities and local leaders to increase access to contraceptives and FP messaging.
  • Between 2012 and 2013, a total of 2,238 women obtained services from ISSU’s Free Consultation Days.

The unmet need for FP in the six Senegalese intervention cities is high.

Senegal has a high total fertility rate. The Measurement, Learning & Evaluation (MLE) Project’s Baseline Survey Report for the Senegal Reproductive Health Initiative (ISSU) in the cities of Dakar, Guédiawaye, Pikine, Mbao, Mbour and Kaolack indicated that, on average, women had more than four children. The highest rate was observed in Pikine, where women reported having over 4.5 children. At the same time, unmet need was over 20% in all the cities, as high as 27.6% in Mbao.

The ISSU team has implemented a strategy known as Free Consultation Days at the community level. This approach depends on the support of a variety of local stakeholders (religious leaders, neighborhood leaders, opinion leaders, women and youth groups in the community and sanitation authorities) to increase access to modern family planning (FP) methods for women of reproductive age. The strategy aims to decrease unmet need for FP methods for spacing of births as well as to decrease maternal and infant morbidity and mortality rates.

The Senegal Urban Reproductive Health Initiative (ISSU) developed a tripartite agreement with municipalities and in Ministry of Health and Social Action.

ISSU has also developed a three-party cost sharing model with the Ministry of Health and Social Action (MSAS), each municipality and ISSU. The Ministry, through its district-level operational entity, provides personnel, materials and logistical support; the municipalities provide the space for the event, personnel, chairs, tents and purchases FP methods offered; ISSU provides support through qualified service providers, sensitization and branding materials. The Free Consultation Days approach addresses the three key components of the ISSU program: strengthening supply of, demand for and advocacy on modern contraception among urban populations with unmet need for spacing or limiting their children.

During the Consultation Days, free quality FP services are offered to the population of certain urban districts through gynecologic consultations and the communication of reproductive health and FP messages.

Results of the Free Community Consultation Days

According to ISSU’s program monitoring, in 2012, 1,295 women benefited from FP services. Of these, 586 women (45.25%) selected a long-term method. In 2013, a total of 943 women benefited from the services. Of these, 427 women (45.28%) selected long-term methods. This activity has contributed to an increase in women’s use of FP methods observed in the mid-term evaluation conducted by MLE in 2013.

The percentage of women in union using a family planning (FP) method in the three intervention cities has increased at mid-term when compared to baseline data.




Modern method use in Gueydiawaye.





Modern method use in Mbao.






Modern method use in Pikine.







The percentage of non-users of family planning (FP) reporting non-use due to religious opposition decreased in the three intervention cities.

Other reproductive health services are offered during the Free Consultation Days. For example, ISSU and partners diagnosed 114 precancerous cervical and breast lesions. The women with suspected cancer were referred to specialists.

Many religious leaders participated in the Consultation Days. There was a reduction in the percentage of women who reported concerns about not using FP methods due to religious reasons at mid-term when compared to the baseline results; Consultation Days may have contributed to this reduction.

This story was originally written by the Measurement, Learning & Evaluation Project, which evaluated the Urban Reproductive Health Initiatives (UHRIs) in Kenya, Senegal, Nigeria and India. The Challenge Initiative is charged with expanding access to the proven solutions and successes developed under the UHRIs.