According to the 2011 Demographic and Health Survey (DHS), only 12% of married women use a modern method of contraception in Senegal, with injectables (3%) and oral pills (3%) being the most used methods. The same DHS showed that nearly 95% of infants receive the BCG vaccine shortly after birth to protect them from tuberculosis, 82% receive the anti-polio vaccine at nine months, and nearly 63% of Senegal infants are fully vaccinated.

Senegalese mother and child
(click for more photos)

In Senegal, the IntraHealth-led Health Services Improvement Program is working with the Ministry of Health to scale up the integration of a package of health services. As part of this package, health posts throughout the country are working to integrate family planning and immunization. Considered one of the promising High Impact Practices in family planning, this integration, when scaled up, could have an important impact on increasing contraceptive prevalence in a country where family planning use continues to stagnate.

Studies have found that integrating services such as immunization, which tends to be widely used and acceptable, with other less-used services such as family planning can have a positive impact—and ultimately save resources and time on the part of both health workers and clients1.

In early 2012, the Health Services Improvement Program started to integrate family planning and immunization programming in 2 of the 54 districts covered by the project. Health posts have regular immunization days scheduled each week. During these days a large number of women regularly visit the health post for routine child vaccinations. These visits present a unique opportunity to provide post-partum women with information and services that they might not otherwise be aware of.

Women, who come to the health post to vaccinate their children, are invited to listen to informational sessions on a variety of topics including family planning, antenatal and prenatal care, the benefits of routine vaccinations, and the advantages of facility-based births. The sessions provide clients with an opportunity to ask questions of qualified personnel and, in the case of family planning, receive counseling and service that same day. Long-term methods such as implants and IUDs are provided by the head nurse while community health workers provide other shorter-term methods. 

Oumoukhaïry Bâ, the head nurse at the Keur Soce health post, said, “It makes sense to provide integrated services. Since women are here for their children anyway, the [women] can also get information and the other services, like family planning, at the same time,” instead of returning several times to the clinic for other services like immunization.

One client who benefitted from family planning services the same day that her child received immunizations said, “The availability of these two services, on the same day at the health post, allows me to save on transportation costs as well as time.”

IntraHealth is tracking the integration of these services through regular monitoring on the number of women who attend information sessions, the number of women who choose a method, and the number of children vaccinated over a given month. The collection of this information will help the Ministry of Health and IntraHealth better understand how integrated services are helping improve the provision of services and meeting the needs of the Senegalese population.   

The Health Services Improvement Program is led by IntraHealth International and funded by the United States Agency for International Development.

1. Wallace AS, Ryman TK, Dietz V. 2012. The Journal of Infectious Diseases. Experiences integrating delivery of maternal and child health services with childhood immunization programs: systematic review update. 205(Suppl 1):S6–19.