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Star of Senegal: A Midwife Fights for Affordable Family Planning

A version of this article was originally posted to Impatient Optimists

Aïssatou Dia Fall has become a star in Yeumbeul, Senegal. She is neither a popular singer nor a famed dancer, but she excels at empowering women in the poorest suburbs of Dakar. With her help, poor urban women are able to fully enjoy their lives and families.

“I cannot allow these women to lose control over their lives because they have to choose between feeding their families and planning them,” Fall says.

To help eliminate some of the many fees involved in family planning services, Fall, a head midwife at Yeumbeul’s Gallo Dia Health Center, reached out to the mayor of her commune. As a result, the city hall agreed to cover the administrative costs—1,500 FCFA or roughly $3—of family planning files and appointment cards for new clients. Clients can now invest this money in their families instead, Fall says.

But Fall thought even more could be done to make family planning and counseling services more affordable. So she contacted her local health committee, which agreed to pay clients’ fees for initial family planning consultations (a contribution of approximately $3,000 per year). This investment made contraceptive commodities, such as pills and implants, more accessible to women who want to space their children.

“We lose a little bit of money, but we also save many lives,” the president of the health committee says.

Individuals facing social hardship or living with disabilities are also entitled to this benefit, which has helped to increase the total number of family planning users.

Every year the Gallo Dia Health Center serves about 400 family planning clients from a total population of 154,199. “The services I received at the Gallo Dia Health Center changed my life forever,” says Nogaye, a 27-year-old mother of three. “I want to thank God and the health facility’s managers for encouraging me to manage my own health through family planning. I finally have time to devote to my fishery business. I was also able to enroll my children in a better school.”

Strategies like Aïssatou Dia Fall’s will help improve Senegal’s national contraceptive prevalence rate, which is currently only 12%. It will also help reduce one of the world’s highest maternal mortality rates (410 deaths per 100,000 live births[1]) and reduce the fertility rate (an average of 5 children per woman).

Greater commitment from health providers and political leaders, as well as more efficient health committees, are at the center of the Senegal Urban Health Initiative’s (ISSU’s) demand-creation and advocacy strategies. Funded by the Bill & Melinda Gates Foundation, ISSU is a five-year project to improve contraceptive prevalence and use among Senegal’s urban poor. ISSU is implemented by IntraHealth International in partnership with FHI360, Marie Stopes International, ENDA Santé, Action and Development, the Islam and Population Network, the National Association of Midwives, and the Association of Journalists in Population and Development.

[1]  Senegal: Standard DHS, 2010-11. MEASURE Demographic and Health Surveys.