PubMed1988
Senegal, situated on the west coast of Africa, has a history of high fertility and high infant mortality. Preliminary results of the 1986 Demographic and Health Survey (DHS), administered by the Institute for Resource Development, Columbia, Md., indicate a slight decline in the birth rate and reveal a high prevalence of child health problems associated with poor sanitation and nutrition. Senegal's 7.1 million people (1987 estimate) are unevenly distributed throughout the country's dry, flat landscape. Some 40% of the population is urban, and about 1/2 of these urban residents live in the capital, Dakar. Heavy rural-to-urban migration has been encouraged by the high population growth rate--2.8% annually--and a poor standard of living in the countryside. With about 70% of the labor force dependent on agriculture, a drought-related drop in the yields of groundnuts and other cash crops contributed to the rural exodus and to growing unemployment in the capital. The 1986 survey of family planning and child health collected information from 4415 women 15-49 years of age, and measured the height and weight of their children between 6 and 36 months. The findings suggest that fertility may have fallen slightly since 1978. The Senegal DHS recorded a total fertility rate (TFR) of 6.5 average births/woman during the 1981 Senegal World Fertility Survey (WFS). The DHS also found that women at the end of their childbearing--age 45-49 in 1986--had borne 7.4 children on average, further evidence of a slight decline in births among the younger women. Senegalese women marry young. The average age at 1st marriage is only 16.1, according to the 1986 DHS, and family planning within marriage is not widely accepted. In 1986, 11.7% of the currently married women 15-49 used some form of birth control, but only 2.7% used a modern method. While this is a large increase over the 3.9% rate of contraceptive use recorded in the 1978 WFS, almost 3/4 of the gain was due to a higher reported use of abstinence and withdrawal. In fact, 29% of the married women had relied on abstinence some time in the past, while only 6% had ever used a modern method. Current use of the pill and the IUD increased 4-fold between 1978 and 1986, but the 1986 level is still too low to have much effect on fertility rates. The knowledge of various contraceptive methods did increase significantly between 1978 and 1986. For example, only 18% of the married women said they were familiar with the pill in 1978, while 51% knew about it in 1986. In general, knowledge of modern contraceptives grew from 20%-68% of married women, while knowledge of traditional methods increased from 50-90%., between 1978 and 1986. When asked why they did not use contraceptives, 34% of the women said they were trying to become pregnant, and 19% said religious proscriptions against birth control discouraged them from using contraceptives. The preliminary DHS report also showed that 43% of the children under age 5 had vaccination cards, according to their mothers, although interviewers were able to verify the existence of cards for only 23% of the children. Up to 77% of the children under age 5 living in the Dakar region had vaccination cards (46% verified by interviewers), in marked contrast to the rest of the country.