{
  "abstract": "Background Senegal has made significant progress in family planning (FP), with the modern contraceptive prevalence rate (mCPR) increasing from 12% in 2010 to 26% in 2023, along with a sharp decline in unmet need. Once among West Africa’s lowest performers, Senegal now stands out for its advancements in FP access and equity.Objectives This study examines the main factors driving Senegal’s FP progress—including policy leadership, financing mechanisms and community engagement—while identifying ongoing challenges and lessons for policy and practice.Methods We employed a mixed-methods approach, combining trend and decomposition analyses with a review of FP policies, financing and programmes, guided by the WHO’s health system building blocks. Qualitative data were collected from interviews and focus groups with policymakers, providers, community leaders and users across various regions.Results Senegal’s early gains in FP were driven by strong political leadership, task-shifting, community-based service delivery and supply chain improvements. Social mobilisation campaigns, including Moytou Nef and engagement with religious leaders and men, promoted supportive norms and increased demand. These efforts improved method availability, reduced stockouts and expanded access. Decomposition analysis identified FP knowledge (35%), education (18%) and facility access (16%), particularly among young women, as the main drivers of performance. Broader shifts in gender norms, women’s empowerment and male involvement also supported uptake. Since 2017, mCPR has plateaued, with persistent gaps among adolescents, unmarried women and rural populations due to stigma, provider bias, limited youth-friendly services and donor dependence. These findings highlight the need for targeted, equity-focused interventions to sustain and expand Senegal’s FP achievements.Conclusion Senegal’s FP progress demonstrates how strategic governance, service innovation, and community engagement can increase contraceptive use. To sustain and build on these achievements, renewed investment is necessary in youth-focused services, domestic funding, and equity-centered strategies that are integral to larger health and development plans.",
  "authors": [
    {
      "affiliations": [
        "Laboratoire de Sociologie, d’Anthropologie et de Psychologie (LASAP- ETHOS) FLSH, Universite Cheikh Anta Diop de Dakar, Dakar, Dakar Region, Senegal"
      ],
      "name": "Sylvain Landry Birane Faye"
    },
    {
      "affiliations": [
        "S&F Pro Consulting LLC, Manteca, California, USA"
      ],
      "name": "Georgette Helene Coumba Sow"
    },
    {
      "affiliations": [
        "Laboratoire de Sociologie, d’Anthropologie et de Psychologie (LASAP- ETHOS) FLSH, Universite Cheikh Anta Diop de Dakar, Dakar, Dakar Region, Senegal"
      ],
      "name": "Rose André Faye"
    },
    {
      "affiliations": [
        "Laboratoire de Sociologie, d’Anthropologie et de Psychologie (LASAP- ETHOS) FLSH, Universite Cheikh Anta Diop de Dakar, Dakar, Dakar Region, Senegal"
      ],
      "name": "Marie Gabrielle Ndong"
    },
    {
      "affiliations": [
        "Laboratoire de Sociologie, d’Anthropologie et de Psychologie (LASAP- ETHOS) FLSH, Universite Cheikh Anta Diop de Dakar, Dakar, Dakar Region, Senegal",
        "Mother and Child Health Directorate, Government of Senegal Ministry of Health and Social Action, Dakar, Dakar Region, Senegal"
      ],
      "name": "Martine Eva Tine"
    },
    {
      "affiliations": [
        "Mother and Child Health Directorate, Government of Senegal Ministry of Health and Social Action, Dakar, Dakar Region, Senegal"
      ],
      "name": "Ndeye Awa Diagne"
    },
    {
      "affiliations": [
        "Mother and Child Health Directorate, Government of Senegal Ministry of Health and Social Action, Dakar, Dakar Region, Senegal"
      ],
      "name": "Amadou Doucoure"
    },
    {
      "affiliations": [
        "Institute of Global Health and Development, The Aga Khan University, Karachi, Sindh, Pakistan"
      ],
      "name": "Hina Najmi"
    },
    {
      "affiliations": [
        "Institute of Global Health and Development, The Aga Khan University, Karachi, Sindh, Pakistan"
      ],
      "name": "Mishal Zulfiqar"
    },
    {
      "affiliations": [
        "The Hospital for Sick Children, Toronto, Ontario, Canada"
      ],
      "name": "Sacha St-Onge Ahmad"
    },
    {
      "affiliations": [
        "Community Health Sciences Department, The Aga Khan University, Karachi, Sindh, Pakistan"
      ],
      "name": "Zahid Ali Memon"
    },
    {
      "affiliations": [
        "The Hospital for Sick Children, Toronto, Ontario, Canada"
      ],
      "name": "Zulfiqar Bhutta"
    }
  ],
  "title": "Policy in practice: assessing Senegal’s family planning progress using a mixed-methods approach",
  "uid": "ae402a2b-6974-59c1-a878-975eb21ecd13"
}