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Birth spacing has emerged since the early 1980s as a key concept to improve maternal and child health, triggering interest in birth spacing practices in low-income countries, and drawing attention to prevailing norms in favour of long birth intervals in West Africa. In Senegal, the Wolof concept of Nef, which means having children too closely spaced in time, is morally condemned and connotes a resulting series of negative implications for family well-being. While Nef and \"birth spacing\" intersect in key ways, including acknowledging the health benefits of longer birth intervals, they are not translations of each other, for each is embedded in distinct broader cultural and political assumptions about social relations. Most notably, proponents of the demographic concept of birth spacing assume that the practice of using contraception after childbearing to postpone births could contribute to \"empowering\" women socially. In Senegal, by contrast, preventing Nef (or short birth intervals) is also viewed as strengthening family well-being by allowing women to care more fully for their family. This paper draws on policy documents and interviews to explore women's and men's understanding of Nef, and in turn critically reflect on the demographic concept of birth spacing. Our findings reinforce the relevance of the concept of birth spacing to engage with women and men around family planning services in Senegal. Accounts of the Nef taboo in Senegal also show that social norms stigmatising short birth intervals can legitimise constraints faced by women on control of their body.

Background Female genital mutilation (FGM) is a deeply rooted practice in Senegal, generally affecting girls at a very young age. The prevalence of FGM has remained virtually unchanged for at least two decades. The aim of this study is to identify the factors associated with the evolution of this practice in Senegal. Methods This study is a secondary analysis of data extracted from the Senegalese Demographic and Health Surveys (DHS) from 2015 to 2023. The record individual file of women aged 15 to 49 was used for the analysis. For both women aged 15-49 and their daughters, the dependent variable was \"being circumcised\". This is a binary qualitative variable which was coded as\"Yes\" if the woman and/or her daughter had been circumcised. A descriptive analysis was performed. A multivariate analysis was performed to determine the Adjusted Odds Ratios (ORaj) and estimate the corresponding 95% confidence intervals (CI) for all variables. Adjustment was made on a yearly basis. Results The prevalence of female circumcision was 24.2% in 2015, 22.7% in 2016, 24.0% in 2017, 23.3% in 2018, 25.2% in 2019 and 20.1% in 2023. The majority of women who undergo FGM do so between the ages of 0 and 9. The most frequent form of mutilation is \"flesh removed from genital area\", the frequency of which rises from 58.3% in 2015 to 76.5% of cases of mutilation in 2023. Infibulation (genital area sewn closed), which was the least common form of mutilation at 7% in 2015, will increase to 25.6% in 2023. The factors associated with the development of FGM among Senegalese women were region of residence and socio-economic level. Conclusion Our study has shown that the fact that the mother has been circumcised is a risk factor for the daughter. However, the level of wealth and education of women and their husbands would appear to be protective factors against the development of FGM in girls. To bend the curve, political decision-makers need to take targeted action in hotspot regions, considering aspects linked to women's empowerment.

Female genital mutilation (FGM) is a deeply rooted practice in Senegal, generally affecting girls at a very young age. The prevalence of FGM has remained virtually unchanged for at least two decades. The aim of this study is to identify the factors associated with the evolution of this practice in Senegal. This study is a secondary analysis of data extracted from the Senegalese Demographic and Health Surveys (DHS) from 2015 to 2023. The record individual file of women aged 15 to 49 was used for the analysis. For both women aged 15-49 and their daughters, the dependent variable was \"being circumcised\". This is a binary qualitative variable which was coded as\"Yes\" if the woman and/or her daughter had been circumcised. The prevalence of female circumcision was 24.2% in 2015, 22.7% in 2016, 24.0% in 2017, 23.3% in 2018, 25.2% in 2019 and 20.1% in 2023. The majority of women who undergo FGM do so between the ages of 0 and 9. The most frequent form of mutilation is \"flesh removed from genital area\", the frequency of which rises from 58.3% in 2015 to 76.5% of cases of mutilation in 2023. Infibulation (genital area sewn closed), which was the least common form of mutilation at 7% in 2015, will increase to 25.6% in 2023. Our study has shown that the fact that the mother has been circumcised is a risk factor for the daughter. However, the level of wealth and education of women and their husbands would appear to be protective factors against the development of FGM in girls. To bend the curve, political decision-makers need to take targeted action in hotspot regions, considering aspects linked to women's empowerment.

Introduction The coronavirus (COVID 19) pandemic is one of the most terrifying disasters of the twenty-first century. The non-pharmaceutical interventions (NPIs) implemented to control the spread of the disease had numerous positive consequences. However, there were also unintended consequences—positively or negatively related to the nature of the interventions, the target, the level and duration of implementation. This article describes the unintended economic, Psychosocial and environmental consequences of NPIs in four African countries. Methods We conducted a mixed-methods study in the Democratic Republic of Congo (DRC), Nigeria, Senegal and Uganda. A comprehensive conceptual framework, supported by a clear theory of change was adopted to encompass both systemic and non-systemic interventions. The data collection approaches included: (i) review of literature; (ii) analysis of secondary data for selected indicators; and (ii) key informant interviews with policy makers, civil society, local leaders, and law enforcement staff. The results were synthesized around thematic areas. Results Over the first six to nine months of the pandemic, NPIs especially lockdowns, travel restrictions, curfews, school closures, and prohibition of mass gathering resulted into both positive and negative unintended consequences cutting across economic, psychological, and environmental platforms. DRC, Nigeria, and Uganda observed reduced crime rates and road traffic accidents, while Uganda also reported reduced air pollution. In addition, hygiene practices have improved through health promotion measures that have been promoted for the response to the pandemic. All countries experienced economic slowdown, job losses heavily impacting women and poor households, increased sexual and gender-based violence, teenage pregnancies, and early marriages, increased poor mental health conditions, increased waste generation with poor disposal, among others. Conclusion Despite achieving pandemic control, the stringent NPIs had several negative and few positive unintended consequences. Governments need to balance the negative and positive consequences of NPIs by anticipating and instituting measures that will support and protect vulnerable groups especially the poor, the elderly, women, and children. Noticeable efforts, including measures to avoid forced into marriage, increasing inequities, economic support to urban poor; those living with disabilities, migrant workers, and refugees, had been conducted to mitigate the negative effects of the NIPs.

International development work involves external partners bringing expertise, resources, and management for local interventions in LMICs, but there is often a gap in understandings of relevant local shared values. There is a widespread need to better design interventions which accommodate relevant elements of local culture, as emphasised by recent discussions in global health research regarding neo-colonialism. One recent innovation is the concept of producing ‘cultural protocols’ to precede and guide community engagement or intervention design, but without suggestions for generating them. This study explores and demonstrates the potential of an approach taken from another field, named WeValue InSitu , to generate local culturally-informed protocols. WeValue InSitu engages stakeholder groups in meaning-making processes which ‘crystallize’ their envelope of local shared values, making them communicable to outsiders. Our research context is understanding and reducing child stunting, including developing interventions, carried out at the Senegal and Indonesia sites of the UKRI GCRF Action Against Stunting Hub. Each national research team involves eight health disciplines from micro-nutrition to epigenetics, and extensive collection of samples and questionnaires. Local culturally-informed protocols would be generally valuable to pre-inform engagement and intervention designs. Here we explore generating them by immediately following the group WeValue InSitu crystallization process with specialised focus group discussions exploring: what local life practices potentially have significant influence on the environments affecting child stunting, and which cultural elements do they highlight as relevant. The discussions will be framed by the shared values, and reveal linkages to them. In this study, stakeholder groups like fathers, mothers, teachers, market traders, administrators, farmers and health workers were recruited, totalling 83 participants across 20 groups. Themes found relevant for a culturally-informed protocol for locally-acceptable food interventions included: specific gender roles; social hierarchies; health service access challenges; traditional beliefs around malnutrition; and attitudes to accepting outside help. The concept of a grounded culturally-informed protocol, and the use of WeValue InSitu to generate it, has thus been demonstrated here. Future work to scope out the advantages and limitations compared to deductive culture studies, and to using other formative research methods would now be useful.

Background Urogenital schistosomiasis is a major public health concern in sub-Saharan Africa. In Senegal, the disease is endemic in all regions of the country. Recently, WHO strongly recommended including pre-school children and women of reproductive age during a mass drug administration campaign. It is important to describe the burden of the disease in these group at risk using innovative diagnostic tools. This study aimed to assess the use of real-time PCR in the detection of schistosomiasis cases at the community level in a seasonal transmission area. Methods A cross-sectional survey was carried out in Niakhar located in the centre of Senegal. Pre-schoolchildren, school-aged children and female adolescents and adults were invited to participate in the study in April 2018. Urine samples were collected and examined using Hemastix reagent strips, filtration technique and real-time PCR. Schistosoma haematobium was detected, identified by targeting the Dra1 gene. The prevalence of urogenital schistosomiasis was determined for each group and the performance of the real-time PCR was compared with the conventional techniques. Results A total of 428 participants were enrolled in this study including 87 (20.4%) pre-school children (1–5 years), 262 (61.3%) school-aged children between (5–14 years), 17 (3.9%) adolescents (15–17 years) and 62 (14.4%) female adults. The comparison of the diagnostic techniques has shown that the prevalence of urogenital schistosomiasis is higher using molecular technique (34.6%) compared to microscopy (20.3%). The percentage rate of haematuria using Hemastix was 23.1%. School-aged children between 5 and 14 years old were the most affected with 29.0% and 43.1% under microscopy and RT-PCR, respectively. In female participants, microscopic prevalence decreases with age, from 21.4% in school-aged children to 17.6% in adolescents and 9.7% in adults. There was good correlation between the number of eggs per 10 ml and the cycle threshold range. Conclusion These results show the importance of using molecular tools in the surveillance of schistosomiasis particularly in pre-school children and women of reproductive age. Graphical Abstract

Adolescents in low- and middle-income countries face numerous developmental, sexual and reproductive health (SRHR) challenges, including exposure to multidimensional violence. Dealing with gender-based violence (GBV) is of great importance and health personnel are key players. The objective of this work was to study the knowledge and practices of health personnel on SRHR and gender-based violence in Guédiawaye, Kaolack and Kolda communities in Senegal. A descriptive and analytical cross-sectional study was conducted, which consisted of health professionals (general practitioners and specialists, nurses, and midwives) and community health workers (community relays, bajenu gox, matrons). All health facilities in the three communities were included. Data analysis consisted of univariate analysis and logistic regression modeling to investigate the factors associated with the knowledge and practice of health personnels. An alpha risk of 5% was taken. A total of 78 health professionals and 128 community actors were included in the study. More than half of the health personnel (56.3%) had good knowledge of policies, standards and protocols relating to sexual and reproductive health services for women (adolescents) and about 60% on conventions and laws. The level of knowledge was good among 51% of respondents and good practices among 54.9%. The factors associated with good knowledge were the municipality in which the profession was practiced, and the effects of training received in the social construction of gender. The factors associated with the practices were knowledge of policies, standards and protocols through training, training received in the provision of family planning services, and in medico-psychosocial management of cases of sexual violence. We conclude that the knowledge of stakeholders (health professionals and community health workers) about sexual and reproductive health and gender-based violence is important for better service provision and good management of cases of gender based violence. Les adolescents des pays à revenu faible et moyen (PRFM) sont confrontés à de nombreux défis en matière de développement, de santé sexuelle et reproductive (SSR), notamment l'exposition à une violence multidimensionnelle. La prise en charge des violences de genre est d'une grande importance et le personnel de santé en constituent des acteurs clés. L'objectif de ce travail était d'étudier les connaissances et les pratiques du personnel de santé sur la santé sexuelle et reproductive (SSR) et les violences basées sur le genre dans les communes de Guédiawaye, Kaolack et Kolda au Sénégal. Une étude transversale descriptive et analytique a été menée. La population était constituée des professionnels de santé (médecins généralistes et spécialistes, infirmiers, sages-femmes) et des agents de santé communautaires (relais communautaires, bajénu gox, matrones). L'ensemble des structures de santé des trois communes ont été inclus avec un choix raisonné des cibles. Une analyse univariée une modélisation par une régression logistique a été effectuée pour rechercher les facteurs associés à la connaissance et la pratique du personnel de santé. Un risque alpha de 5% a été pris. Au total 78 professionnels de santé et 128 acteurs communautaires ont été inclus dans cette étude. Plus de la moitié du personnel de santé (56,3%) avaient une bonne connaissance des politiques, normes et protocoles (PNP) des services de santé sexuelle et reproductive des femmes (adolescentes) et environ 60% sur les conventions et Lois. Le niveau de connaissance était bon chez 51% des enquêtés et les pratiques bonnes chez 54,9%. Les facteurs associés à la bonne connaissance étaient la commune d'exercice de la profession, le fait de bénéficier d'une formation en construction sociale du genre. Les facteurs associés aux pratiques étaient la connaissance des PNP à travers la formation, les formations reçues en offre de services PF et contraception d'urgence, en prise en charge médico-psychosociale des cas de violences sexuelles. En conclusion, la connaissance des acteurs (professionnels de santé, agents de sante communautaires) sur la santé sexuelle et reproductive et les violences basées sur le genre est importante pour une meilleure offre de service et une bonne prise en charge des cas de violences.

health care systems in West Africa have been under strain since the beginning of the COVID-19 pandemic. The exposure of health personnel to infection during the COVID-19 pandemic has been reported in several studies. The purpose of this study was to analyze health workers' actual and perceived risk in the first hospital faced with managing a community-acquired COVID-19 case in Senegal. we conducted an exploratory descriptive study of health care providers' perception about their own risk during the COVID-19 pandemic. Forty-seven health-care providers were interviewed in personal, extensive interviews in this hospital. the fear of disease was present among the health staff. This fear was caused by several exogenous and endogenous factors, including the lack of knowledge of the virus and COVID-19 disease, the feeling of vulnerability due to insufficient availability of personal protective equipment, healthcare professionals' position in relation to the priesthood from the medical profession and the real and perceived risk of putting their family and their entourage in potentially dangerous situations. this study highlights the need for psycho-affective management of health care workers during this pandemic by taking the gender dimension into account. The provision of personal adequate protective equipment and stress management measures could enable front-line workers to cope with this pandemic in complete serenity.

Introductionles systèmes de soins en Afrique de l´Ouest ont été mis à rude épreuve depuis le début de la pandémie à COVID-19. L'exposition du personnel de santé à l'infection dans le cadre de l´épidémie à la COVID-19 a été évoquée dans plusieurs études. L´objectif de cette étude est d´analyser les risques perçus et réels par le personnel de santé dans le premier hôpital à avoir reçu un cas communautaire de COVID-19 au Sénégal.Méthodesune étude descriptive exploratrice de la perception des prestataires de santé vis à vis du risque encouru lors de la COVID-19 avait été fait. Quarante-sept prestataires de santé ont fait l´objet d´entretien individuel approfondis dans cet hôpital.Résultatsla crainte de la maladie était bien présente auprès du personnel de santé. Cette crainte était la résultante de plusieurs facteurs exogènes et endogènes parmi lesquels on comptait la méconnaissance du virus et de la maladie à COVID-19, le sentiment de vulnérabilité liée à une insuffisance dans la disponibilité des matériels de protection individuels, la position du prestataire par rapport au sacerdoce de la profession médicale et le risque réel/ perçu d´être un potentiel danger pour leur famille et leur entourage.Conclusioncette étude a pu faire ressortir la nécessité de la prise en charge psycho-affective des personnels de santé dans le cadre de cette pandémie en prenant en compte la dimension genre. Une mise à disposition suffisante d´équipement de protection individuelle et de mesures de gestion du stress pourraient permettre aux personnels en première ligne de faire face à cette pandémie en toute sérénité.