Barriers to Contraceptive Access in Senegal: Insights from Providers' Restrictions

In Senegal, while modern contraceptives are available to women, health care providers often impose their own age and marital status restrictions on family planning services, limiting access to young women in need. According to a study by Estelle M. Sidze and colleagues, over half of public-sector providers apply age restrictions to provision of the pill and injectable, with an average minimum age of 18 years required for contraceptive provision. These restrictions disproportionately affect unmarried and sexually active young women, leaving them vulnerable to unwanted pregnancy and its consequences.

Key Takeaways:

• More than half (57%) of public-sector providers in Senegal apply age restrictions to provision of the pill and slightly fewer than half (44%) apply age restrictions to provision of the injectable.
• The average minimum age required for contraceptive provision is 18 years.
• Fewer providers apply eligibility restrictions on the basis of young women's marital status, but 12-14% of public-sector providers still refuse to supply the pill or injectable to unmarried young women.
• Providers' imposition of marital status restrictions reflects a socially conservative environment, where premarital sexual activity is frowned upon.
• Male providers in the public sector are more likely than their female counterparts to impose age restrictions on provision of the injectable.
• Nurses in the public sector are more likely than other providers to apply age restrictions to provision of the pill.
• Older providers are more likely to refuse to prescribe the pill to unmarried women.

Statistics:

• 57% of public-sector providers apply age restrictions to provision of the pill.
• 44% of public-sector providers apply age restrictions to provision of the injectable.
• 49% of private facility providers apply age restrictions to provision of the pill.
• 41% of private facility providers apply age restrictions to provision of the injectable.
• 1 in 10 unmarried, sexually active young women have an unmet need for modern contraception.
• 12-14% of public-sector providers refuse to supply the pill or injectable to unmarried young women.
• 62% of nurses in the public sector apply age restrictions to provision of the pill.
• 54% of male providers in the public sector impose age restrictions on provision of the injectable.
• 18 years is the average minimum age required for contraceptive provision.

Sources:

• "Young Women's Access to and Use of Contraceptives: The Role of Providers' Restrictions in Urban Senegal" by Estelle M. Sidze of the African Population and Health Research Center, et al. (available online in International Perspectives on Sexual and Reproductive Health)