Senegal is a relatively small country (196,712 km2) bordering the Atlantic coast in West Africa. Its population of
roughly 13 million (ANSD, 2013) is concentrated in the west of the country, with 7,748 inhabitants/km2 in the
capital region of Dakar and only 15 inhabitants/km2 in the eastern region of Tambacounda. Senegal has a young age
structure, with 42.1% of the population under 15 years and only 3.5% over 65. Today, the urban population (58%)
outnumbers the rural population. While being a multi-ethnic society, Islam is the predominant religion (94%) with
Islamic communities typically organized in Sufi orders or brotherhoods and playing a key role in social life.
In mainstream economical terms, Senegal is classified as a low-income country with a high poverty headcount.
Applying a broader concept of development, Senegal is still categorized as a low-human development country: its
Human Development Index ranks it at 154th place among 186 countries (UNDP, 2013). Men have on average six
years of schooling; women score lower with four years of schooling. Overall, gender disparities – including schooling
– exclude women from decision-making and deprive them of employment opportunities. More than two thirds of
all workers are to be found in the informal sector; 34% of all workers earn less than $1.25 PPP a day. Again, poverty
is highest among women, and concentrated in rural areas. Social security coverage as percentage of employment is
only 5.1% (ANSD, 2011; ANSD, 2013; RdS-MEF, 2004; RdS-MEF, 2006; World Bank, 2013).
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Not unsurprisingly then, the greater part of the Senegalese population lacks access to basic social amenities. In rural
areas, more than half of the population is in a precarious situation with nearly 40% having no access to tap water.
While some improvements has been made over the last decade – for example in access to education – inequalities
between regions, between urban and rural areas, between socio-economic groups and between men and women
are still manifest (RdS-MEF, 2009; Diagne, 2012).
Access to health services is particularly difficult for large segments of the population. In rural areas, over 58% of the
population is more than 30 minutes from the nearest accredited health facility; even in the capital region, this is the
case for nearly 43% (RdS-MEF, 2004). Barriers to access to care are numerous, but transport difficulties related to
distance and poor quality of roads remains a major constraint.