Demystifying data
In 2014, Senegal had an estimated 765,000 young women aged 15-19, or 10% of the country's total female population.
Few young women in Senegal use formal sexual and reproductive health services; many appear to be unsure whether they are allowed to use contraception before age 18. Young women also cite cultural and religious attitudes and norms that censor premarital sexual activity as reasons for not seeking services.
Just over half (56%) of girls attend primary school; however, only 27% of young women attend secondary school.
Media access varies widely among young women aged 15-19: 62% report at least weekly exposure to radio, 66% to television and 16% to print media. Media exposure is generally higher among young women in urban areas than in rural areas.
Young unmarried women who become pregnant face stigma and social discrimination; they are often rejected by their parents and expelled from school.
SEXUAL ACTIVITY
Nearly one-third of Senegalese women aged 15-19 report having ever had sex.
34% of women aged 18-24 report having had sex before age 18; in rural areas and in the poorest wealth quintile, these proportions are much higher, at 48% and 66%, respectively.
One in four young women aged 15-19 has been married; the proportion is much higher in the poorest (52%).
ACCESS TO REPRODUCTIVE HEALTH CARE
16% of young, unmarried, sexually active women (who have had sex in the last three months), and only 6% of young married women, use a method of contraception.
Among recent births to women who were under 20 at the time of delivery, 20% were unplanned.
Among sexually active young women aged 15-19 who have never been married, 77% have an unmet need for contraception, because they want to avoid pregnancy in the next two years but are not using any contraceptive method. These unmet contraceptive needs are equally high in urban and rural areas (80% and 74%, respectively).
Among young married women aged 15-19, nearly one-third have unmet need for contraception; among married women, the proportion with unmet need is greater in urban than in rural areas (41% versus 27%).
75% of mothers who were under 20 years of age at the time of their last delivery report that it took place in a health facility; a smaller proportion (65%) report skilled professional assistance.
SEXUAL HEALTH KNOWLEDGE
Young women aged 15-19 have heard of an average of three modern methods of contraception.
One-fifth of women aged 15-24-and only one-tenth of those in the poorest two quintiles-report being able to obtain a condom themselves.
While most Senegalese women know that condom use and having only one uninfected partner reduce the risk of contracting HIV, less than one-third (29%) of those aged 15-24 are well informed about HIV/AIDS (i.e., they know about these two prevention methods, they know that a healthy-looking person can be HIV-positive, and they reject the two most common local misconceptions about HIV transmission).
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GENDER INEQUALITY AND SOCIAL NORMS
Three quarters of young women aged 15-19 (72%) believe that if the husband has an STI, his wife is right to ask him to use a condom.
However, 61% agree that the husband may be right to beat his wife in at least one situation. Furthermore, 63% agree that a woman has the right to refuse to have sex if she knows her husband has an STI.
Only 20% of married women aged 15-19 report making decisions alone or jointly with their husbands about their own health care.
POLICY ENVIRONMENT
The Reproductive Health Act 2005 recognises that the right to reproductive health "is a fundamental and universal right guaranteed to every human being without discrimination on the basis of age, sex, property, religion, race, ethnicity, marital status or any other status.
There are no legal restrictions on young people's access to contraception and other basic health services, such as pregnancy and STI testing, except for the requirement that they be at least 15 years old to consent to HIV testing.
Senegal's Penal Code states that induced abortion is not legal, even to save a woman's life, and imposes heavy prison sentences and fines. Many young women, however, resort to clandestine abortions, which can often compromise their health.
POLICY AND PROGRAMME IMPLICATIONS
These data indicate that a large proportion of young Senegalese women have had sexual intercourse and are therefore in need of sexual and reproductive health information and services.
Young women in rural areas and those from the poorest households have the least access to information and services. They are therefore the most vulnerable to unplanned pregnancies and STIs. Priority must be given to reaching these groups with sexual and reproductive health information and services.
Unmet need for contraception is very high among young unmarried women. Measures must be taken to address the underlying factors that explain this situation, i.e., the lack of accessible and affordable health services, the stigma of sexual activity outside of marriage and the lack of self-determination among young women.
Data on young women's attitudes towards sexual rights and gender equality reveal the widespread acceptance of women's inferior status and unequal treatment. More investment is needed in rights-based sexual and reproductive health education and programmes.
Many young women are unlikely to receive any sex education in school: few go on to secondary school and probably few schools address the subject.
Key stakeholders need to adopt effective strategies-including in-school sex education and out-of-school forums such as community outreach programmes and media campaigns-that provide young women with the information they need to protect their sexual and reproductive health and rights.
The majority of the data cited are from: Anderson R et al,Demystifying the data: a guide to using available data to improve the sexual health and rights of young peopleNew York: Guttmacher Institute, 2013; and special calculations of data from the 2010-2011 Multiple Indicator Cluster Survey in Senegal.
This paper, and the guide that formed the basis, were funded by a grant to the International Planned Parenthood Federation (IPPF) from the Dutch Ministry of Foreign Affairs, awarded under the Choices and Opportunities Fund programme.
