Rising from a challenging baseline
Over the past decade, Senegal has achieved a remarkable milestone in maternal health. The country’s maternal mortality rate dropped from 392 deaths per 100,000 live births in 2015 to 153 in 2023, a reduction of more than 60 percent. This progress is not just a statistic; it reflects a deliberately designed health system reform centered on WHO-recommended care models that place pregnant people at the center of care, ensure continuity, and promote skilled attendance at birth.
What drove the change?
The transformation stems from a multi-pronged strategy aligned with World Health Organization guidelines. Key components include improving the quality of care across the continuum—from antenatal checkups to delivery and postnatal follow-up—investing in trained birth attendants, and integrating emergency obstetric and neonatal care (EmONC) into district health systems. By standardizing protocols, the state ensured that high-quality, evidence-based practices were available at the community and facility levels alike.
Expanding access to skilled care
One of the central goals was to increase the proportion of births attended by skilled health personnel. The government expanded the network of facilities capable of providing essential obstetric services, ensuring women in rural and peri-urban areas could reach care when labor began or complications emerged. Community health workers were mobilized to encourage timely antenatal visits and to facilitate referrals, creating a smoother care pathway for pregnant people.
Quality improvement as a cornerstone
Quality improvement efforts focused on adherence to clinical guidelines, continuous training, and mentorship for healthcare workers. Facilities adopted standard checklists and emergency protocols, mirroring WHO recommendations for safe delivery. Regular supervision, data-driven feedback, and problem-solving huddles became routine, allowing frontline teams to identify bottlenecks and test solutions in real time.
Emergency readiness and rapid response
Delays in recognizing danger signs can be fatal in childbirth. Senegal’s model emphasizes rapid recognition and response to obstetric complications. By strengthening referral networks, transport options, and facility readiness, the system reduced the time between diagnosis and treatment—critical in preventing maternal deaths from hemorrhage, sepsis, and eclampsia.
Community engagement and trust
Community buy-in is essential for sustaining improvements. Community health workers, religious and local leaders, and women’s groups were engaged to promote respectful care and reduce stigma around certain conditions that may deter timely care. The emphasis on respectful, person-centered care helps build trust, encouraging more women to seek care early in pregnancy and to deliver in facilities equipped to manage complications.
Data, accountability, and sustained funding
Robust data collection and accountability mechanisms enabled policymakers to monitor progress, identify gaps, and allocate resources effectively. Investments—from training programs to improved supply chains for medicines and equipment—are paired with ongoing funding strategies to maintain improvements. The result is not only a dip in mortality rates but also better outcomes for newborns, reflected in higher survival rates and healthier early-life indicators.
Lessons for other countries
Senegal’s experience offers several takeaways for nations seeking to reduce maternal mortality: adopt WHO-recommended care models that integrate antenatal, delivery, and postnatal services; commit to quality improvement and staff capacity building; strengthen emergency obstetric and neonatal care; and ensure continuous community engagement. Equally important is building resilient systems with reliable data, sustainable financing, and strong governance to withstand health shocks and shifts in demand.
Looking ahead
While the progress is encouraging, challenges remain. Ensuring equitable access across regions, maintaining supply chains, and continuing to train the next generation of skilled birth attendants will be critical. With continued focus on WHO guidelines and locally tailored strategies, Senegal can sustain momentum and push further toward eradicating preventable maternal deaths.
